Bluesky's guide to surviving your first year in the ICU
My Guide to Surviving Your First Year in the ICU:
1. Don't complain about anything. They don't want to hear it and you'll be labeled.
2. Know your unit's standards very well. You are accountable to these.
3. During report, check every line and every pump to make sure it's done right. Trust me on this one.
4. Verify that all the orders you expect for a certain pt type are actually in the chart (i.e. restraints, c-spine precautions, DNR, etc).
5. Spend at least 10 minutes at the beginning of your shift looking through the progress notes and history. Don't assume what you got in report is true. Do this even if it puts you behind in your vitals, etc.
6. If you are even 0.01% uncertain about a med or an IV med interaction, look it up or call the pharmacy before giving.
7. Your patient's family is not your enemy, a nuissance or an inconvenience. Your patient's family is a group of scared, powerless people who may or may not know how to react and behave in this environment. Remember this.
8. If you make a significant mistake, don't cover it up. That's not honorable.
9. All that glitters is not gold and all that smiles is not a friend. (sorry about the cynicism, y'all).
10. All of us have made the following mistakes at one point or other so don't feel bad when it happens to you, just correct it and try not to do it again:
* push too hard into a small bowel feeding tube with a syringe and splash all over ourselves and the patient.
* made a momentary stop cock error and let blood out of an artline or central line for a second.
* fail to assemble the correct equipment for a Swann placement (gloves, introducer, blah blah blah) and get yelled at by a doc.
* been caught feeling like an idiot when not able to answer a seemingly simple question.
* get yelled at for not being perfectly sterile in some dressing change or device insertion by a senior RN and then proceed to observe her doing the same within the next month.
* repeat something in report that you were told by the previous RN only to feel exposed when it turns out what you heard wasn't accurate.
* act like a diva the first time you give report to a floor nurse and proceed to get your a*s kicked.
11. Always have another RN watch you mix high risk IV bags such as vasoactives, not just sign it.
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