[TX_ICU_RN]

I am a former Pedi NP who has taken the last four years off to be a SAHM. When I started looking for jobs recently, I decided to look for a job in an adult ICU. I know it is a HUGE change, but I have always wanted to do ICU and know that I could not emotionally handle a pedi ICU.

I am going to work on an 18 bed general ICU. The only other critical care unit in the hospital is the CCU, but we get anyone with a balloon pump, immediately post-cardiac surgery, etc. We are not a major trauma center, so I will not be seeing that population. Also, our facility does some neuro, but there is a hospital about 5 miles away that has a fantastic neurosurgical team. We do have a major psych hospital on-site (it is physically seperate from the hospital but on the same campus)...so we do see quite a few ODs. Besides that, we generally see cardiac, renal, oncology, infectious disease and major non-trauma related surgery.

So, since I have a few weeks before I start working, I would like to try and learn a few things. I am not going to do a formal internship. I will have 6-8 weeks with a preceptor as well as being able to attend any of the GN courses that I would like during their June internship. I just finished ACLS and am working on EKGs, procedure basics, meds and the AACN Core Curriculum.

What would you recommend I focus on before I start? I know I won't be able to really get a handle on things until I am in the thick of it...but a little knowledge would be nice.

What do you wish you had known before you started?

Thanks!!!

[mrsportsmedicine]

With ACLS, Dysrhythmia and AACN Core Curriculum... you seem to have all your bases covered. That's a great start.
Besides, you really won't have a good measurement of your needs until you 'get into the thick of it'.
Sounds to me like your as best prepared as one can be.

[delta32]

here is a quick cheat site for learning the basics of ICU. the writer makes it very easy to understand. HTH ....ok i need to go to my other computer for the link. brb

also there is a book called Critical care made incrediably easy that helps alot and is easy reading

[TX_ICU_RN]

Thanks so much!! I just want to be somewhat competent...I know that it will be a steep learning curve. I am going to order the Critical Care Made Easy book.

[delta32]

you can actually get that book over at barnes and noble in the medical/Nursing section
here is the link that i promised you.
http://icufaqs.org/

Jamie

p.s. the basics that you will need medication wise is:
*Neosynephrine ( increases BP)
*levophed ( increase BP- try to use as last resort0 remember- levophed=leave them dead....finger and toes die off. its a good med don't get me wrong but thoses are the effect.
*vasopressin (increase BP)

you can look at EKG's, CVP's, A-lines, I would not worry about swan gans cathitors they are not using them to much anymore but its a hands on learning thing anyways

good luck to you!

[TX_ICU_RN]

Thanks!! I am praying that the first six months will be over before I know it. I love learning...but hate that initial "I am completely stupid" feeling.

[suanna]

If you are comfortable with the ACLS and CCRN Core Curriculum you shouldn't be taking orientation, you should be precepting others. It sounds like knowlage base isn't your weakness. The biggenst hurdle you will face is getting into the "way of thinking" that is pertinent to that unit. Do the nurses have a great deal of autonomy or do the docs want to be called with any change in patient status, are there residents/interns- and how much authority do they have.
What drug you use, the signs of a developing problem, assessment skills, may be the easiest part of what you have to know.

[jemommy]

Originally Posted by delta32

you can actually get that book over at barnes and noble in the medical/Nursing section
here is the link that i promised you.
http://icufaqs.org/

Jamie

p.s. the basics that you will need medication wise is:
*Neosynephrine ( increases BP)
*levophed ( increase BP- try to use as last resort0 remember- levophed=leave them dead....finger and toes die off. its a good med don't get me wrong but thoses are the effect.
*vasopressin (increase BP)

you can look at EKG's, CVP's, A-lines, I would not worry about swan gans cathitors they are not using them to much anymore but its a hands on learning thing anyways

good luck to you!

Thank you soooo much. I am going to read this entire website from front to back before I began working. It seems to have a plethora of information!!!!

[TX_ICU_RN]

Jemommy,

When do you start? I can't believe that this month has already passed and I am gong to start work on Monday. I have not been to work in over four years...I am so excited and scared at the same time. Fortunately, the first week is general hosptal orientation and general nursing orientation....so I don't think it will be too bad the first week. However, I do have to be at work Mon-Fri from 9-5 that entire first week, which I am really not looking forward to.

I got my April/first two weeks of May schedule last week and it looks great! I will be spending one 12 hour shift with the ICU educator so that she can target my specific learning needs. It will be SO much better than sitting through the 6-week critical care internship in June. My manager will let me go to any of the internship courses I want to attend, but I really feel like I am at a different place than a new grad.

After my 12-hour shift with the educator, I will spend 5 weeks split between two preceptors. I am really glad I am working with two different nurses so that I can see different styles and personalities. Hopefully, I will learn a lot from them because I am apparently going to be on my own starting May 11th (when the next schedule comes out!

Congratulations on your new ICU job!!! Maybe we can support each other through this transition phase of our careers.

[jemommy]

TX,
Congrats to you too. It's always scary starting a new place (a whole new aspect) for that matter. But I do admire that you are trying to prepare. I won't start until June 23rd. I graduate May 9th and I couldv'e started earlier, but i need a break. I will take a little vacation and breathe a little. Hopefully, I can take the NCLEX in that time frame. Keep us posted on how things are going. I can't wait for the "learning curve" to be over also. I hate feeling like I'm all thumbs.