[thrashej]

I am going to be a new grad in a couple months.

Considering NICU. Wondering what you all feel are important qualities/personality traits in a NICU nurse, or specifically, qualities a new grad should possess to be successful in NICU.

Things good about me:

1. I love learning.
2. Research EVERYTHING. I don't do anything w/o having some knowlege about it first.
3. Want to know "WHY" about everything.
4. Ask so many questions related to the above that I drive most people crazy.
5. Want to be good at what I do.
6. Would like to be an expert in my chosen specialty.
7. Very detail oriented.
8. Assertive

Things I consider not so good about me:

1. Not too comfortable with skills. (only experience is in NS)
2. Don't feel very comfortable with time management/prioritizing (YET).
3. Have trouble understanding complex systems such as Cardiac and Neuro but not so sure this wouldn't change if I had more time to devote to learning only those topics (can't in nursing school, so many other things to learn)
4. I have high anxiety levels, low self confidence (pretty sure related to lack of experience).
5. Don't really like the "adrenaline rush" of the ER/coding pts. I get that "flight" feeling.

I would love to get into a specialty where I can really start researching on my own, really learning everything I can. ICU appeals because you have 1-2 pts to know EVERYTHING about. Seems like you have more autonomy. I like the fact that maybe the pts stays will be long enough there that I can research their conditions at home, on my own.

Assuming a good new grad training program, do you think new grads can be successful in the NICU? Do my above qualities increase my chances or decrease? I'd like opinions. I am an upcoming new grad anguishing over what speciality to choose AND where to do my clinical preceptorship. I need to figure it out in, oh, about two weeks! YIKES!

Thank you!!!

[Dinith88]

Originally Posted by thrashej

I am going to be a new grad in a couple months.

Considering NICU. Wondering what you all feel are important qualities/personality traits in a NICU nurse, or specifically, qualities a new grad should possess to be successful in NICU.

Things good about me:

1. I love learning.
2. Research EVERYTHING. I don't do anything w/o having some knowlege about it first.
3. Want to know "WHY" about everything.
4. Ask so many questions related to the above that I drive most people crazy.
5. Want to be good at what I do.
6. Would like to be an expert in my chosen specialty.
7. Very detail oriented.
8. Assertive

Things I consider not so good about me:

1. Not too comfortable with skills. (only experience is in NS)
2. Don't feel very comfortable with time management/prioritizing (YET).
3. Have trouble understanding complex systems such as Cardiac and Neuro but not so sure this wouldn't change if I had more time to devote to learning only those topics (can't in nursing school, so many other things to learn)
4. I have high anxiety levels, low self confidence (pretty sure related to lack of experience).
5. Don't really like the "adrenaline rush" of the ER/coding pts. I get that "flight" feeling.

I would love to get into a specialty where I can really start researching on my own, really learning everything I can. ICU appeals because you have 1-2 pts to know EVERYTHING about. Seems like you have more autonomy. I like the fact that maybe the pts stays will be long enough there that I can research their conditions at home, on my own.

Assuming a good new grad training program, do you think new grads can be successful in the NICU? Do my above qualities increase my chances or decrease? I'd like opinions. I am an upcoming new grad anguishing over what speciality to choose AND where to do my clinical preceptorship. I need to figure it out in, oh, about two weeks! YIKES!

Thank you!!!

nice quasi-resume.

I think of all the icu-type specialties, Neuro out of all of them requires alot of patience...

that may be an unexpected 'trait', but the reason i say this is because ALOT of the neuro patients who are *awake* tend to be disoriented, confused, goofy, and generally hard to care-for (especially when you consider all the tubes, wires, and such standard in the ICU...). It takes a special person to deal with this stuff...and it drives alot of nurses nuts.

-and keep in mind if you 'dont like adrenalin of coding people', 'have high anxiety', and 'trouble understanding complex systems'....you may want to re-consider any icu-setting. These are all par for the course in any critical-care area. (remember-these are the sickest people on the hospital)

[thrashej]

Thank you for the reply. What you said makes sense.... I have a lot of thinking to do!

Originally Posted by Dinith88

nice quasi-resume.

I think of all the icu-type specialties, Neuro out of all of them requires alot of patience...

that may be an unexpected 'trait', but the reason i say this is because ALOT of the neuro patients who are *awake* tend to be disoriented, confused, goofy, and generally hard to care-for (especially when you consider all the tubes, wires, and such standard in the ICU...). It takes a special person to deal with this stuff...and it drives alot of nurses nuts.

-and keep in mind if you 'dont like adrenalin of coding people', 'have high anxiety', and 'trouble understanding complex systems'....you may want to re-consider any icu-setting. These are all par for the course in any critical-care area. (remember-these are the sickest people on the hospital)

[OkieICU_RN]

I agree with the above post. You definitely need to know what to do STAT when an ICP is up or a patient has mental status changes. These patients can crump in a hurry and you have to be on top of your game.

If you really think you want to do this, depending on where you are in your training, maybe you could do an externship in NICU over the summer and see what you think about it then.

[CCPam]

Thanks for asking....you should LOVE what you do!!! See if you can shadow in a Neuro icu for a couple of days....or get a summer externship....you'll either love it or hate it! But, you'll know before you hire in!
CCPam

[neurogeek]

Priorities are very important in the NVICU. So is being a quick, critical thinker. It will take time. Neuro nurses are very special people. We possess something different.....call it "gut instinct" if you will......a true neuro nurse can just look at a patient and know something isn't right....no HUGE changes, but something so subtle that you more sense it than see it....it's like a 6th sense. Anyway, you have to be on top of your game at all times. These patients can crump in a heartbeat. I once had a patient with a basilar tip aneurysm who was going for coiling that very day. It was non-bleed, stable, etc. Anyway, I'm in the room during the preprocedure checklist and he's sitting in bed with the bedside table in front of him working on a crossword puzzle. I turned around to set up supplies to start a second IV and a heard this huge THUMP! I spun around and he was face down on the table. Within seconds he went to a HR of 30, BP from 120/70's to 180's/70's. Oops! By the time I flattened the HOB he was in asystole. This all happened in about a 5 minute timeframe. Anyway, he died. Turns out his aneurysm ruptured & poof, he was gone! Had an infratentorial upward herniation. Yikes! Well, so much for that......but the moral is: they change fast. They do nasty things. Like a good girl or boy scout you must always be prepared!

[ELKMNin06]

You have to be very observant and flexible. sometimes neuro changes are so subtle..as subtle as a pt. not talking to you for an hour. Also, you have to be able to be flex. bc in neuro world the brain takes presidence...its hard knowing that HHH a pt and overloading them with fluids when they have CHF but the brain comes first...hard to get used to

[ELKMNin06]

1. I love learning. <---good you wont ever stop

2. Research EVERYTHING. Good...knowledge is key, but sometimes youwont have time to look up everything and you will just have to trust yourself and rely on your knowledge base.

3. Want to know "WHY" about everything.<---that will make you a better nurse...never do anything just bc you were ordered to...know why you are doing it

4. Ask so many questions related to the above that I drive most people crazy.<----yep me too, but oh well, if it helps me take better care of my pts..like i said..oh well

5. Want to be good at what I do. <---I think we all do...you will be but it takes time. the most frustrating thing to me at first was that, while I was smart, I was just inexperienced...nothing I could do but keep on truckin through...it was tough bc im a book/school type person...if im not good at something I just study more....you can read all the books you want as a new grad but sometimes you just gotta get out there, make mistakes and learn. Dont be too hard on yourself.

6. Would like to be an expert in my chosen specialty.<---that too, will come in time. The more I learn, the more I realize I don't know.

7. Very detail oriented.<----This seems to be a comman trait among nurses...LOL.

8. Assertive<--you have to be in an ICU setting

Things I consider not so good about me:

1. Not too comfortable with skills. (only experience is in NS)<---no big deal. How many times do you really have to insert a foley to get it???? Once or twice, in an ICU you will put a foley maybe once a shift. thats the beauty of the ICU, you have all the opportunity in the world to perfect your skills. I might insert 2-4 IVs or more in one shift. It doesnt take long to catch on to the technical skills...worry more about critical thinkin and preventing situations.

2. Don't feel very comfortable with time management/prioritizing (YET).<---experiement, bring different report sheets, make your own..whatever helps you stay organized...when i was first out of orientation....after i got report I would sit for about 30 mins (had about an hour before 9pm meds due) and just write down everything i could think of that i had to do for my 2 pts that night. Then I would just map it out...
1930:check ICP
2000:zero EVD, ICP, UO, CSF drainage, Fullbody assess/neuro assess
2030:check ICP
2100: meds, draw CBC
etc. then id make notes on things that needed done and cross them off as i went. We also have dry erase boards in our rooms so I would write all my parameters on there like EVD open at 10...BP parameters 18-220, etc.
I never try to get rushed either. Plan. Integrate tasks. You will find yourself as a newbie running around in circles at times. Stop, ask yourself why you just make 4 seperate trips to the supply room when youcould have just made one and picked up fresh linen on the way back...etc. Youll get it, it will start to come naturally.

3. Have trouble understanding complex systems such as Cardiac and Neuro but not so sure this wouldn't change if I had more time to devote to learning only those topics (can't in nursing school, so many other things to learn)<---The real lernng takes place once you are out of school. NS gives you the tools and the basic, basick knowledge base to practice nursing. Once you starting seeing things in the real world, things will start clicking...ohhh yeah, that makes soo much more sense now....get a good handle on blood pressure bc you will be constantly manipulating BP in the neuro ICU. I like to say BP is relative...

4. I have high anxiety levels, low self confidence (pretty sure related to lack of experience).<----dont we all. This is what keeps us safe. You will gain confidence.

5. Don't really like the "adrenaline rush" of the ER/coding pts. I get that "flight" feeling. <----you will find the more experience you have the less scary it is, well maybe not less scary, but less intimidating. You eventually just start knowing what to expect...uh oh BP is dropping...first instinct: rev trendelenburg...oxygen...etc...you will get there


I would love to get into a specialty where I can really start researching on my own, really learning everything I can. ICU appeals because you have 1-2 pts to know EVERYTHING about. Seems like you have more autonomy. I like the fact that maybe the pts stays will be long enough there that I can research their conditions at home, on my own.

*yep pts stay on our unit for a long time so you have the chance of working with that pt several times. Thats why I love the ICU, I get the ability to concentrate my thoughts on just two patients so I can really critical think..Titrating drips, multi system functioning...basically knowing the whole body works and integrating that is awesome. The brain literally controls everything.


Assuming a good new grad training program, do you think new grads can be successful in the NICU?

*Absolutely. Like ive said before: if its all you know you adapt very quickly. Plus, as my preceptor said, you are never alone. You are never expected to land a pt on your own, you always have coworkers to support you and teamwork is KEY! In my opinion the most important part of an orientation program is time with a preceptor. Classrooms stuff...eh...you just grad from NS. A good preceptor and the amt oftime with that preceptro is key.

Do my above qualities increase my chances or decrease? I'd like opinions. I am an upcoming new grad anguishing over what speciality to choose AND where to do my clinical preceptorship. I need to figure it out in, oh, about two weeks! YIKES!

*You sound like youve thought this decision out. I think your concerns are valid and very normal. I think all the new grads in the neuro icu ive talked with (and we have a ton! prob 10-15 on my shift alone) feel the same way. My manager told me: give yourself some credit, you are a new grad, straight out of NS starting into a highly specialized area. Your job is to keep your patients safe, the rest will come. Just keep learning....everyday.

Hope this helps Can you tell how much I love the NICU????

[ladybird1292]

Hi ELKMNin06, Just read your post and want to thank you. I also am looking at going into ICU, and although I am nervous about it I really want the challenge and learning it presents me.

Thanks for the positive input...........

[thrashej]

Oh my gosh, ElkMN, I just now saw this, thank you so much!! I was really thinking about ICU and then I spoke with a nurse in clinicals this past weekend who said that new grads really shouldn't start in ICU. She was really nice about it and talked to me at length concerning her opinion. Made sense. I am so torn though because I need time to think things through and overall it seems I can do more of that in the ICU. I have applied at a couple hospitals so far thought and they said they do not hire new grads in the ICU. I have been waiting too to apply you know where (wink, wink) because I want to see if I get ICU for my preceptorship (it is either there or PP). It won't be at the hospital I want to stay at but atleast I will get to see...I just got out of ICU clinicals but I only spent two days there and my pt's were getting better and therefore not too complex. All the equipment did have my head spinning though!!

Thanks again!! You have been so helpful to me!

Originally Posted by ELKMNin06

1. I love learning. <---good you wont ever stop

2. Research EVERYTHING. Good...knowledge is key, but sometimes youwont have time to look up everything and you will just have to trust yourself and rely on your knowledge base.

3. Want to know "WHY" about everything.<---that will make you a better nurse...never do anything just bc you were ordered to...know why you are doing it

4. Ask so many questions related to the above that I drive most people crazy.<----yep me too, but oh well, if it helps me take better care of my pts..like i said..oh well

5. Want to be good at what I do. <---I think we all do...you will be but it takes time. the most frustrating thing to me at first was that, while I was smart, I was just inexperienced...nothing I could do but keep on truckin through...it was tough bc im a book/school type person...if im not good at something I just study more....you can read all the books you want as a new grad but sometimes you just gotta get out there, make mistakes and learn. Dont be too hard on yourself.

6. Would like to be an expert in my chosen specialty.<---that too, will come in time. The more I learn, the more I realize I don't know.

7. Very detail oriented.<----This seems to be a comman trait among nurses...LOL.

8. Assertive<--you have to be in an ICU setting

Things I consider not so good about me:

1. Not too comfortable with skills. (only experience is in NS)<---no big deal. How many times do you really have to insert a foley to get it???? Once or twice, in an ICU you will put a foley maybe once a shift. thats the beauty of the ICU, you have all the opportunity in the world to perfect your skills. I might insert 2-4 IVs or more in one shift. It doesnt take long to catch on to the technical skills...worry more about critical thinkin and preventing situations.

2. Don't feel very comfortable with time management/prioritizing (YET).<---experiement, bring different report sheets, make your own..whatever helps you stay organized...when i was first out of orientation....after i got report I would sit for about 30 mins (had about an hour before 9pm meds due) and just write down everything i could think of that i had to do for my 2 pts that night. Then I would just map it out...
1930:check ICP
2000:zero EVD, ICP, UO, CSF drainage, Fullbody assess/neuro assess
2030:check ICP
2100: meds, draw CBC
etc. then id make notes on things that needed done and cross them off as i went. We also have dry erase boards in our rooms so I would write all my parameters on there like EVD open at 10...BP parameters 18-220, etc.
I never try to get rushed either. Plan. Integrate tasks. You will find yourself as a newbie running around in circles at times. Stop, ask yourself why you just make 4 seperate trips to the supply room when youcould have just made one and picked up fresh linen on the way back...etc. Youll get it, it will start to come naturally.

3. Have trouble understanding complex systems such as Cardiac and Neuro but not so sure this wouldn't change if I had more time to devote to learning only those topics (can't in nursing school, so many other things to learn)<---The real lernng takes place once you are out of school. NS gives you the tools and the basic, basick knowledge base to practice nursing. Once you starting seeing things in the real world, things will start clicking...ohhh yeah, that makes soo much more sense now....get a good handle on blood pressure bc you will be constantly manipulating BP in the neuro ICU. I like to say BP is relative...

4. I have high anxiety levels, low self confidence (pretty sure related to lack of experience).<----dont we all. This is what keeps us safe. You will gain confidence.

5. Don't really like the "adrenaline rush" of the ER/coding pts. I get that "flight" feeling. <----you will find the more experience you have the less scary it is, well maybe not less scary, but less intimidating. You eventually just start knowing what to expect...uh oh BP is dropping...first instinct: rev trendelenburg...oxygen...etc...you will get there


I would love to get into a specialty where I can really start researching on my own, really learning everything I can. ICU appeals because you have 1-2 pts to know EVERYTHING about. Seems like you have more autonomy. I like the fact that maybe the pts stays will be long enough there that I can research their conditions at home, on my own.

*yep pts stay on our unit for a long time so you have the chance of working with that pt several times. Thats why I love the ICU, I get the ability to concentrate my thoughts on just two patients so I can really critical think..Titrating drips, multi system functioning...basically knowing the whole body works and integrating that is awesome. The brain literally controls everything.


Assuming a good new grad training program, do you think new grads can be successful in the NICU?

*Absolutely. Like ive said before: if its all you know you adapt very quickly. Plus, as my preceptor said, you are never alone. You are never expected to land a pt on your own, you always have coworkers to support you and teamwork is KEY! In my opinion the most important part of an orientation program is time with a preceptor. Classrooms stuff...eh...you just grad from NS. A good preceptor and the amt oftime with that preceptro is key.

Do my above qualities increase my chances or decrease? I'd like opinions. I am an upcoming new grad anguishing over what speciality to choose AND where to do my clinical preceptorship. I need to figure it out in, oh, about two weeks! YIKES!

*You sound like youve thought this decision out. I think your concerns are valid and very normal. I think all the new grads in the neuro icu ive talked with (and we have a ton! prob 10-15 on my shift alone) feel the same way. My manager told me: give yourself some credit, you are a new grad, straight out of NS starting into a highly specialized area. Your job is to keep your patients safe, the rest will come. Just keep learning....everyday.

Hope this helps Can you tell how much I love the NICU????