New grad needs help

  1. Hi everyone!

    I'm a new grad RN working in ICU. I was just wondering if any of you know of some really good critical care reference materials (books, web sites, etc.) I feel like there's still so much I need to learn, and I didn't get much of an orientation because we were so short staffed( I never had a preceptor, I just got passed around from nurse to nurse). I also work with a very young crew(three of us are new grads, 2 graduated last year, 2 more the year before that, only our charge nurse has more than three years of nursing experience). Everyone on my crew is really willing to help me out when I need it, unfortunately many times they don't know the answers either.
    If anyone knows of some material that might help me I'd really appreciate it.

    Thanks,
    Allison
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  2. 8 Comments

  3. by   Zee_RN
    This is a fellow allnurses member's website. Check it out:

    http://www.icufaqs.org/

    Welcome to the world of critical care! It's a wonderful field and you will feel quite unsure of yourself for a while but stick with it if that's what you really want to do. I love critical care nursing. I did long-term care at first (for about 18 months) because there were NO hospital jobs when I graduated. Then I did med-surg for 3 years and have now been in ICU for 3 years. I've found my home.
  4. by   TheLionessRN
    There is a set of video tapes from a lady named Laura Gasparas Vonfrolio, RN MSN, etc etc. The tapes are the CCRN Review Cram, and they are fantastic. I don't know if they will answer the questions you want to ask, but they will entertain you all the way thru and give you a good shot in the arm, esteem wise, as a nurse.

    Good luck to you! The ICU where I started was and still is staffed by old nurses who ran the gamut from loving to teach to being annoyed at questions. The resources are very helpful when they are there. Just find nurses you admire and pick up what you can from them.
  5. by   Allison P
    Thanks for the help. The website is really great. I'm going to see if I can find those videos, too.

    Thanks
    Allison
  6. by   ERNurse752
    This is a really nice book, and it's small enough to carry around with you...

    www.kathywhite.com

    Good luck!!!
  7. by   whipping girl in 07
    I graduated last December and went straight into ICU too, and I love it. I had a really good orientation, though, and excellent preceptors. My best advice is to seek out fellow nurses who really know their stuff and learn as much as you can from them. AACN is also a good resource; our local chapter has monthly meetings with CEUs on different topics that are important in critical care. If you are a member, you can access all kinds of CEUs on their website and also get two free journals. Also, pharmaceutical and medical supply companies periodically offer inservices on drugs, pacemakers, etc that provide CEUs. Try to take as many classes as you can to learn about things you have not seen/done yet, because you never know what might roll through the door.

    Congratulations and good luck!

    BTW, I'm originally from Arkansas, and my parents and in-laws still live there.
  8. by   NMAguiar
    As a current student who is definately considering intensive care upon graduation, I have concerns:

    --I know I'm smart enough and I'm driven to attend extra conferences and opportunities to gain more knowledge. But is there a greater legal risk for new grads if a patient goes south on us?

    --What reactions are there from others that strolled the ICU route after graduation? Was it tough -- would you do it again? What are your suggestions for other new grads?

  9. by   hoolahan
    I can only speak from my own personal experience NM, and that is, if I had gone straight to ICU after grad, I would've killed people for sure.

    My nursing school experience was pitiful. I would get the pt who died the eve before, so at the lasy minute, the instructor would re-assign me to an easy case. Never had any difficult cases in nsg school. I had all the bunionectomies. So, even when I hit the med-surg floor, I wasn't just green, I was still in a bud stage, not even green yet. I had difficulty with the most basic skills, passing meds, doing a blood sugar, IV calcs, and I was so incredibly disorganized!!

    So for me, a year of med-surg was essential, even if just to help me get organized. Then again I reflect back now, and I think that some people's minds just cannot handle to sensory overload of so many pt's at once, and maybe for people like me, med-surg would have never been a good expereince b/c I get too caught up in the details. So, for people like me, maybe they should go right to critical care. I think it is a very individual thing. I am glad I did have my med-surg experience, but I never really learned too much until I went into critical care, I had the time to give attention to the necessary details with only two or three patients.
  10. by   whipping girl in 07
    NM, the legal risk for a nurse when a patient goes south is the same whether he/she is "new" or not. When looking at malpractice, the law looks at what a reasonable and prudent nurse would do. Of course, experience has to do with being reasonable and prudent, but just because a nurse is experienced does not mean the nurse has experience in a certain situation. So the most important thing to do when you have a patient going bad is to keep calling the dr and document every order you are given in your nurses notes. Example: BP 78/55. Dr. So&so notified. New order for Dopamine noted. Dopamine started at 3 mcg/kg/min to L arm IV. Then under evaluation: BP 90/56.

    If you contact a dr and they do not give you orders, note that in your nurses notes as well. That way, if the patient dies and there is a lawsuit, you can say, "See, I contacted Dr. So&so when the patient's BP was 78/55, and he did not give me any new orders." If you have to call Dr. So&so six times before he calls you back, note each time you called the answering service.

    Other things to remember: in ICU (at least in ours) you have a little more leeway in ordering labs, EKGs, x-rays, etc. So if you notice a significant change in your patient's heart rhythm at 2 AM (like a heart block, or what may be a-fib but it's hard to tell) get a stat EKG first, then call the dr. Same thing with resp. status: patient's pulse ox is 78% or you can't pick one up anymore and the patient is in distress, get some stat ABGs, then call the dr. And if the patient is going south quickly and there's no time to call the dr, then call a code if you must. Better to intubate someone with severe respiratory distress than someone who's not breathing at all; better to push atropine when patient's heart rate is in 30s than when he goes asystole.

    Nursing is all about using your judgement to prevent problems if possible, to catch things before they start or get bad. That's what we are there for; that's what the drs and patients are trusting us to do. It's a big responsibility whether you work in ICU or on a med/tele/anything else floor. Good luck to you and PM me if you have any other questions.

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