Quote from ruby vee
the new grads i've worked with recently who started in the icu are very weak on the basics. just today, a nurse who has been here for a year told me she'd never checked an ng residual and didn't know how. turning every two hours seems to be a thing of the past. no one knows how to start an iv anymore because our patients come from surgery with lines in. drawing an abg without an arterial line? no way! applying an incontinece bag? nt suctioning? where's rt? check with the ostomy nurse. the basics seem to be glossed over or missed completely. worse, making assessments without the technology seems to be a lost art. so a patient who goes bad after being de-lined and assigned a room for transfer seems to get missed. "i didn't know her blood pressure was low because i'd already taken out her art line." or "i didn't know i had to check a blood pressure if his art line was out."
not every new grad who starts in the icu is this bad, but enough of them are that i'm thinking more new grads ought to start in med-surg!
ugh. i used to really argue that new grads are perfectly fine starting out in the icu as i am one myself.
but, as the last semester nursing students keep rolling through our unit, it makes me sometimes scared when i hear that they want to work in icu.
when i hand you an ivpb, and you don't know how to mix the powder with the liquid, and you don't know how to hang the miv lower, i'm thinking that icu may be out of your reach. or when i ask you about propofol, and you say it's a beta blocker-well, it's not a good sign. not to mention it tells me you didn't do your care plan properly...
i was fortunate that i got to do a lot as a tech. i was a phlebotomist as part of my tech training, and so i got a lot of iv starts thanks to some icu nurses. i also did perform some nt suctioning, was instructed on vents and swans and alines. lots of foley placements, lots of flexi-seal placements (our rectal bags). i was taught abgs, and i had to do the q2 rolls on all the icu pts (with each pts nurse). plus, working in a cvicu, i had a lot of experience with pacers, cts, chest/leg incisions, ekgs, chf'rs, and other cool stuff! in addition, i was an emt prior, which helped with my confidence.
i was lucky. and yet, it still was and is very difficult to be a new grad in the icu.
some people won't like you there. you will have to do outside studying. i have spent many a day at the barnes n noble with my critical care books and my laura gasparios vonfrolio tapes-just to be at the level of beginning to nurse at the critical care level.