difficulties in transitioning to ICU

SL2014 · Jan 15, 2014

I started in ICU as a new grad and I was a nervous wreck and almost quit nursing. When I got transferred to a different unit I promptly realized that it wasn't me, it was the nurses I was with.

Lennonninja, MSN, APRN, NP · Jan 18, 2014

I came to the ICU with 1 year of M/S experience and I was just as scared to come off of orientation in the ICU as I was as a new grad. I've been there 18 months now, and still feel dumb frequently, but I know where to look up information, who to ask, and have learned to trust my instincts more. I've been told a million times, you won't feel like you're comfortable in the ICU until it's been about 2 years.

ASHRN828 · Jan 19, 2014

Hi There,

I totally get where you are coming from. I went to a MSICU after being an RN on a medical floor for 3 1/2 years. I had a 3 month orientation and I remember at first feeling so overwhelmed in the beginning. I would "shut down" emotionally sometimes in an emergency, made several mistakes when I was learning to do insulin gtts and things like that.

What really helped me is I made my own "book" for the ICU in a 3 ring binder. The first section was Code Blue stuff and I memorized and studied the algorithms for V-tach without a pulse, v-fib, PEA/Asystole etc. I also reviewed pacing and cardioverting with a page of heart blocks as well every night before I went to work. I figured if I knew that stuff, anything else I could review or look at the policy. It greatly pumped up my self- esteem and it showed, too. A charge nurse told me that she thought I had the potential to be one of the best nurses in the ICU (wow).

In my "ICU book" I also have a section for Hemodynamics, Paralytics/Train of Four, Epidurals, Therapeutic Hypothermia, Arterial and CVP lines, and a Neuro section. I also have a section for critical care gtts and our hospitals reference material. I bring this to work with me every day and can pop it open whenever I need it!

Good luck! It just takes TIME, and you will get it.

valsalvamanuever2 · Jan 19, 2014

Thank you all for sharing your feelings. I thought that I probably wasn't the first to feel this way. It does feel good to have this outlet.

My unit was nice enough to provided us with a giant binder of things to know/learn/tips. I agree that a factual background can help when lacking experience as I do.

Thanks again all.

nightengalegoddess · Jan 28, 2014

Been doing ICU for about 18 months and yes, still feel overwhelmed at times. A lot of ICU nurses don't like to hear this. But one of the things that has saved me...(.because I have over 8 years of medical/surgical/telemetry experience prior); is to remember that ICU nursing is the same as any nursing but it happens faster and there is more of it. More technology to learn, more evidence to compare, faster impeding death, etc. But we are still doing the nursing process; same as it ever was.

And yes, I still feel afraid and stupid at times. I am getting used to feeling stupid. That helps. It is difficult to come from an area of nursing where you feel you can go no further, and then get into ICU where you feel like a new grad all over again. I am still very humbled by the transition.

LordFarquad · Feb 1, 2014

You are lucky that they give you 12 weeks of orientation. At my hospital they only give 2 weeks orientation for new hires and 2 months if you were to have transferred from tele at the same facility. I am a new grad with no prior nursing experience and I am starting out in SICU and will be getting just 12 weeks of orientation. :)

ChipNurse · Feb 6, 2014

You will feel nervous and scared no matter how much time you have on orientation. I have heard it can take a couple years for you to feel comfortable. No one ever knows all the answers. Just practice safely and when you encounter something you have never seen, ask a more senior nurse.