I start as a new grad in a large medical and surgical ICU and will have a approximately 12 weeks on orientation with a week on Neuro ICU and cardiac ICU. My question is how do you guys preform an efficient head to toe assessment in the ICU? I did a 290 preceptorship in the cardiac ICU in a large teaching hospital and feel comfortable with the assessments that I previously did on the CICU but would like a more efficient and complete approach. Also, what should I start doing now? I purchased a few books for reference I bought-Kathy whites book-the ICUFAQ book-The ICU book-and pass CCRN (just for reference)What else should I do to become a successful new grad ICU RN?Also, it will be a night position which is a big change for me! How did you guys deal with that?
Jan 26, '13
In all honesty I will say it may be difficult for me to give you advice on how to do a thorough and more full approach to a patient assessment; but here's best I will try to offer: First, make sure to obviously focus on the big picture of why they're admitted in the first place, but dont overlook complications or the smaller less obvious clues/hints. Personally for me depends on how my patient is once you walk into the room (vented and sedated/awake) and that right there is half your neuro assessment lol. But figure out how your hospital approachs the patient assesment whether its a reference to the documentation and our rounds with the residents and attendings. It can be slightly frightening going to ICU as a new grad RN trust me (did it straight from a diploma based program); but there will be guidance on the way. Get a hold on the fundamentals you know, and let your preceptor guide you along the way.
In terms of nights, well get yourself into a healthy sleeping schedule; try to make it as close to what you would do on days, just reversed (i.e sleep x amt of hours, activities, then work, or w/e your schedule used to be). Coffee always helps, and the adjustment takes time, but you'll get the hang of it.
Hope this slightly helps you, any other thoughts/concerns, reply, I'll do what I can to help you, currently a MICU RN (nights!) straight from school in 2011...
Oh and this: Kudos on the New Grad ICU position, hard to come by!
Jan 27, '13
Thanks for taking the time out to answer my questions Brandon!
Since you started off as a new grad, what do you think is the most important things to know for my first day of orientation. My main goal is being a safe and competent nurse and I want to also have an extensive knowledge base oh and my biggest fear = looking like an idiot!!
Jan 27, '13
Well I'd say first day on the floor, take the time to let your preceptor explain everything to you....they're going to have a wealth of knowledge and you should be familiar with your settings. The basics of each system dont change with ICU care, some just more in depth, and let them explain the ways that things will happen. I'd say what you should to do be competent, is dont be too over zealous or confident, ask the questions you need answers to; they understand its a first day, so they'll be prepared for it. And in terms of looking like an idiot, no worries; long as you just go with the flow and take it step by step.
Feb 5, '13
I'll also be starting in Surgical ICU this coming Monday! I've been looking into which reference books I should purchase...I plan on gettin the Pass CCRN and I've been reading notes from the icufaqs website...
I just borrowed an assessment book from a friend to refresh my memory on some anatomy, assessment skills and terminology.
I was at a bookstore today and Health Assessment made incredibly visual seemed like a good resource...it included some detailed anatomy as well...