Quote from bella1231
I am a new grad and I am starting in the ICU/CCU next week. Any advice? Anything I need to know???
A few tips off the top of my head:
Consider your patient's last 12 hours (per previous shift's report) and then ask yourself: "What is the worst thing that can happen to this patient during my 12 hours with him/her?" Then prepare for it. Even stable, ready to move to the floor patients will surprise you with the tricks they pull! My preceptor taught me this, and it has served me well over the years.
Always check your equipment early in the shift. Make sure you have suction available, and that it's HOOKED UP and ready to go!
Know your patient's lab values early in the shift. Like, at report.
Do your own drug calculations! It ensures that the IV rates are correct, and you get enough practice that soon you will know how to do it in your sleep. You will need this skill.
Pull back the covers and look at your patient's feet! (In other words, make sure they HAVE feet. There's a long story to go with this one. OH MY.)
Confused patients know how to act oriented. No one can fake knowing the year or the president, so ask.
Patient on insulin drip and hourly glucoses, and you keep missing the time? Set your "volume to be infused" to the same as the rate for that hour (i.e. drip at 7 cc/hr, set the VTBI for 7 cc). In one hour, your pump will think it's empty and will beep. Voila! Check your sugar, reset the rate accordingly, and reset your VTBI for the next hour. It's like an alarm clock for accu-checks.
Develop a good rapport with your coworkers. You will all depend on and support each other. You need them and they need you. ICU is tough.
Develop a good rapport with your patient's family. Nursing encompasses them as well, and they often need our support and education.
Sick people often act out due to fear and loss of control. Keep that in mind when dealing with a difficult patient.
Wear support hose.
Monogram your stethoscope. That way, when it's stolen (or "borrowed"), the person wearing it may at least feel some semblance of shame when they see your name.
Do your best to leave work AT work. It's hard, but necessary.
And that's all I have for now. It's late, and there are a thousand more things floating around in my brain, but I'm tired. Good luck and enjoy the world of ICU. It's challenging, but rewarding.