New Graduate in ICU- Advise and Tips

  1. 0
    Hi, I'm finishing nursing school in the next month and have recently been hired into a medical/surgical ICU. To all the nurses who started out in the ICU, or all the nurses who have watched others start out in the ICU: what advise and tips do you have in preparing to begin working as a new grad/ ICU nurse? What was your experience like during your first year in the units, and can you pass along any helpful suggestions? I'm so excited about critical care, and I would love to hear your thoughts!

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  2. 10 Comments...

  3. 7
    I was fresh out of school into a medical ICU.

    Ask all the questions you can, but don't be cocky. Unless asked, don't ever admit you "know that." If your preceptor is worth a darn, they'll teach you everything from the ground up, even if you've learned it before.

    Get all the experiences you can, help with every line insertion, art stick, etc. That type of stuff is a joke to me now, but at first it was overwhelming. The more times you help/do certain things, much like with anything, you'll get better.

    Don't come home and cry if your preceptor tells you you're slow. Ask what you can do to improve and work on it.

    READ! Read everything related to ICU you can get your hands on. This forum is a goldmine too, as is icufaqs.com.
    my_purpose, on eagles wings, kraven, and 4 others like this.
  4. 1
    icufaqs.com is the best site for a new grad, it will give you lots of easy to digest, practical tips on everything you will commonly see and be expected to do. once you have "gotten your feet wet" move on to a more scholastic text, like "the icu book" by john marino.

    Basically you need to be doing about 10 hours a week of "extra" reading in addition to whatever training and education you are assigned. start slow and general and ease yourself into more specific topics.
    Straight up, its going to take 9 months to 1 year before you really feel comfortable. Don't worry, as long as you are safe and never give a med before understanding its effects and ask for help when you need it, you will be fine. But....you have to study! I went home every shift for my first 6 months with a little pad of paper, where i kept a list of topics and concepts to look up before the next shift.

    ICU is huge responsibility, its not tele or medsurg. you are expected to think and perform on a much higher level. but its also very rewarding. The Doc's often rely on you to "fix" or "clean up" the mess that patient is in due to lack of proper care on the floor. They will also speak to you professionally and A LOT of times you will be the one making suggestions at 3am, so you gotta know your stuff
    on eagles wings likes this.
  5. 3
    I'm a new grad starting in a Medical ICU. I really recommend the website some have mentioned, Icufaqs. I've been reading through it and I think its great. It's easy reading and has some humor to it.

    One of the best pieces of advice I've been given is don't be afraid to ask questions! Nobody expects you to know everything fresh out of school, especially in an ICU! It's dangerous to think you know everything, you could kill someone!
    Tell every nurse that you meet on the unit that you want to gain as much experience as possible during your orientation and ask them to tell you when there are interesting cases/ procedures/ skills to practice with their patients so you can get the experience.

    Write things down during the day that you come across and feel like you don't know enough about, so you can look them up when you get the time.

    Ask a lot of "what if" questions. Learn what your resources are on your unit, and who you should call for what, especially if you are working nights- what things are serious enough for me to call and wake up the MD, and what things should I handle myself/ watch carefully?

    Also, be a good neighbor to the nurses working next to you. Help them when they have crazy assignments and your pts are stable, and they will most likely do the same. ICU is all about teamwork!

    Good luck, like me I bet you are super excited!!
    on eagles wings, arnie1234, and esie like this.
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    I also went into a med surg ICU as a grad, but I had the experience of a paramedic background. Best piece of advice I can give is ask lots and lots of questions! Don't be afraid to ask your CN's, senior RN's, doctors, physiotherapists, speech therapists, and anyone else! Otherwise, take a deep breath, and don't panic
    on eagles wings likes this.
  7. 0
    Great advice! I'm also starting in the ICU next month and while I'm very excited..I'm also nervous!! I love the website icufaqs.com -- I used it during my critical care semester (this past semester) and it really helped!

    Good luck to all of us starting in the ICU soon! I'm sure we'll do great!
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    Eyes open, mouth shut (except to ask questions of course). Hands on, Take hard assignments (not right off the bat, but work your way up), Go to codes if you havent been on one and take the first shot at CPR and crack ribs so you know what it feels like and you dont freak out. Ask LOTS of questions, and as someone said never say "Oh i know that already" Because ya know what? You don't..I said that one to many times when I Was a new grad and my preceptor said to me "Well then if you already know it then you obviously don't need me" Nursing school teaches us alot, but what we do on the unit and what we learn in a text book and be 2 different things. A good ICU nurse knows what to ask for or either does what she has to do and then asks questions later! These patients are sick, and if you aren't ahead of the curve you're patients are sometimes the ones who suffer. If you don't know something then DO NOT DO IT. I love to teach people and most of us ICU/CCU people have no problem showing you how to do it. Do people cut corners ? Sure we do, how do you think we get 16 hrs of stuff done in 12? Can it be done safely? Yes, but starting out, learn to do things the RIGHT way, even tho it might be the loooong way, get into good habits now...Then learn to cut corners, safely! Oh and always have a pair of kelly clamps, they will be your best friend!
  9. 1
    Thanks so much guys!!!!!!
    hlechuga likes this.
  10. 0
    The ICU FAQ site is http://www.icufaqs.org/ .
  11. 0
    Yes, the icufaqs site is fantastic. I have to say that i wish I were among you all that say you started out in an ICU. Where I am from, it is not easy to get into an ICU as a new grad. Any advice on what will sell me to the Nurse Manager/recruiter and make them want me over all others? I would really appreciate it. Thanks


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