newly hired to icu

  1. 0 I've been a med surg nurse for 4 yrs and I interviewed for a ccu position and I got it. I'm nervous now because I feel like there is so much I don't know and I feel the only thing med surg has taught me is time management,pushing pills,and how to work under high stress lol. I'm starting to second guess myself and thinking about turning theposition down because it seems so overwhelming sigh. I guess my question is how can I better prepare myself for this transition?
  2. Visit  TNT_RN09 profile page

    About TNT_RN09

    Joined Aug '12; Posts: 12.

    12 Comments so far...

  3. Visit  CrufflerJJ profile page
    2
    Quote from TNT_RN09
    I've been a med surg nurse for 4 yrs and I interviewed for a ccu position and I got it. I'm nervous now because I feel like there is so much I don't know and I feel the only thing med surg has taught me is time management,pushing pills,and how to work under high stress lol. I'm starting to second guess myself and thinking about turning theposition down because it seems so overwhelming sigh. I guess my question is how can I better prepare myself for this transition?
    Looking at your post, it appears to me that you are well on your way to CCU. You KNOW that "there is so much I don't know", which is better than many newbies applying for ICU slots. You also say that "the only thing med surg has taught me is time management,pushing pills,and how to work under high stress..." Time management and working under high stress will serve you well in the ICU.

    You are not a seasoned ICU nurse, and you already know that. That's a step above some folks entering the ICU.

    I'd urge you to NOT turn down the opportunity. If you were not seen as capable of doing the job, you'd probably not received the job offer (I say this as somebody who interviews candidates for my hospital's ICU). Your 4 years experience will serve you well in the ICU.

    Go for it, and GOOD LUCK!
    Meriwhen and sapphire18 like this.
  4. Visit  sapphire18 profile page
    0
    I agree with Cruffler. If you want it, go for it!! Time management skills and the ability to work in a high-stress environment will serve you well in ICU. I highly doubt that they would cut you loose from orientation without making sure that you are competent first. I'd say, if you're not an extremely detail-oriented person, then don't do it. Otherwise, take the plunge and enjoy!! You will learn SO much...I love that about the ICU...I am challenged each and every day.

    Oh, and congrats!
  5. Visit  TNT_RN09 profile page
    0
    Thank you for the confidence boost I so needed that. I have ordered some critical care books so I can have some sort of knowledge base. I guess i'm just afraid of failing then having to go back to the floor I dread. I feel like i'm not learning on ms and want to expand my knowledge bank. I'm notlooking to go into crna school,I just want to be a better nurse
  6. Visit  ISeeYou3100 profile page
    0
    Don't let the fear of what you don't know keep you from accepting an amazing job! You can learn everything that will be required of you Good luck !!
  7. Visit  CrufflerJJ profile page
    0
    Quote from TNT_RN09
    ...I have ordered some critical care books so I can have some sort of knowledge base...
    The ICU will offer you a tremendous learning opportunity. You might also want to take a look at index . TONS of handy information, nicely presented.
  8. Visit  TNT_RN09 profile page
    0
    Thanks for the website going to check it out
  9. Visit  TNT_RN09 profile page
    0
    They told me in the interview I would get 6 wks orientation,does this seem reasonable?
  10. Visit  sapphire18 profile page
    0
    I got 12 when transitioning to ICU..every place is different though. 6 doesn't seem unrealistic. You said you worked PACU? If so you already know vents and drips.
  11. Visit  sapphire18 profile page
    0
    Sorry, the PACU thing must've been from a different thread. It depends how high the acuity is in your CCU. But with 4 years of experience you already have the *nursing* part down pat- now to just hone your assessments and shift your skills to the technology used in the ICU- usually people can extend their orientation if they're not quite ready yet when it comes time to fly solo.
  12. Visit  Sun0408 profile page
    0
    6 weeks is what I got when I went to the ICU from the floor.. Just remember, you will never be alone... Don't run from this, you will be trained to be an ICU nurse, your ms days will help you more than you know. The transition will be tough and you still have much to learn but it will come.. Jump in, ask questions and plan on looking lots of stuff up and reading in your free time.. LOL, after 2 years in the ICU, I had something I never heard of.. Thank goodness for smart phones and apps like medscape
  13. Visit  DutchRN09 profile page
    0
    Congratulations on your job offer! I am about to finish my orientation, you have a lot more pertinent experience! Time management and med management is a real asset. You will do great! Onward!
  14. Visit  CrufflerJJ profile page
    1
    Quote from TNT_RN09
    They told me in the interview I would get 6 wks orientation,does this seem reasonable?
    Every facility is probably different. My facility's Critical Care Fellowship program is 16 weeks of mixed class & precepted time in our ICU.

    Plan on being overwhelmed the first time you step into the ICU.....OK, for at least the first week or two. Lots of sick patients, hooked up to multiple powerful drips, attached to multiple machines all beeping/alarming. Then it gets even more "interesting" when your previously "stable" pt takes a turn for the worse. Fun times!

    Ask questions, listen & work to understand the answers you're given. If you don't truly understand the response, ASK again. Far worse than asking a second time is to blindly move forward, HOPING that you know what you're doing. If you're not sure, ask. Your pt deserves this level of caring/effort.

    Realize that the "ICU way" may be very different from the "med/surg way" of doing things. In general, I'd expect that the ICU RN may have greater autonomy to order basic tests (not out of the blue, but based on pt-specific conditions) than the med surg nurse, be capable of interpreting the results, and would be willing/able to aggressively advocate for your pt based on the results. In my ICU, the RN has a decent amount of autonomy, but also significant expectations to plan ahead (i.e., if you know the doc is planning to place a central line, it might be good to make sure there's recent PT/APTT/INR results available....if your pt had a K of 3.6 at the start of your shift and has dumped 3 liters of urine thanks to Bumex since then, it's probably a good thing to spot check a K level).

    Try to get a feel for how experienced nurses in your unit handle situations. Do they respond purely from physician orders, or do they try to "get ahead of the curve", and anticipate the needs/whims of the ICU docs? Once again, every ICU is likely different. Some will be more centrally directed than others.

    Please don't be afraid...too much. It's a balancing act between being a "scared newbie wimp" vs a "dangerous newbie know it all." The experienced (hopefully sometimes awe-inspiring) ICU nurses you will encounter all started out as ICU newbies. Hopefully they won't forget this when interacting with you and your fellow ICU newbies. Most of the folks I've seen fail to successfully transition to the ICU have failed for 2 main reasons:

    - "know it all", unwilling to accept repeated strong preceptor hints on a safer/better way to do their job, thus putting their pts at risk
    - "uncaring idiot" - a space cadet who is highly intelligent, yet doesn't feel the need to do the basic due diligence - refusing to look up the pt's history, lab values, or even listening to report from the previous nurse. They are oblivious to important pt trends during the shift (has O2 demand gone up, did Levo start at 0.02 mcg/kg/min, and are you now at 0.16 mcg/kg/min?)

    It's scary, leaving your "comfort zone" for a new environment. It's even scarier to feel your soul shrivel when you're stuck in a rut, doing the same thing...day after day after day after day. Life is too darn short to be unhappy. Congrats to you for being willing to try something different.

    Please keep your head up, your mind and heart open, and your hands busy as you start your new position. Ask questions, learn every day, and offer to HELP your coworkers on a daily basis. Helping your neighbors will go a long way at minimizing any stress caused by your inexperience.

    You can do it.
    DutchRN09 likes this.


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