Telemetry to ICU

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    So I have 2 weeks left of my current job. I work on a general telemetry floor designated as intermediate care. Not a step-down though. Average ratio of 1:5, sometimes 4, a little more often 6. I graduated nursing school in August 2011 so this was my first job as a new grad. I have loved everything about my floor and working at my hospital other than the patient population. It just wasn't giving me the satisfaction at the end of the day that I was looking for.

    I recently, applied, got offered, and accepted a position in another city (at the beach! ) in to a medical ICU and I'm incredibly thrilled for this new chapter. I did my final immersion experience in school in a M/S-ICU and absolutely loved it. I knew it's where I eventually wanted to end up.

    So, here I am. Getting what I've wanted. I'm nervous for obvious reasons, but probably just as excited for both the job opportunity and the prime location. I've been told by many of my peers and managers at my current job that I have done extremely well. At almost a year in to this position I was getting to the point where with a lot of the typical day-to-day stuff I was beginning to feel comfortable in what I was doing and not to be completely lost trying to put the pieces together. Soon I will be back in those shoes again, although my confidence in some of the basic aspects of nursing will be there (assessments, pumps, etc etc etc).

    I was just curious for others who have made the transition from the floor to the ICU, what was the experience like for you? I know I have much to learn in the days, weeks, months and years ahead, but how was the transition for you? For anyone who transitioned earlier in your career, did you feel like a new grad all over again or did you feel like you were able to focus on more of the specifics of the unit since you had a chance to focus on the basics earlier?

    Sorry for the long-winded post, but like I said I'm very excited and look to hear from others on their experiences. Thanks!
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    I definitely felt like a new grad all over again. Exactly like a new grad.

    But you have to remember, it's all relative. When you were starting in tele, you were not a nurse yet, so you had to learn how to be a nurse at the same time as what the job was...if that makes sense.

    I transitioned to ICU this year and I have to say it was much harder than I thought. I didn't think it would be easy, but I didn't think I'd feel incompetent at times and question if it was the right thing for me to do. Those feelings are how I connect it to being a new grad again. Thinking I'm not giving the care to my patients that other nurses can because of stupid things like not knowing where certain things are, or having to figure out who will know the answer to any question. Things take twice as long because I've only done them once or twice.

    I thankfully have amazing support and never feel alone in what I'm doing.

    I remember thinking the same things about simple tasks when first starting in tele. I used to get a little nervous when a patient had ANY iv med because I was sure I was going to fight with the pump or mess something up. Now in the ICU I feel the same way about setting up a SWAN or intercool. These things are a little complicated but with time they will become second nature to you.

    It can be frustrating because you can worry about all these complicated things and then a small detail of less importance becomes important. Just try to take it one step at a time and never do anything you're not sure of, never feel stupid asking other departments questions like pharmacy or procedure areas. Same goes for physicians. If they give you an order you're unfamiliar with say "I've never given that drug, is that the usual dose" or "how will this treat what is going on with this patient, I've never used that before". They will be more patient with you if they don't think you're just clueless for the sake of being clueless.
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    I was totally clueless when I moved to the ICU-so yes you will feel like a new grad. It all depends on your orientation-for me it was very short and sink or swim basically. Now I see the new employees get 3 months! amazing! with great support, the extra classes, etc, you will be fine. Yes a bit nervous and asking tons of questions-but that's what we want!

    good luck and congrats!
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    I also graduated in August 2011 and I'm also looking into applying for ICU positions when I move in few months. I'm currently working on a Med-Surg floor. I honestly feel like critical care is a better fit for me, but I'm anxious about learning how to mess with ventilators O_O. I'm a pretty quick learner, but I'm expecting there to be a lot of training with new, high tech medical devices that will make my brain want to explode.

    I wish you good luck and hope you would come back to post your experiences after a few weeks on your new job
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    kimmzors-the medical devices are not that big of an issue, and most places have great resp therapists that will indepth go over any vent questions. The big thing to wrap your head around is that critical thinking piece, the why did they decide to do that and not this-and really understanding what all of the data that you can get with the medical devices really means. It's a lot!good luck!
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    Thank you all for the insight. I pretty much figured I would feel like a new grad again, but maybe with a little less being completely lost like in the days of trying to talk and setup a pump

    I have been reading up (icufaqs, fast facts for critical care, etc) trying to refresh my memory on some of the things that I hadn't thought about in a while. It's interesting re-learning this stuff again and I'm so excited because one of the things that I have missed most with working on the floor now is the critical thinking. Not to say I don't do that at all, but many times patients are more stable and with 6 patients sometimes you are just so busy checking tasks off the long list of things to do that you don't have the time to think much beyond the surface.

    Going in to the ICU I know there are going to be many things that will have me questioning what I know, but I think one of my biggest traits as a new RN is that I can recognize when I don't know something and I am more than humble enough to ask the questions.

    So I will definitely update on here. I have 5 more shifts left at my old job and then sometime the week on the 23rd of July I will be hitting the floor for my orientation on the unit. I will let everyone know how it goes! Thanks again.
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    Just checking in with ya.. Which unit did you end up on?? How is orientation going?? I know you have to go through all the units and PCU. Its kinda crazy at first being with different people and all but it does get better and once you are in your unit; things get alot better.

    Keep us posted
    ozarkmomma likes this.
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    I'm doing the exact same thing. I work on a tele unit that is 3:1 on days and 4:1 at night. In a few weeks I'll be starting a 4 month training program for a Surgical / Trauma ICU. Sad to leave my unit (started on it about 1.5 years ago) but I'm excited to work on my preferred unit. Good luck to us!
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    Hey there, sorry for taking so long to get back. Things have been going great. LOVING the new job much better than the old one! So many interesting stories, as you know. The last too nights were full of traumas. Day by day I am feeling better with what I'm doing there so thats finally nice. Last night I took full care of 2 ICUs (head on MVA, and GSW to face), and did probably 90-95% of the work so that felt good being able to really manage things myself.

    I have 1 more week in SI, then a couple days MI, and a couple days CV, and I believe a day of PCU (although I wouldn't mind if I skipped that part). Then back to SI for probably just a bit more. The staff is really nice. Starting to feel more comfortable with them so that is good. Missing my old group of coworkers, but just takes time to get to know everyone and I'm getting there.

    Oh yeah and meditech is HORRID!!! Hahah
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    Haha, yeah Meditech is a beast but you will get better and faster at it. It just takes time. As far as the trauma's go, they are almost non stop their One thing I do actually miss about SI. I do miss my old co-workers there and just stopped by two weeks ago to say hey.. It takes a bit of time to get to know everyone but over all they are great to work with and they will be there to help in a second if/when you need it..


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