Advice for new grad starting CCU

BULLYDAWGRN, RN · May 16, 2007

Jane I know sometimes it feels like you have a sensory overload with all the bells and ringing and flashing screens in the unit. I think the best info I can give you is to master your basics first. Try to get as competent as possible in iv starts, ng placements all your technical skills, do as many as possible esp. when you are being precepted. Breakout the old manual b/p cuff, concentrate on your physical assessment of the pt, all the basic stuff you learned in school. Don't worry about getting to do that fancy TV stuff, it should come in time. Try to get and learn your als guidelines too.

collegemomrn · May 17, 2007

It is a learning/orientation issue. You are very capable of aquiring the same skills as the older nurses in the ICU/CCU, they need to teach you. Make sure that you get an orientation that fits your needs not the hospitals, it is your lisence at stake not the hospital's. All of the nurses working in the critical care area were not born in there, they had to learn it too. I am a critical care nurse. I think it is good to get someone right out of school without other preconceived ideas about how to be a nurse. You don't need to be a general medical floor nurse first. It is hard to retrain those people.

jane24 · May 17, 2007

Thanks a lot for your replies, its good to know it gets easier with time. I've often heard the its good to have some medsurg experience before moving to ICU. Is it really much easier to make the transition from medsurg to ICU?

BULLYDAWGRN, RN · May 18, 2007

Well I think thats a yes and no question, some people do fine in the unit without any other type of nursing exp, some don't. I can't knock anyone for going to a med/surge unit to get exp. But I can see how it might be easier to come to the unit from a med floor vs jumpining into the unit brand new. After some time on the floor you'll be versed in all of your technical skills and on how the hospital works (who to call for what, where is what dept, and who does what and when). Our hospital used to have a policy that you had to have at least 1 yr of nursing exp before coming to the units, but that has since changed do to no nurses around here, so we do have a few brand new nurses units and er. But some people goto the floors and get shafted and hammered and by the time they get back to the unit they have such a bad taste in their mouths that it's hard for them to loose a med/surge mentality and pick-up a icu mentality.

collegemomrn · May 22, 2007

Don't you think it is easier to train the GN to the bells and whistles of the ICU and not have to retrain them after they are trained to other bells and whistles? I like have fresh eyes and new education to share. These new GN have a lot to share besides learn. I think it is better to start in the unit. I can't say that there was one thing that the med/onc floor taught me that helped me in the ICU.

jane24 · May 26, 2007

I can see how it will be easier to train a new grad to ICU compared to after their exposure to other areas. But one of the other things I've heard over and over is that it is best for a new grad to start out on a medsurg floor. to my understanding this is where the newgrad gets the opportunity to practice what he/she learned in nursing school. What are your views concerning this.

lubdubRN · Jun 13, 2007

You know, I have heard the "go the med/surg floor first and get your feet wet before you go the unit." I chose to go to the unit-Cardiac Surgery ICU. They have an intern program in place for new grads. I jumped on it! Most are coming around about the new grad on the unit, but there is still some resistance. Thanks for sharing your thoughts on that. I needed to read that.

lubdubRN

deeDawntee, RN · Jul 4, 2007

I am the nurse who started out in LTC, home care, then TCU, then Vent house, then hospital (orthopedics, tele) before I went to the ICU. (I never worked on a strictly medicine unit.) In my mind and in my perception (please no one be offended by this) I worked myself up to the point where I then felt ready for ICU. I have seen new grads do pretty well starting out in the ICU, but their biggest issue (I have talked to them) has been the attitude of some nurses who believe they have no business starting out in the ICU. I think if you can handle that kind of environment, where there will be some resentment and skepticism, there is no reason a bright new grad can't succeed in the ICU.

Personally, the most valuable background for me was being proficient in telemetry before I started ICU. So, my personal advice would be to get a year of cardiovascular telemetry, that will give you a great base to expand to ICU. You will know your rhythms and interventions. You will have some experience with codes, chest pain management, post angiograms, etc. Certainly all the rest of my background has been useful, but tele was the most essential, at least for my peace of mind and security starting caring for ICU pts. Perhaps you can start in a tele unit that does sheath pulls?

I know people will criticize this point of view, but remember it is YOUR path, you can do it the way you want to. I am grateful for having worked in so many areas in nursing as I truly respect all nurses in all avenues. Let me tell you, there are great nurses and weak nurses everywhere, including ICU. Every area has it own challenges.

I hope this helps. Good luck to you.

Burnt2 · Jul 5, 2007

I started as a new grad; I did just fine, although it was extremely stressful at times.

There will be times when you will be completely overwhelmed and feel like quitting, but it's really worth it.

Don't give up, keep learning on your off time, reading up. www.icufaqs.org is EXCELLENT.

-do all the ABG's in the unit every morning for practice

-volunteer to take all the swan patients and the crash and burns from the floor/ER.

- take the code pager :-D

etc

bugluv23 · Jul 7, 2007

I worked on Tele/Cardiac IMU for about 2 years then transferred to CVICU. I think that was the best decision for me. I catch on pretty quick and I think I am pretty smart but I see new grads in ICU now..and for instance they have to learn how to start ivs..basic stuff like priming ivs, knowing meds and dosages. It is hard when you have to learn all the basics along with advanced hemodynamics and drips with these fresh hearts. I think it is good to learn your basics on med/surg or tele for about a year then go to ICU. I work in a CVICU with alot of really sick patients so it is very intense. In ICU you have to really think critically and quickly..which as a new grad you don't have that nursing judgement yet.

This is just my opinion..but I know of many people who have gone straight to ICU and did fine. Good luck!!

teenynurse · Jul 10, 2007

I can see how it will be easier to train a new grad to ICU compared to after their exposure to other areas. But one of the other things I've heard over and over is that it is best for a new grad to start out on a medsurg floor. to my understanding this is where the newgrad gets the opportunity to practice what he/she learned in nursing school. What are your views concerning this.

I completly agree with this, I was an aide for 10 years LPN for 1 now an RN for 1 I going to the ICU in a few weeks I worked med surg per choice for a year, getting the experience med surg I believe will help me alot