Any advice for a new grad looking to transfer to ICU?

[onconewgrad]

This May, I will complete my first year as a new graduate RN. Currently, I work on an Oncology/Medical Surgical/Telemetry unit. I have dealt with a large range of patients, and I have been exposed to tons of different experiences because our floor can have a pretty high acuity.

Now my interest has always been in a medical/surgical ICU, but I wanted to start out on a medical surgical floor in order to gain confidence and time management skills as a new graduate nurse. Lately, I have felt like I have plateaued out; I don't feel like I am being challenged enough and I feel like I am losing my critical thinking skills.. every night seems like a routine and I am ready for something more challenging. The other night, we had a patient who coded on our floor, and I had a huge adrenaline rush. Everything clicked in place in my head, and all that high stress just gave me a burst of energy and I could think ten times more clearly. For me, it erased all my doubts of going to the ICU.

For any ICU nurses, what do you recommend I can start doing now so I can hopefully transfer to the unit towards the end of this year? How can I present myself to the managers and the staff that I am a serious candidate?

I am aware that I may need more experience, and considering how young I look (I get called "baby" and a "kiddo" all the time by the nurses on my floor) and my age (22) I am nervous I may not be taken seriously. Any advice or recommendations are greatly appreciated!

[billybulldog]

Start getting any certifications you can (ACLS, PALS, CCRN, etc.) and studying up on your critical care nursing. Volunteer to do a share day in your hospital's ICU, make friends, and ask for advice from the RN's there. Be warned ICU nursing is not all running codes: You will have days and nights of tipping urine, entering vitals, and cleaning up your patients bc they just pooped/peed themselves again. You'll also have to deal with family that can't/won't let go and lots of death regardless, so be ready for that. You will also have the nights where you feel like you saved the world and that makes it worth it!

[Dranger]

1. It's total care nursing. Sure you only have 2 patient's but you have to EVERYTHING. Rectal tubes, trachs, daily baths and mundane I/Os are the norm most days. There are no CNAs in most hospitals, just you and your other ICU compatriots.

2. Pulmonologists are notoriously hard to deal with. They aren't the familiar hospitalists you see every day/night, you need to know your stuff backwards and forwards right out of the gate.

3. It's stressful and you don't get paid anymore than any other floor nurse

4. Death gets old, families get old

Don't get me wrong, the ICU is the only place I would work inpatient but it certainly has it's days where I just want to up and quit. If clinic nursing paid as well I would be there in a second haha. Just because you are young doesn't mean you don't know your stuff. Sure the old crusty nurses are intimidating and generally well versed in ICU-land but that doesn't mean they are up to date on everything.

Good luck

[onconewgrad]

Be warned ICU nursing is not all running codes: You will have days and nights of tipping urine, entering vitals, and cleaning up your patients bc they just pooped/peed themselves again. You'll also have to deal with family that can't/won't let go and lots of death regardless, so be ready for that. You will also have the nights where you feel like you saved the world and that makes it worth it!

I always have at least one patient who is a q 2 hour turner, incontinent of both urine and stool, etc. I am used to total care, and sometimes we only have 1 PCT for 32 patients, so often times I don't have a PCT to help me with ADLs so I do it myself. As for death, we see that a lot on our floor with terminal cancer and patients and their families deciding on whether hospice is their option. Thank you for your reply, I appreciate it!

[Larry3373]

I agree with getting ACLS if you don't currently have it. Tncc is an excellent course to take if you don't have it. would also make friends with the ICU director and find out what he or she is looking for from prospective candidates.

The adrenaline rush that you experienced unfortunately may not happen in ICU as much as you would like. ICU is like floor nursing in the sense that you are responsible for everything that the med surg of telemetry nurses do and additional responsibilities. Some of those additional responsibilities include titrating meds, taking care of patients on the ventilator, monitoring art lines and cvp monitoring, icp monitoring, insulin drips, and taking care of fresh cabg patients.

It sounds to me like you might want to look into the emergency room also. You will do a lot more codes down there. And you won't have the constant routines that you get with floor nursing.