new to nursing/ICU

cmggriff · Sep 16, 2001

Well not-nancy, not many replies. I'll give it a shot. I have had a number of "discussions" with nurse managers over the years re: new grads in the units. I am against hiring new grads for the ICU for a number of reasons.

But, since you are already there let me say good luck. First and most importantly, determine your support people in your unit. You are going to need someone yu work with to use as a resource often. If you are on one of "those" units where you are thrown in to sink or swim, you might want to consider looking for a new job.

Second, keep things as simple as you can. Try to learn to assess the patient and not the equipment. If the pt looks bad, it doen't matter what the machines say about the numbers.

Third, read everything you can find about critical care. If you have trouble understanding the text at first, then it is probably too technical. Find something you can understand and work your way up.

I was a new grad in critical care many years ago. You have my sympathy. Good luck, Gary

mattcastens · Sep 17, 2001

First of all, don't give up. As a new grad, you'd feel overwhelmed no matter where you were. Second, don't expect to learn it all at once. Ask questions!! Also, set aside some time at home to study up on the things you've seen at work. I know, sometimes one of the last things you want to do is crack a book after work, but do it right away, while it's still fresh -- don't spend a long time reading, just enough to debrief yourself. Find your support people, as Gary mentioned.

At my hospital, we have a year-long orientation for new grads moving into critical care, and we only accept those who have had certain experiences prior (EMTs, LPNs, etc.). The new grads I've dealt with through this program have all done quite well. In general, though, I think that they should have some floor experience first -- not a lot, necessarily, maybe only six months or a year. That amount of time will allow one to learn their organization skills and get a handle on the basic assessments which are expanded upon in critical care.

However, with the nursing shortage getting worse, I think we'll be seeing more new grads in the ICU and ED settings, so we all have to remember to help and teach.

Zee_RN, BSN, RN · Sep 18, 2001

It will take awhile before you get beyond that overwhelmed feeling; just go with it and accept it as a given for right now. Use your resources...experienced nurses working with you...don't be afraid to ask questions, don't feel stupid for saying "Hey, I've never done this before." ICU nurses have been known to be a tough lot but they respect those who know their limitations.

I went into critical care after 3 years in med-surg and I felt like a brand-new nurse. The ICU nurses in my hospital were known to be tough and many other nurses in the hospital were "afraid" of them. I had some trepidation about going into the unit. It's been over two years now and I wouldn't want to be anywhere else. One of our most experienced nurses said to me just last week...."I knew you were going to be fine when you had just started in the unit when you stood at the nurses' station and said 'OK, I need help...I've never hung Cardizem drip before...how do I mix it and how do I run it?' " Because I admitted my ignorance and sought help and didn't just try to bluff my way through it, I was given a lot of support.

Stick with it! It's a great place to work. You're gonna feel overwhelmed for awhile, just accept that :) .

Curlytop · Oct 8, 2001

I completely agree with Zee-RN. As a new grad 10 years ago I felt totally overwhelmed and completely stupid for atleast a year.

But it's okay to feel that way and it's nurses like you that I respect so much- as opposed to the "know-it-all" new nurse---- who scares me to death!

Never be afraid to ask questions. There is Never a stupid question when you are dealing with people's lives. Invest in a good drug reference book like -The Nurses PDR. Also buy a critical care nursing manual. Also, really work on your assessment skills because pt status can change drastically within seconds. Never be afraid to ask for help..... Oh yeah- One day you will get the 'big picture' and a good nurse learns something everyday.

not-nancy-nurse · Oct 8, 2001

I've been looking for a good pocket-sized reference book for ICU--any suggestions?

Also, thanks for the encouragement & advice! I'm currently looking forward to day #4 on my own--and I would never have made it through the first three if the RN's I work with hadn't helped me! Most people are very nice about helping, thank god! And they all know I'm new at this, so that helps too.

Thanks,

not-nancy

mattcastens · Oct 8, 2001

There are two that I would recommend. One is "Critical Care Checkmate", a small, black, truly pocket-sized book that has everything from lab values, to hemodynamics, to conversion tables.

The other one is called "Fast Facts". This is a slightly larger 3-ring book with several standard ICU sections, plus expandable sections for Peds, IABP, Trauma, etc. It's not really pocket-sized, but could be easily carried in a bag (or maybe in a lab coat pocket).

I have both. I carry the "Checkmate" in my pocket for quick reference, and the "Fast Facts" in my bag in case I need a little more detail.

For the "Critical Care Checkmate":

http://www.nnccusa.com

For "Fast Facts":http://www.kathywhite.com

tlmagraw2 · Jan 30, 2002

i, too graduated in may 2001. my first nursing job is in the icu of a small community hospital (

it has been almost a year since you've graduated. do you still feel the same way? i think what has helped me is the fact that i was a nursing assistant before becoming a nurse. another thing that may help is making a list of things to do and crossing them off as they are completed.

please feel free to contact me at [email protected] .

blitz · Apr 2, 2002

Hello,

Boy, do I understand where you're coming from! I've been a nurse for 15 years, with experience in everything from OR to oral surgery and Psych. Not much floor experience, in other words. Two years ago, I took the plunge, took a 12 week critical care course and started on the ICU. Like you, I had my butt kicked from one end of the unit to the other, from doctors and co-workers. I cried on the way home many nights and feared going to work the next morning. It is now 2 years and two hospitals later. Not all nurses eat their young, fortunately. The first place was hell, and I felt like a third elbow, just in the way and thrown to the wolves. I am now in a smaller city hospital. I enjoy my coworkers and the resulting comraderie. I am only starting to feel comfortable in this end of the spectrum and have discovered that 90% of the nurses I work with also have the same fears and doubts about themselves. Never be afraid to ask questions, and, as the previous poster said, find someone on the unit that you can talk to. Have heart; over time it does become easier and you will gain confidence in yourself and your judgment. Above all, know that you will make a difference to someone.

Best,

maizey · Aug 22, 2002

I worked OB for 7 years and then med surg for 15 years. Five weeks ago I accepted a position in a CCU. Oh my goodness, have I second guessed myself for making this decision. I feel like a brand new nurse. I'm scared to death. I have to go back tomorrow and my stomach is in knots. I am reading everything I can get my hands on and studying so I will understand what I am doing. Everyone tells me I will be fine and that it takes time but I am questioning myself for this decision.