Changing to ICU

The ICU is a very fast paced environment. You will see a lot of patients that you are seeing in the the rehab facilities. Although you have 1-2 patients, you still won't have a lot of time to dedicate to patient family as your day is many times consumed by tasks, roadtrips, total care, labs, calling pharmacy, calling MDs with critical values, etc. For the sick patients, you will be calculating medications, on a half hour/hourly basis, sometimes even more frequently. You will start to learn the subtle changes, how to respond to ABGs/VBGs that are abnormal, or finally WNL, learning to titrate drips, advocating for appropriate sedation, or specific consults. You will be educating about meeication, treatments, there will be days when you wished you could have spent more time with your patients.

It sounds like you have a great background, that rehab has made you familiar with trachs and vents and neuro assessments which are so important. Multitasking will be very important as well as setting priorities. Some days, just be thankful all the meds got in on time and your patient is still alive.

On the positive side, it is great when the patient you have had the past several shifts, is finally starting to respond to therapy. There is a lot of team work because you will need 3-4 people to help turn/bathe/change your patient, someone always knows something more than you or has read something new, or attended a conference with interesting information.