Considering Critical Care

BULLYDAWGRN, RN · Oct 11, 2007

congrats on the consideration to move. i can give you a few tips though i'm not a expert or have many yrs in the icu, but these have worked for me. consentrate on your basic fundamentals of icu nsg, your basic rhythms, review acls, and assessment, assessment and assessment. i've found in my short career that a mythotical approach to pt assessment and freq assessment of the patient has saved the patients butt (ass well as mine) on a few occassions. soon thereafter you'll be able to pick up on little subtle changes in your patient that very well could turn into a all out contastrofe. icu is a awsome place to learn about nursing and the dynamics of acute pt care. don't worry about picking up all the fancy icu stuff in the begining, that cool stuff will come to you plenty in the near future and you'll be the "old salt" helping the new folks in the unit. hope this helps, good luck.

CarVsTree · Oct 14, 2007

Looking for some feedback. I am currently an RN on a Med-Surg specially floor. I work with primarily Trauma/Ortho patients, and now I am considering a move to the ICU. Shock Truma we are a level 1 trauma center and I am truly loving my time with the stable trauma patient and looking for an up-grade to something more critical. Always been drawn to Critical Care, just wanted some experience first. Just looking for some helpful advice to the move from the big move from pulse ox's to vents, single blood pressure cuff to a-lines.
Going to shadow a day first to make sure it's what I want, before I drive in head first.
Thanks

Good question! I work in a transitional trauma unit in a level 1 TC. We have 4 low level cc beds and 26 trauma/tele. I make the move to CC in November. I'm excited and anxious at the same time.

deeDawntee, RN · Oct 14, 2007

First of all, I would caution you not to look at ICU as an "up-grade" because you will soon see that though it entails a distinct set of nursing skills and abilities, your basic good nursing assessment and skills are what is at the core of what you will be doing. It is best not to see yourself going to a "better" area, because, believe me, it will make you humble real fast. There are strong and weak nurses everywhere and just because a nurse works in the ICU does not make them superior. I know that is not what you said, but I had to address that!

ICU nursing is just that, a specialized set of skills and abilities, once I understood that, working in the ICU became a lot easier for me. As soon as the patient no longer needed those particular nursing skills and assessments, they were transferred off to another unit. Hemodynamic lines and drips, Vent management and sedation, insulin drips, lumbar drains and ventrics....end stage organ failure managament etc. etc. etc.

Personally, I knew I eventually wanted to work in the ICU when I was in nursing school, but I did a lot of other areas on the way. I would highly encourage you to go for it, but if it turns out not to be for you, don't feel like you failed, because you certainly did not. We need strong nurses everywhere. Follow your heart and that inner voice and you will make the right choice for you!

Trauma Columnist · Oct 14, 2007

How cool! Good luck. I worked ICU about 15 years ago and loved it. Not as much as the ER, but definitely a close second.

RoxannMM · Oct 15, 2007

Thanks Deedawntee!

I deff. appericate your feedback. I most admit I myself in nursing school wanted to work in Critical Care unit but wanted to become more acustomed with my skills and assessments before. ALong with the put down from a follow classmate that made me feel inadequate. I think working where I am at now has helped me esp. in post-operative patients. Assessment skills are key esp. when your only ordered monitoring is BP-HR-RESP-SPO2-TEMP. It has helped me link my assessment to my vitals and dig deeper with my assessments when things aren't adding up. This continues on from acute post operative pt.'s to trauma transfer pt's. I have this constant need for more, like I want to be able to ask more question and get more answers just LEARN MORE. I love learning and be able to use my knowlegde as a clinician, to help my patients. I found that I have become very "anal" or so I am called by other nurses. I just like everything followed through and try my hardest to see that done. Sorry I hope this is not sounding like my plee to be in Critical care. Just trying to state where I am coming from.

This is in generally why I love being a nurse. I like to ask question and get the "that's a GREAT question" response. Or when things aren't followed through in thier entirety they respond with the "well need to look into that" or "well need to find that out." I just dig hard at the "we're not sure" or "we don't have that answer" responses. I don't like those answers I want TRUE backing answers.

I just hope others esp. new nurse like myself find the drive and continue to follow it and let in LED them to sucess.

EVERYONE PLEASE KEEP THE FEEDBACK COMING... Thanks ALL!

deeDawntee, RN · Oct 15, 2007

Thanks Deedawntee!
I deff. appericate your feedback. I most admit I myself in nursing school wanted to work in Critical Care unit but wanted to become more acustomed with my skills and assessments before. ALong with the put down from a follow classmate that made me feel inadequate. I think working where I am at now has helped me esp. in post-operative patients. Assessment skills are key esp. when your only ordered monitoring is BP-HR-RESP-SPO2-TEMP. It has helped me link my assessment to my vitals and dig deeper with my assessments when things aren't adding up. This continues on from acute post operative pt.'s to trauma transfer pt's. I have this constant need for more, like I want to be able to ask more question and get more answers just LEARN MORE. I love learning and be able to use my knowlegde as a clinician, to help my patients. I found that I have become very "anal" or so I am called by other nurses. I just like everything followed through and try my hardest to see that done. Sorry I hope this is not sounding like my plee to be in Critical care. Just trying to state where I am coming from.
This is in generally why I love being a nurse. I like to ask question and get the "that's a GREAT question" response. Or when things aren't followed through in thier entirety they respond with the "well need to look into that" or "well need to find that out." I just dig hard at the "we're not sure" or "we don't have that answer" responses. I don't like those answers I want TRUE backing answers.
I just hope others esp. new nurse like myself find the drive and continue to follow it and let in LED them to sucess.
EVERYONE PLEASE KEEP THE FEEDBACK COMING... Thanks ALL!

Oh yeah definitely!! You are on your way...sounds like you will LOVE critical care. Go for it!! What a great post!

RoxannMM · Oct 16, 2007

DeeDAWNtee,

Thanks AGAIN! I can't wait to shadow/observe next monday. I hope what I am expecting plus more. YAY, starthing to feel like a llittle kid who is waiting for christmas.

ESP. After my horrible night of work last night. I HATE COMPUTERS, but I can TRULY say even though I had a conflict with a co-worker last night my patient's got more than adequate care, and I got thanked by a OMF(Oral-Maxilo-Facial) Surgeon this morning for my good nursing care. That made me feel like "WOW, sometimes things just workout"

The other thing I forgot to comment on above it that I love to teach patient's and/or families. I think that you can be the smartest Doctor/Nurse/PA in the world and if you can't explain things for a patient and/or family to uderstand it's worthless. MY first Apperciation award was becasue I took the time to explain Hip precations for a family (mother and son) to the point where they could understand. Visually and verbally it made me feel like I would worth a million bucks.

PATIENT CARE FIRST... my living moto!