Critical Care Clinicals

[1969]

Starting 3rd semester next month. Expecting critical care, emergency, and psych. Any suggestions on prepping for the cc clinicals? Little bit nervous about it. I just want to do well, you know?

[foreverLaur]

What type of critical care setting will it be? MICU, SICU, TICU, CCU/CVICU, step-down, etc...

[NCRNMDM, ASN, RN]

What type of critical care unit will you be in? My mom currently works in CVICU caring for post-open heart surgeries, lung surgeries, transplants, vascular surgeries, etc. Before that she worked in a medical/surgical ICU which cared for a ton of different diagnoses and surgical procedures (except heart surgeries). From what I hear her say, from my own experience volunteering and doing CNA work, and from my knowledge through nursing school, I can tell you that these two units are drastically different. Being experienced in medical ICU won't really help you all that much if you go to CVICU, or another highly specialized ICU (for instance, burn ICU or trauma ICU). The patient's preexisting medical conditions certainly play a part in the care in these units, but they are not the primary reason for the admission.

In any critical care setting, you should be prepared to see arterial lines, tons of peripheral lines, vasoactive drips, ventilators, foley catheters, cardiac monitors, tracheostomy patients, etc. If you are going to a specialized unit, like CVICU, expect to see balloon pumps, PA lines, chest tubes, hemovac drains, JP drains, NG tubes, tons of IV medications, PA lines, cardioPAT systems, etc. If you are going to neuro ICU, be prepared for ICP bolts, ventriculostomy drains, and other equipment. Surgical ICU will be filled with drains, tubes, vasoactive drips, etc. Trauma ICU is an interesting environment, and each patient will be different. Some may be trauma surgeries, some may be traumas without surgery, etc. The equipment you see in trauma ICU really varies from patient to patient. Nearly every trauma ICU has, and regularly makes use of, the level one rapid infuser. If you don't know what this is, look it up and learn the basics of it and what it does. Most importantly, good luck, have fun, and learn. I love critical care, and I can't wait to become an ICU nurse!

[1969]

I think it's your basic hospital ICU ~ Kaiser to be exact if that helps ~ Fontana, CA

[NCRNMDM, ASN, RN]

In a basic medical ICU, you will see DKA, HHNK, CHF, COPD, respiratory failure, asthma exacerbation, sepsis, ARDS, acute and chronic renal failure, hypertension, hypotension, drug overdose, GI bleed, post cardiac arrest patients, pneumonia, hypoglycemia, hypokalemia, hyperkalemia, hypernatremia, hyponatremia, and other electrolyte imbalances, respiratory alkalosis and acidosis, metabolic alkalosis and acidosis, hypovolemia, hypervolemia, etc. Think of the things you saw on medical floors, and magnify the level of criticality by ten or twenty. If the hospital is a trauma center, and I mean a level II or I center, then you will see even sicker patients. If your facility is a level III trauma center, or isn't a trauma center, then the really acutely ill patients will be flown to an outlying facility and you will be left with the remainder. Medical ICU is a place where you can learn a lot, and I think it's a fun environment. I love surgical and trauma patients, so I want to be a surgical/trauma ICU nurse, but I would also enjoy MICU. Good luck!