Feeling overwhelmed

Specialties Critical

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Specializes in Critical Care.

I'm a registered nurse with 2 years experience. I've recently made the move the ICU and I feel like a new grad nurse all over again.

On the floor I'm able to anticipate, act, and even recommend to the baby doctors.

Here, I can't even remember to remind the team to give me n X-ray order to clear a line! Why??? On the floor this would never happen to me.

Today I didn't get to chart my assessments until 6pm.

I feel so confused as far as time management and priorities. Sure you can tell me... Make sure everyone's alive but we all know it's more complex.

Priorities in critical care are a bit different than the floor.

This is the 2nd time in a row (with same patients) that my charting is not done until after shift change and that I don't get lunch- I don't mind no lunch break but I'm just trying to quantify how It is.

On the other hand I do enjoy the ICU. Learning about the drips and the sedation. The end goal of ICU vs the floor. I just feel likes I'm so slow right now and I keep stopping to think and think and think.

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Specializes in Ortho.

You'll feel different a year from now and it'll be all routine. Hang in there. I'm glad you like it

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Specializes in Critical Care.

Thanks. Feeling much better today. Had a CABG learned so much. (;

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Specializes in ICU, CVICU, E.R..

Knowledge and education is power! This power will give you the confidence and skill set to overcome your fear in the ICU.

This website on ACLS algorithms will help you master the basic foundation of critical care.

https://ACLS-algorithms.com/

Then take your CCRN.

I guarantee you will have the confidence to run a Code Blue without an MD present. You will be able to anticipate patient needs way before they decompensate.

Do not rely solely on your bedside ICU experience alone. You need to arm yourself with education.

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Specializes in Critical Care.
Pheebz777 said:

Knowledge and education is power! This power will give you the confidence and skill set to overcome your fear in the ICU.

This website on ACLS algorithms will help you master the basic foundation of critical care.

https://ACLS-algorithms.com/

Then take your CCRN.

I guarantee you will have the confidence to run a Code Blue without an MD present. You will be able to anticipate patient needs way before they decompensate.

Do not rely solely on your bedside ICU experience alone. You need to arm yourself with education.

Thank you so much. You are definitely right. I am equipping myself with all sources of knowledge. I have downloaded an amazing app that has the basics such as drip ranges, pharmacology of basic ICU drips/emergency meds, it even has the entire ACLS algorithm and it only cost me 10 bucks.

I'm also on the hunt for some gently used ICU books either ICU for dummies or CCRN study books. My unit has one but I want one to have my own highlight, color, underline, and write questions for myself.

I am a HUGE fan of pathophysiology and pharmacology and the sciences in general, so it is good to hear that arming myself with knowledge can bring some comfort and confidence to my new practice as an ICU RN.

Message me anytime to discuss ICU topics, I'm always down for that! ? and I'm eager to learn.

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Specializes in ICU, CVICU, E.R..

That ACLS website I posted has a bunch of megacode scenarios which both multiple choice and videos which will really get you familiar with all the ACLS meds, prioritizing, interventions for the different cardiac rythms. I've read multiple ACLS books in the past but nothing really boosted my knowledge more than that website.

There's a small payment to fully access the site but the good news is that you can share it with multiple users at the same time! Just give them the username and password and they have access to the site as well. 4 of us at work split the payment and we all tried it at the same time.

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I'm right there with you. I've been on a cardiac floor for 4 years, knew my sh*t, advised Drs on what orders they should give, was a preceptor for new RNs, charge nurse almost every night...then I decided to transfer to ICU about a month ago to challenge myself & a challenge it has been. I feel like a brand new nurse...slowly getting the hang of it & educating myself. Try the app scribd. It has books, PDFs, all kinds of stuff. I've got a lot of stuff off of there.

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Specializes in Cardiac/Transplant ICU, Critical Care.

Hey brother, we have all been in that situation, but admitting and knowing your limitations is a step in the right direction to working on becoming better. When it comes to charting, get your vitals, Is & Os, and drips in because that information directly affects the team's plan of care. The other stuff (Braden, CAM, pt education, even assessments) you can do later or even after your shift, lord knows I used to do that all the time when I started.

One thing you can do is assess the situation, identify the problem, get all the information the MDs need to make a decision and follow the normal/standard algorithms of care i.e. "oh noes they are in rapid afib with RVR and are getting hypotensive! Better order that amio bolus, and drip, get stat gas and chem with mg++, phos, order that stat ekg, and get some fluid and levo ready depending on how low their BP is and wait for the team to "officially" make their decision.

Preparation is more than half of the battle IMHO. I made a video on pressors a while back that was meant as a review for seasoned Critical Care Nurses as well as newer ones. Hope it helps! [video=youtube;hiI-8GV-kBk]

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Specializes in Critical Care.

OMG thank YOU so much for sharing this.

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Specializes in ICU, Postpartum, Onc, PACU.
CardiacDork said:
Thank you so much. You are definitely right. I am equipping myself with all sources of knowledge. I have downloaded an amazing app that has the basics such as drip ranges, pharmacology of basic ICU drips/emergency meds, it even has the entire ACLS algorithm and it only cost me 10 bucks.

I'm also on the hunt for some gently used ICU books either ICU for dummies or CCRN study books. My unit has one but I want one to have my own highlight, color, underline, and write questions for myself.

I am a HUGE fan of pathophysiology and pharmacology and the sciences in general, so it is good to hear that arming myself with knowledge can bring some comfort and confidence to my new practice as an ICU RN.

Message me anytime to discuss ICU topics, I'm always down for that! ? and I'm eager to learn.

AACN Certification and Core Review for High Acuity and Critical Care

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Specializes in ICU, Postpartum, Onc, PACU.

I think that the reason you're forgetting the "little things" (which are important, don't get me wrong!) is that you're freaking yourself out too much. I'm not talking down to you in any way because I used to do it all the time and still start on that path sometimes if I get a really complex patient and let myself get carried away. You've said it already: you know what to do on the floor. The same disease processes happen in the ICU, just more intensely and frequently. You're now at the step BEFORE the patient would have gotten to you out there and it's scary when you first start out. You'd be crazy if you weren't having some sort of angst right now, but try to not let it get to you and impede your work. It's completely natural and the sooner you realize you'll never EVER know everything and will always be learning (I mean really internalize it and come to grips with it haha), the better time you'll have. Sounds like you're doing well and keep on truckin', newbie! xo

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