New grad on step down icu unit

Specialties Critical

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I am a new grad and have accepted an offer on a step down icu unit and want advice on what to expect and tips from anyone with experience in this area... and if transfer to icu later on was easy?

You can expect to see anything, and everything! It sounds simplistic, but you really will have the opportunity to see a wide variety of problems (which makes those review of systems cramming you may have done for NCLEX very much worth it). We see a lot of CHF, COPD, sepsis, arrhythmias, electrolyte imbalances, and the ever present "altered mental status"....as a "passing through" area, we are often the halfway point between ICU and home, or between the ED to the ICU at times. It has been a great starting point for many of our ICU nurses as it gives you a good foundation (those system reviews again) and helps sharpen your assessment and that nursing intuition. Almost two years in and I'm still seeing new things and learning all the time. Congratulations!

Specializes in ICU, PACU.

Step down like telemetry? Expect to know chest tubes, stable drips like NTG, cardizem, dopamine,Heparin, dobutamine. EKG rhythms, pulling sheaths if Cardiothoracic, cardiac oral drug classifications. Top that off with general med-surg stuff like foleys, ductioning, NGT...

Thanks AmyRN303 and ruthbaltes I cant wait to get started !

On the topic of of step down units like intermediate care, what are people's position on starting off on a cardiac intermediate care vs a medical intermediate care unit?? Please and thank you.

I dont know how your step down is, but the one I was in most of the time did not have patients hooked to monitors. That mean you will have to know and see if/when your patient begins to deteriorate. Since you wont have a hundred bells calling you to alarm you when that happens, you will need to have great assessing skills. One advice is to not take a step down lightly. A lot of times, the patients there are still very sick, just means that someone was a little sicker that needed the bed in the icu.

Best of luck!

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