New graduate and working in ICU

[prenfrow]

I graduated from nursing school in May and started in ICU in July. I'm about to begin my 6th week in orientation and I have learned so much. However, I'm overwhelmed with the thought of being on my own after 6 more weeks of orientation. I feel so disorganized and wonder if I will ever get all there is to know. I'm nervous about rounding with doctors and having to give them report on my patients. Any tips on how to start your day and help me stay on task!?

Thanks!!!

[Okami_CCRN, BSN, RN]

I'm also a new graduate in the ICU, started in April and this is my first week on my own. When I was on orientation during the day shift the first thing I would do when I walked in was print my patients tele strips and do my measurements. I would then take report and once that was done I would assess my most critical patient first do any high priority things and then see my second more stable patient. Usually I was done with this by 8:30am, which usually put me right on time with rounds. I would listen in on rounds and let them know what I needed for this patient and then I would give meds, turn, chest PT, etc.

Sometimes this wasn't always feasible, especially if I had to go to a STAT CT or my patient had to go to OR. The biggest thing I took out of orientation besides knowing how to care for a critically ill patient was prioritization. Can this wait? Could I delegate this out? Also know when you are drowning and ask for help. My preceptor was fabulous at knowing when I needed to be helped and when she could let me be alone. Always speak for yourself and if you need more time on orientation dont be afraid to ask.

[hawaiicarl, BSN, RN]

There are different schools of thought on whether new grads should go into ICU. Some say they should go to medsurg/tele first to learn organizational skills. Others say to ICU first so we don't have to break any bad habits they learned on the floor. I have oriented new grads to ICU in a couple of hospitals, one thing I would recommend is asking for a schedule buddy who will be your mentor. After orientation there will still be a million questions you want to ask, at our facility we try to have the new grad on the same schedule as their preceptor for up to a year after orientation is over exactly for that. Don't expect to ever know everything, technology and EBP assure that what you know this year will be different next year, so stay flexible, and ready for change.

Cheers​