New ICU position, little orientation?

[RNexplorer]

I just got a PRN position in an ICU (smaller hospital, approximately 250 beds or so). I am thrilled because critical care nursing is where I want to be! However, I am very concerned about the lack of orientation. At first, I was told to come in 2 to 3 hours before my shift started. I can't help but feel nervous, especially when I hear that the norm for ICU is a month of orientation... or MORE! I don't want to risk losing my new job, but I also want to ensure safety..

Therefore, I asked my employer if I could have a full buddy shift. I was granted the full buddy shift, but I'm still feeling nervous about this whole thing!!

Please note: My employer is already aware that I have had NO experience in the ICU other than a little experience with trachs and vents. I have started reviewing how to care for a mechanically ventilated patient, but I am worried that there are many new skills and procedures that I will need to review!

So.. I really need some advice. What kinds of things should I be studying? How can I make my buddy shift as effective as possible? How can I ensure patient safety and success in this field??

[87RN]

You have no ICU experience and your orientation is one day? Seriously, try not to kill somebody. You need to know your vasoactive drips, sedation and paralysis meds, insulin drips, ACLS, how to prepare for and manage art lines, central lines, PA catheters, ventilators/bipaps, ekg interpretation and so much more. If it were me, I would not accept a position without the proper training. You are putting your license at risk as well as patients lives!

[AmyRN303, BSN, RN]

No orientation at all????

[RNexplorer]

I do have one buddy shift... Who knows? Maybe it's not a real ICU? If I don't feel comfortable in the environment, I'll definitely speak up. I don't want to put patient's lives at risk, that's for sure!

[RNexplorer]

You have no ICU experience and your orientation is one day? Seriously, try not to kill somebody. You need to know your vasoactive drips, sedation and paralysis meds, insulin drips, ACLS, how to prepare for and manage art lines, central lines, PA catheters, ventilators/bipaps, ekg interpretation and so much more. If it were me, I would not accept a position without the proper training. You are putting your license at risk as well as patients lives!

I've done ACLS 3 times and I can interpret ECGs. I've had some experience with ventilators and trachs. I know my vasopressor drugs, sedatives and paralytics... I'm comfortable with insulin drips. But I think you are right. There's still so much to learn! Depending on the nature of the ICU, I will probably have to step down from the job... which is really a shame!

[RNexplorer]

How much orientation does an RN generally need when working in a LTAC ICU? After doing some more research, I realize this facility is LTAC...

Advice needed!! I just want to do what's best for my patients and also for my career. I really think this PRN experience could be a great learning opportunity and help me transition to a regular ICU.