Critical Care Unit

Nurses General Nursing

Published

Specializes in Medical Surgical.

Hello everyone, 

I will soon start working 12 hour shifts in a small Critical Care Unit in a small tiny (critical access hospital). 
I have no prior experience in critical care so this is a big change for me. 
1. What tips do you have for 12 hour shifts? 
2. If you have experience in critical care, what books/resources/videos to learn? 
3. How long did you study to get your Critical Care nurse certification? 

Thank you so much! 

ICU in a hospital you describe is not the same as ICU in a regional medical center or bigger. If you have a ventilated patient there for very long at all, I'd say it was because the decision to let them die has been made or there is something really wrong with moving them. You won't take care of really sick patients very often and even then not for very long as they will be transferred pretty quickly (or should be). 

 Get a copy of Critical Care Nursing and just start reading and so you can refer to it with specific questions. You'll know where to go from there.

Specializes in Vents, Telemetry, Home Care, Home infusion.

Check out the FAQ document list of topics written for new ICU nurses: Notes on ICU Nursing (www.icufaqs.org)  examples

  •  Starting Out - New in the ICU
  • Labs
  • Arrythmias
  • Pressors and Vasoactives
  • IVS for beginners
  • Blind suctioning for beginners
  • Vents and ABG's
  • Central Lines
  • Blo,od, Transfusions
  • NG Tubes for beginners
  • Defibrilation
  • Sedation and Paralytics
  • Med Tips

Best wishes learning this specialty.

Specializes in Medical Surgical.
On 10/8/2022 at 10:09 PM, offlabel said:

ICU in a hospital you describe is not the same as ICU in a regional medical center or bigger. If you have a ventilated patient there for very long at all, I'd say it was because the decision to let them die has been made or there is something really wrong with moving them. You won't take care of really sick patients very often and even then not for very long as they will be transferred pretty quickly (or should be). 

 Get a copy of Critical Care Nursing and just start reading and so you can refer to it with specific questions. You'll know where to go from there.

Thank you so much! You definitely seem to have a very clear idea of the dynamics of an ICU unit in a critical access hospital. Everything you said was absolutely right! 
For the most part, I am concern that the unit can sometimes be “closed” or patients are not necessarily too sick to really learn critical nursing care. And on top of that working 12 hours in a slow unit can really drag time. 
 

During my interview, it was brought up that I will learn if I put in the work and initiative to learn. I can be asked to help around in the ED or other units. So, I will be definitely be getting out of my comfort zone which is Med-Surg. 
 

On 10/9/2022 at 5:30 PM, NRSKarenRN said:

Check out the document list of topics written for new ICU nurses: Notes on ICU Nursing  examples

  •  Starting Out - New in the ICU
  • Labs
  • Arrythmias
  • Pressors and Vasoactives
  • IVS for beginners
  • Blind suctioning for beginners
  • Vents and ABG's
  • Central Lines
  • Blood Transfusions
  • NG Tubes for beginners
  • Defibrilation
  • Sedation and Paralytics
  • Med Tips

Best wishes learning this specialty.

Thank you so much for the link! 
I am very excited! Cannot thank you enough for the link to so much knowledge! 
;) 

Specializes in New Critical care NP, Critical care, Med-surg, LTC.

It sounds like ICU in a critical access hospital in many ways is more like an ED where you will be stabilizing for transfer in many cases. You will definitely get lots of experience with intubating patients, starting pressors, and other infusions like insulin, cardiac drips, giving tPA, etc. It sounds like a really good place to learn, but as you mentioned, 12 hours on slower days will go by very slowly. (That's really the case in any ICU that has some lower acuity patients thrown in) 

Nurse Karen gave you a lot of good resource information, there are also a few threads you could probably find on this board with tips. There are some great Youtube resources out there with free information.

As for the certification exam, you are eligible for CCRN after 1750 hours of critical care within two years. One thing you might find more challenging is that much of the CCRN exam is based on cardiac interventions and therapies that you may not be exposed to in your practice. Certainly people can pass certification exams with more theoretical knowledge than practical experience, there are good review books and courses for that exam. 

Good luck in your new position! 

Specializes in Medical Surgical.
On 10/11/2022 at 6:27 PM, JBMmom said:

It sounds like ICU in a critical access hospital in many ways is more like an ED where you will be stabilizing for transfer in many cases. You will definitely get lots of experience with intubating patients, starting pressors, and other infusions like insulin, cardiac drips, giving tPA, etc. It sounds like a really good place to learn, but as you mentioned, 12 hours on slower days will go by very slowly. (That's really the case in any ICU that has some lower acuity patients thrown in) 

Nurse Karen gave you a lot of good resource information, there are also a few threads you could probably find on this board with tips. There are some great Youtube resources out there with free information.

As for the certification exam, you are eligible for CCRN after 1750 hours of critical care within two years. One thing you might find more challenging is that much of the CCRN exam is based on cardiac interventions and therapies that you may not be exposed to in your practice. Certainly people can pass certification exams with more theoretical knowledge than practical experience, there are good review books and courses for that exam. 

Good luck in your new position! 

JBMmom,

Thank you so much for your excellent input and advice! I am hoping to learn as much as I can and if the unit is closed due to low census. Help around in another unit. 
I was thinking of applying to another Hospital for a per diem position in an ICU so I can see and learn more if they are willing to give me a good orientation and preceptorship. But I don’t know if they will be willing to take a nurse with little CCU experience for a per diem experience. 
 

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