Excited? Now Nervous!

[StudentOfHealing]

Hi AN... as many of you know I'm beginning my ICU & ER rotations soon... very soon... like June soon...!

I'm excited but I'm nervous about assessments. I know or can imagine that in critical care the nursing assessments are paramount to the possible recovery of the patient with the collaboration of the entire healthcare team.

My question? I really don't know.... here's the story:

My instructor is a Nurse Practitioner and he's THE health assessment Go-To at our school.... I'm soooo happy about that... because I want to learn BUT... I'm a little nervous.

can you describe to me how you conduct/or conducted your assessments in the ICU?

I feel things will be different with all the vents and machines in contrast with medsurg.

Forgive my grammar, spelling, and typos... I'm on a mobile device.

[Esme12, ASN, BSN, RN]

Be systematic.....Just like anything else....ABC...Head to toe.

Never forget to introduce yourself and to ask (if alert) how they are feeling!

Make sure your patient has a open airway, is being oxygenated/ventilated with the right device/vent settings. That the ETT is secure and taped at the lip at what number. Check that your invasive devices are not hemorrhaging in the bed. Check any devices/NGT that is around the face.

Now head to toe....color, pupils, LOC, lungs, ventilation equal chest expansion, heart tones, abdomen NGT, pulses/circulation, edema, LOC commands, are they breathing? Are they safe?

Check equipment like the monitors, IV's and gtts...correct gtt and infusion rates....any due to be changed?, zero/calibrate lines, check meds, tubing dates, drsg dates...any due to be changed?

Head to toe....systematically. If you need help...we are here ((HUGS))

[Luckyyou, BSN, RN]

Don't forget to check your monitor limits too!

[BSNbeauty, BSN, RN]

You've gotten great advice so far! I have some too ( I used to be a CVICU nurse). If you have questions ASK. No question is a stupid question. If your patient just isn't looking right but you cannot put your finger on it than ask another seasoned nurse.

Buy a good critical care reference guide. This helped me tremendously ! Always look at your patient and don't rely on the monitors. While monitors are very helpful in the Critical care setting they can also be very deceiving. Always check the patient first !!!!! Don't ignore alarms. That was my biggest pet peeve when nurses ignored vent alarms. Don't do it!!!!

Good luck and keep us posted. I loved critical care! You will learn so much, most intensavists are brilliant !

[StudentOfHealing]

Thanks to all!

[ktliz]

Google "the new nurse podcast." She has a great podcast on critical care assessments. ICUfaqs.org is super helpful also. I don't remember them having a tutorial for assessment specifically but it's a great site overall.