Tips for New Grad offered ICU position

  1. Hi, I have been offered a position for ICU nights. I am a new grad, and even though this is something I have wanted, and was chosen for after my interview, now I am nervous about how I am going to do. Does anyone have any advice/tips etc. about what a new grad should or needs to know going into the ICU? Or specific things I should be brushing up on? Any advice would be really appreciated. I have read other reviews of new grad orientation being 5+ months long.. my "new grad orientation" consists of 1 week general nursing orientation of the hospital, and then 8-12 wks on the floor with a preceptor. I think that short time is something that is making me nervous too just because it seems other facilities have longer programs.. Anyway, any help would be greatly appreciated! TIA
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    About gmsal971

    Joined: Feb '18; Posts: 3
    Specialty: 1 year(s) of experience

    12 Comments

  3. by   PeakRN
    Think critically, use your team for help. Know your emergency drugs like the back of your hand. Know your ACLS pathways. Buy the ICU book and the ventilator book by marino, if your facility pays for uptodate is amazing.
  4. by   gmsal971
    thank you so much for the advice!
  5. by   YUKONrn
    Good way to start. The nurse to patient ratio is low and you will be surrounded by very seasoned nurses should something come up. You will learn a lot.
  6. by   YUKONrn
    Look up "setting up and calibrating arterial lines", "ET tubes and Mechanical ventilators", "titrating vasopressors and cardiac drips", there is so much more it all depends on what kind of ICU you will be working in. Oh and start studying cardiac arrhythmias, how to recognize and treat them.
  7. by   Rocknurse
    This site will be a really good resource for you:

    index
    ICU faqs

    Also, use YouTube videos for certain concepts. There's a ton of really good information on there.
  8. by   Crush
    Quote from PeakRN
    Think critically, use your team for help. Know your emergency drugs like the back of your hand. Know your ACLS pathways. Buy the ICU book and the ventilator book by marino, if your facility pays for uptodate is amazing.
    Quote from Rocknurse
    This site will be a really good resource for you:

    index
    ICU faqs

    Also, use YouTube videos for certain concepts. There's a ton of really good information on there.
    I would agree with these tips. Be open in your learning and proactive. When you run across something you either don't know or are not sure of, ask your preceptor and/or find a YouTube video of the skill or concept and reach out to nursing education. There is also under nursing specialties as segment here for ICU nurses that would be a good place to read.

    Best of luck to you. Use the lower patient ratios as an opportunity to have a great connection both with the patient and their family.
  9. by   MrNurse(x2)
    Probably would have told you to go for it twenty years ago, but... given the new relationship employers have with new grads, I would encourage you to put this great opportunity on hold. This is a career, not a job. You will get more of these opportunities. You may be avoiding a huge disappointment. This is what I wrote about employer attitudes toward new grads. I feel like I am sharing this to death, but it really tells you the real picture of what you are entering into.
    Welcome New Grads!
  10. by   Rocknurse
    Quote from MrNurse(x2)
    Probably would have told you to go for it twenty years ago, but... given the new relationship employers have with new grads, I would encourage you to put this great opportunity on hold. This is a career, not a job. You will get more of these opportunities. You may be avoiding a huge disappointment. This is what I wrote about employer attitudes toward new grads. I feel like I am sharing this to death, but it really tells you the real picture of what you are entering into.
    Welcome New Grads!
    I disagree with this and think it's unfair to try to get someone not to take up an opportunity. I have found in my 28 years of nursing that it's mostly all about the new grad's attitude and aptitude. If you want to succeed you will. We take on new grads all the time in our ICU, and they get a very thorough orientation in our new grad program. Most of them have been extremely successful and several of them have gone on to grad school. Just be open, want to learn, be proactive, ask questions and be able to get along with people. You'll be fine.
  11. by   MrNurse(x2)
    Quote from Rocknurse
    I disagree with this and think it's unfair to try to get someone not to take up an opportunity. I have found in my 28 years of nursing that it's mostly all about the new grad's attitude and aptitude. If you want to succeed you will. We take on new grads all the time in our ICU, and they get a very thorough orientation in our new grad program. Most of them have been extremely successful and several of them have gone on to grad school. Just be open, want to learn, be proactive, ask questions and be able to get along with people. You'll be fine.
    There must be a few employers out there that have a long sighted view, but under three different managements, as well as friends at other hospitals in the area, most are short sighted and do short the educational aspect of training new grads. I wanted to give the OP the overview of employers in my major market, one of the most competitive medical communities in the country.
  12. by   Crush
    Certainly w/ most newer grads, the 1-2 years of general med-surg is probably the best route to go especially if one does not have a particular specialty in mind. However, there are some who are able to start out in a specialty and flourish there. It should be a case by case thing.
  13. by   PeakRN
    Quote from MrNurse(x2)
    Probably would have told you to go for it twenty years ago, but... given the new relationship employers have with new grads, I would encourage you to put this great opportunity on hold.
    Quote from Crush
    Certainly w/ most newer grads, the 1-2 years of general med-surg is probably the best route to go especially if one does not have a particular specialty in mind.
    My opinion is very different from these. I think that med/surg teaches you how to be a med/surge nurse. How you assess patients, make decisions, given medications, manage social situations, structure your day, et cetera is very different from the unit and the floor. Unfortunately nursing school doesn't do a great job of teaching ICU/PICU/NICU/L&D/ED/OR so there are often new grads who are not a great fit in these positions and end up back in med/surg, but that is not because time in med/surg would have prepared them better. Even among the floors there is a huge variety in what skill set nurses have, I wouldn't expect a nurse from our neuro floor to be able to go work on the BMT or solid organ transplant floors.

    If you want to be in the ICU and you have a chance to be there, go for it! It is easier to teach new grads the right way out of school than to try to break old habits. And if you have a chance to get what you want why would you take anything else?
  14. by   KKEGS
    I started as a new grad in the NICU and had about 14 weeks total orientation but they divided it into 2 "sections." I started off with the bigger, more stable babies (about 6 weeks of orientation) and then did a second round of orientation with the critical care babies (about 8 weeks).

    Pay attention. Ask questions. Seek out new learning opportunities. Hopefully you'll have a good preceptor who will ask around the unit to see if there is anything interesting going on like IV starts, intubations, hanging blood products, etc.

    Good luck! You'll learn so much!

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