Gave Meds For The First Time In the ICU

[NewTexasRN]

I'm a senior and it's really been a year since I've given IV medications. Last semester in the fall I had psych, peds and OB and I only gave p.o. meds in pysch. So, today was my first day giving meds in the ICU and all my meds were IV meds because my pt was intubated! Wow, I know it's normal, but I feel soooooo incompetent. I'm actually crying right now! I knew nothing! It was like IV meds 101. My instructor was very kind and patient with me as we figured out how to reconstitute my meds, prime everything, flush the lines and hang my piggy backs! Plus she's a real stickler about saving ALL the caps without contaminating them. It's intimidating because she's telling me that I should know how to do almost everything next week. Have you guys ever had one of those days?

To make it worse my classmate who is my partner has more experience with IV's so my instructor was telling me that I should take pointers from her. I know that at some point we were all beginners, but God I feel like an idiot! Maybe I'm beating my self up too much it's just how I feel.

[powlwe]

I know it's easy to say, but don't feel bad. I felt totally clueless the first time I gave IV meds. It took me a while to adjust from doing IVs in the nursing lab vs. actually performing on a patient AND my instructor!! I graduated in Dec. and I can honestly say that I still don't feel 100% confident! It takes time. At least you have a rotation in an ICU setting where you gain a wealth of knowledge working with all types of equipment. My school did not provide an opportunity to do this. Remember, take advantage of everything you can learn while you are a student. I'm wishing I could have gained more experience working with IVs as I am now beginning to look for employment!! Try to get more patient's with IVs/IV meds. Let your instructor know that this is area that you want to strengthen and that this is a goal for yourself this semester. Best of luck you!! I know that you will get the "hang" of it :wink2:!

[cak1219]

I'm sorry that your first ICU experience wasn't great - but just keep in mind - administering IV medication is a technical skill that is mastered with practice. It is not an indicator of intelligence. First, just remember the steps that your instructor taught you. Practice, practice, practice. Remember, aseptic technique. Swab swab thouse ports (if you think you contaminated something, swab them again or get another flush, etc. - don't want to give your patient an infection). Then - flush, give medication, flush, and clamp line. Acronym SAS or SASH.

Periph Line:

S -Saline flush

A - Administer

S - Saline flush

Central line:

S - Saline flush

A - Administer

S - Saline flush

H - Heparin.

Don't focus too much on the technical skills only though. Critical care nursing is about advance critical care THINKING not technical skills. Impress your instructor with your knowledge about the drugs and this will leave a lasting impression. Take the wonderful learning experience that the ICU provides and don't focus too much on this. I know your next clinical will be better :)

[NewTexasRN]

Well, first, thank you cak1219 for your encouragement. In the ICU we are are actually paired up with another student. Unfortunately, my buddy is an EMT and she did an externship over the summer that gave her tons of experience with IV meds so she gave meds the first day and I did on the second day of clinical. So my instructor was basically telling me that I should take pointers from her. The following day my instructor ended up apologizing to me. She basically said my classmate had more experience than me and I actually did pretty well for the first time in a year. I feel better now because obviously my classmate had more experience than me and it's not fair to compare me to her. So, yes you are sooo right. It's more of a technical skill rather than a sign of intelligence. Practice, practice, practice and I'll get there. Thank you for your encouragement.

[WDWpixieRN, RN]

Everyone's experiences and exposure to skills will be different while you're in school. Take heart that there's no way too much of anyone comes out totally competent and ready to hit a floor as an experienced RN.

I've been out of school since last May and everyday is still a new learning experience. Thank God for the patient and willing nurses on floors who are able to help all of us "incompetents", lol.

You will be fine!!