Going from SDU to ICU at a different hospital. Anyone else done this?

[RNDude2012]

Hello!

I currently work full-time in an SDU/PCU unit. I've been there for three years. We have a 1:3 ratio. Next month I start in a 20 bed MICU at a different hospital which is a large teaching/tertiary/trauma hospital. This MICU is essentially connected to a 20 bed SICU, so they share a lot of the same patients. I was told I will see a lot of sepsis, ARDS, CHF, ventriculostomies, MVAs, GSWs, CVP, and occassional PA caths (although somewhat rare). I'm going to get 8-12 weeks of orientation depending on how I adapt, along with a CC course.

While I feel like I had SDU down to the tee, I have to admit, I am nervous, but I'm super excited. I have floated to the ICU at the hospital I work at quite a bit, but they would always give me the more stable patients who are usually going to be transferred out the next day. I've seriously only had two stable vented patients, and the rare nontitratable cardiac gtt. I'm super excited about the learning experience I'm going to get. I was told if I can hang in this ICU I can hang pretty much anywhere.

I've already started studying ICUFAQs. Not sure how relevant the info still is (for instance they say neosynephrine is the #1 gtt for sepsis while most people I talk to say levophed is usually used as a first line drug). I have my hemodynamics memorized, and at this point I feel like I just need to start working already to apply the info. Anything else I can study that will be helpful? My goal is to just be the most coachable orientee possible. Pretend like I'm a new grad. I figure I will learn more that way. I don't want to be that nurse who pretends like they know it all. I just want to learn as much as possible, and make the transition as smooth as possible. I generally am a fast learner though. I do have a PRN job and have experience working agency, so I'm used to stepping out of my comfort zone. I feel like I'm moving up to the big leagues though, so naturally I am a little nervous. Failure is NOT an option though, and I'm even taking a small pay cut to work here.

Any other former SDU nurses transfer to ICU? Any tips?

Thanks!

[Esme12, ASN, BSN, RN]

First line drugs...in my experience...vary by facility. ICUFAQ's are pretty accurate when talking about lines and vents...basic but necessary stuff.

Here are some helpful and infomative links

[h=3]Welcome to Critical Care Medicine Tutorials[/h]

Free Critical Care Guidelines and Educational Resources

Links | Critical Care Medicine - McGill University

Grogono's Acid-Base Tutorial

Critical Care Education - Relevant ICU Web Links

[emilyewrn]

Didn't come from a step-down, but went from a year of surg-tele experience to a SICU in a level I trauma. You're definitely on the right track by saying you want to be the most coachable orientee. Many of the experienced ICU nurses I work with have commented that the worst quality in a new hire is acting like they know everything or not being open to learning new things. Ask tons of questions! Once you have a good foundation (i.e. you feel comfortable with critical care pharmacology, understand the basics of mechanical ventilation, etc.), I recommend seeking new experiences. That may mean taking the sickest patient on the unit, or taking a type of patient you have not cared for before. Do this on orientation, but also do this off orientation which you are working with strong, experienced ICU nurses who you know will support you and offer you guidance as needed. Lastly, I highly highly recommend the pass CCRN book if you are looking for outside resources. It offers concise, but very pertinent information on different critical care disease processes, their patho, their presentations, their treatments, etc. It's very up to date. Great purchase if you plan on taking CCRN eventually anyways. It helped me a lot, I would go home after my shift and look up whatever issues my patient(s) that day had.

[RNDude2012]

Thank you so much Esme and Emily. Very good resources and advice. I'm actually going to purchase the pass CCRN book tomorrow :)

[Mully]

I did the same thing you are. It was a very smooth transition for me and I think you're doing all the right things. Good luck and have fun! ICU nursing is my favorite type of nursing.

[RNDude2012]

I just wanted to say thanks again to everybody. I'm loving critical care, and the transition has been really smooth, and I'm really enjoying it. I wish I did this sooner.