graduating and terrified! HELP!

begalli · May 26, 2005

Hi happyrh2!

Congratulations on your accomplishments!

I went straight to CVICU as a new grad too and now I precept new grads to the ICU! Let me assure you that with the proper support you CAN do it and feeling downright terrified is completely normal.

My official orientation lasted 3 months. This included classroom and shifts on the unit with my preceptor(s). Once I went into the unit count on my own there were ALWAYS other nurses very near-by to ask questions to and verify that I was doing okay. It's still that way many years later. ICU is a great team experience!

Some things that you might want to begin studying are drugs, specifically IV drips. You might want to get yourself an IV med book and look at Epinephrine, Dopamine, Nipride, Phenylephrine (Neo), and Nitroglycerin (that's a start). Start with what a particular drug does to blood pressure and then how it does what it does to the blood pressure (vasoconstrictor? vasodilator? learn about alpha and beta receptors and where these drugs act.). A good IV drug book is 2005 Intravenous Medications by Betty L. Gahart and Adreinne R. Nazareno.

You might also want to brush up on intrepreting abg's and exploring ventilator settings. Look at this thread for websites for practicing abg's.

Lastly, read all you can about hemodynamics. Preload, afterload, cardiac output/index, etc. But don't stress too much on this right away. Understanding the complexities of hemodynamics along with your assessment skills will come with time and practice. Don't expect too much of yourself too soon with this stuff!!

Most of all, just be a sponge and soak up all you can and ask lots of questions. If you're in a teaching facility, in addition to the nurses, most residents LOVE to answer questions (I think it's a good review for them as well :chuckle ). If they know you're new, they're usually happy to teach and remember there is NO dumb question!

If your unit takes hearts fresh from the OR, request to be present at as many as you can when the patient is wheeled in and during the initial stablization. Same for codes...if there's one, try to be there just to at least watch. Basically, if something interesting is happening...be there.

Hope this helps.

Good Luck, you're gonna LOVE it!!

Tweety, BSN, RN · May 26, 2005

Stay in the moment. Concentrate on school, the joy of graduation and the stress of NCLEX. Everything is going to fall into place and you'll be fantastic. Trust me. :)

pricklypear · May 26, 2005

:balloons: Congratulations!! It's totally normal to be terrified, whether you're going to ICU or anywhere. It's the people who aren't a little scared who you want to worry about! I work with a bunch of nurses who started in our ICU as new grads, and they have done great. They were well prepared by a critical care course as part of their orientation. When I first started in ICU, I used a little notebook to jot down little things like common drip rates, mixtures, stuff like that. Best of luck to you!!

PS Begalli - those ABG sites are great!!

Antikigirl, ASN, RN · May 26, 2005

It sounds funny, but one of my best nursing instructors told me when I expressed a bit of anxiety about being a nurse out in the huge world outside the doors of school, she told me this...

"You are a baby nurse till you are 5 years in, so don't worry too much...lots to learn, and you will learn it...go into that new adventure with a positive go get em attitude, learn as much as you can, and have some fun too! Call me year 5 so I can say I told you so! LOL!".

She was right! I graduated in 2000 and as of last week hit official year 5! I am still learning, but I think her words took some of the pressure off me. I didn't have to go from school to being a pro..that it would take time, and to embrace that and know it true to my heart! And frankly..I still see every day as a new day to learn, and that is something all my fellow nurses know (because I never feel stupid for asking a question or seeing something new!)!

Life is an journey..and I like to enjoy each mossy stone, each tree, and each new task along the way! I don't take on too much, and I certainly don't take too little!

Good luck and congrats! You really have things set up well for yourself!!!!!!!! AWESOME!!!!!!