ICU advice

[Rin nohara]

Hi, I am a new grad nurse in ICU. It is a small hospital with only 10 beds I guess, I love the nurses there. It is feels like family and everyone is so helpful. But it is not high acuity, most of our patients are med- surg or step-down. The patients' assignments are so easy, most of the patient is on Room air, not even on one IV drip.

I have been there for two months and It is boring, nothing critical care about it. I feel like I am not learning anything new. I did my nurse externship in a big hospital, I saw intubation, and 12 IV drips, and I am more interested in learning about critical care but the staff was snobby, overburn, and rude. In big hospital, I love the critical care, didn't like the stuff (not helpful for a new grad, I had one nurse told me to apply to a different unit because I am too dumb to be in ICU)  I don't know If I should apply to a different hospital or not? 

Thank you

[JBMmom, MSN, NP]

You have time. If you like the people and the environment you are working in, you are better off than MANY people working these days. You are building skills that you don't even know you're building. Yes, the acuity in some smaller hospitals may be lower, but there are going to be sicker patients at times. And you're just starting in your career. Don't underestimate the importance of nursing basics, assessments and time management are VERY important aspects to any area of nursing, but especially in ICU. I would recommend that you stay for a year and get a solid background with supportive nurses in an environment you enjoy. Then you can move on to higher acuity units. No matter what at this point you're going to be expected to have some level of autonomy because you've been working. If you were to transfer to a busier unit with high acuity patients right now, you may very well be left to drown by staff that expect you to be more independent than you're ready for. You may not see something "exciting" on a day to day basis, but you're going to see things in your unit over time.

And for me, there is no boring day, only people that aren't looking hard enough to learn. Unless you can read every report from every consulting service and understand what they say, read the radiology images and reports yourself, recite every medication you're giving the patients along with what you're looking out for when you give them, anticipate the plan of care from the physicians- there's something to learn. I learn something every day on every floor I work, whether it's ICU, step down or med surg. And if you can take the time to be there for your patients, that's huge, too. The tasks of nursing, like managing drips and administering medications, will come along, the art of nursing is taking the time and interest to provide your patients the best care.

I hope that you can find a bright side in that you are enjoying your work environment and learn as much as you can before you move on. Good luck!

[Rin nohara]

8 hours ago, JBMmom said:

You have time. If you like the people and the environment you are working in, you are better off than MANY people working these days. You are building skills that you don't even know you're building. Yes, the acuity in some smaller hospitals may be lower, but there are going to be sicker patients at times. And you're just starting in your career. Don't underestimate the importance of nursing basics, assessments and time management are VERY important aspects to any area of nursing, but especially in ICU. I would recommend that you stay for a year and get a solid background with supportive nurses in an environment you enjoy. Then you can move on to higher acuity units. No matter what at this point you're going to be expected to have some level of autonomy because you've been working. If you were to transfer to a busier unit with high acuity patients right now, you may very well be left to drown by staff that expect you to be more independent than you're ready for. You may not see something "exciting" on a day to day basis, but you're going to see things in your unit over time.

And for me, there is no boring day, only people that aren't looking hard enough to learn. Unless you can read every report from every consulting service and understand what they say, read the radiology images and reports yourself, recite every medication you're giving the patients along with what you're looking out for when you give them, anticipate the plan of care from the physicians- there's something to learn. I learn something every day on every floor I work, whether it's ICU, step down or med surg. And if you can take the time to be there for your patients, that's huge, too. The tasks of nursing, like managing drips and administering medications, will come along, the art of nursing is taking the time and interest to provide your patients the best care.

I hope that you can find a bright side in that you are enjoying your work environment and learn as much as you can before you move on. Good luck!

you are right,  I will, Thank you so much for advice

[ghillbert, MSN, NP]

I would also add while you are in a lower intensity unit, perhaps gather experience and take the time to look up patients' disease processes, perhaps study for your CCRN certification so that when you are ready to move on to higher acuity unit, you are confident that you have the knowledge you need and can build the skills with experience.

I would add that ICU nurses, particularly in high-acuity units, are often hurried and impatient, but are also a tight-knit group who support each other once you get to know them. This is true around the world in each country I have worked in. Sometimes a hospital unit can have a toxic culture, but not all do!