Just a Little Advice After a Year in the ICU

[francoml]

I have been an ICU nurse for about a year now. I have learned a million and one things and still have a lot left to learn. I just wanted to offer a little help to new grads trying to get into the critical care scene and newly hired nurses in the ICU.

First....

If you want to be an ICU nurse go for it. It is one of the biggest learning curves you can take on but if that is your passion don't let anyone shoot your dreams down.

Second....

Apply to a large teaching university hospital. Usually those hospitals will have an internship program that lasts 4-6 months which includes one on one patient care, constant supervision by a preceptor, and critical care classes to teach you critical care medicine.

Third....

Study on your own time. Pharmacology, pathophysiology, A&P, ect. This will all be things that help you tie the whole picture together.

Fourth....

When in clinical (students) or once hired as a new ICU nurse, participate in everything you can if your patients are stable. If they are intubating a patient, ask if you can record or push meds. When coding a patient be the first one to hop on the chest and due compressions, bag the patient if needed, record everything that is going on ect. Watch the nurses place lines with ultrasound and ask them to teach you. Basically, as long as your patients are taken care of and stable, go around and ask if you can watch and learn or help out with procedures.

Finally....

You have to love what you do. You will see more death then any other form of acute care nursing. Some of the things you will see will tear your heart out. You have to go into this career path knowing that there is a very high turn over rate in this field because of how stressful it can be. That being said, there is nothing more rewarding that seeing the 19 year old girl who should have died, walk out of the hospital with a full recovery. It is the "little miracles" that keep you coming back for more even though the day to day can be gut wrenching.

I hope this helps, ICU nurses are a breed of their own. It has been the only job that I have ever had that I truly wake up in the morning and am excited to go to work. You will either love or hate working on a unit and you will most definitely develop a dark sense of humor. I wish all of you students and new grads the best of luck in your nursing careers and always remember, there is a lot of people out there that are "dream killers." Don't listen to the negative people out there. You can accomplish anything you want as long as you put everything you have into it.

[isie]

Good job on this article my work friend, nicely written for great encouragement :) -Krisie

In our unit our ICU suites can also function as surgical suits in the event that a patient is too unstable to transfer to the OR. I once had a patient that had a intestinal perforation and the surgical team came up and opened the patients belly at the bedside and then proceeded to take out the intestines and systematically inspect them for a bleed.

This is something you will never experience in the ED

Dunno about that... I've seen our surgeons open up chests and bellies in our trauma bays because they didn't think the patient would survive the relatively short trip to the OR, even with the rapid infuser going full bore.

I've seen ECMO get set up and run there for the same reason.

And I've had several patients that we've held in the ED because they weren't stable enough to get 'em to the unit.

We do everything we can to get the super-sick patients to the units but sometimes the patient isn't stable enough and sometimes the inn is full. Unlike anyplace else, the ED is the only place in my hospital that's not allowed to say, "we have no beds" or "we don't have a nurse."

[blizzard281]

Well said! I am a new graduate who was recently hired in the ICU. So many people told me not to get my hopes up because many people get turned down from ICU positions, but this was my passion and I am so thankful to be working where I am. I will never let anyone shoot my dreams down, and I hope all new nurses are able to pursue their passion and not let others stray them!