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Med/surg experience for possible change to ICU

Posted

Please, I would welcome any and all good advice on this move. Have experience in med/surg and have floated to ICU many times, have been able to handle it there as assigned to patients. Need some really good insight and tips on ICU nursing.

Depends on the size of the facility and how good that your orientation would be. Also, try to get the same preceptor, if possible, at least for the major part of the orientation, so that you don't have extra stress added in.

Thanks for input Suzanne, I really wanted more info on just what to expect. It really would mean a change for me but one I have been told I could handle and handle well by HN and others in ICU.

Patient care is patient care, I just wanted some pointers. Some good things to look for and some things to make the buzzer go off in my head.

Have a good day.

I'm doing the same thing. I look forward to reading responses, too.

I know you didn't solicit this opinion but...sorry...I'm throwing it out there anyway. When we have someone float to our ICU, that nurse gets two "easy" patients. Floats (unless they are critical care floats from our float pool) do not get vents, Swans, balloon pumps, ICP monitoring, or drips (other than insulin or ativan). I just want to point out that ICU nursing may not be the same as your float experiences.

Okay...with that said... :) My pointer is prioritize, prioritize, prioritize. It isn't task oriented nursing so much as it is a constant flux of what's-going-on-now. It's not a game of 'at 8 AM, I'll do vitals...at 9 AM, I'll give meds....at 10 AM, I'm giving a bath' because things change too fast and too often. The biggest issue I see with med/surg nurses coming to ICU is that they are still doing tasks and not dealing with issues. I've seen a nurse go in to spend 15 minutes turning and fluffing one pt while the other pt has a BP in the 60s. I once saw a nurse walk out of the room during a code on their pt so they could go give 2 units of SQ insulin because it was due right now. It seems to constantly be a game of 'what's the most important thing to do right now?' and what you might think you'll be doing in 30 minutes is shot when your pt blows a pupil and you are with him in CT scan instead. A q day IV Pepcid dose may be delayed 2 hours because your other pt suddenly needs a Neo gtt started and then add some Dobutamine and maybe some Levophed....oh, and the doc wants to float a Swan now....

Good luck!! The best news is that you only have one or two patients and can focus all your attention on doing the best nursing care possible. :) Let us know how it goes.

bluesky, BSN, RN

Specializes in Critical Care, ER. Has 4 years experience.

I know you didn't solicit this opinion but...sorry...I'm throwing it out there anyway. When we have someone float to our ICU, that nurse gets two "easy" patients. Floats (unless they are critical care floats from our float pool) do not get vents, Swans, balloon pumps, ICP monitoring, or drips (other than insulin or ativan). I just want to point out that ICU nursing may not be the same as your float experiences.

Okay...with that said... :) My pointer is prioritize, prioritize, prioritize. It isn't task oriented nursing so much as it is a constant flux of what's-going-on-now. It's not a game of 'at 8 AM, I'll do vitals...at 9 AM, I'll give meds....at 10 AM, I'm giving a bath' because things change too fast and too often. The biggest issue I see with med/surg nurses coming to ICU is that they are still doing tasks and not dealing with issues. I've seen a nurse go in to spend 15 minutes turning and fluffing one pt while the other pt has a BP in the 60s. I once saw a nurse walk out of the room during a code on their pt so they could go give 2 units of SQ insulin because it was due right now. It seems to constantly be a game of 'what's the most important thing to do right now?' and what you might think you'll be doing in 30 minutes is shot when your pt blows a pupil and you are with him in CT scan instead. A q day IV Pepcid dose may be delayed 2 hours because your other pt suddenly needs a Neo gtt started and then add some Dobutamine and maybe some Levophed....oh, and the doc wants to float a Swan now....

Good luck!! The best news is that you only have one or two patients and can focus all your attention on doing the best nursing care possible. :) Let us know how it goes.

Expect a lot of criticism and little appreciation... it's a part of the breaking in process. Expect to not know enough for YEARS. Expect to have to prove yourself to everyone. Expect crappy double almost-IMC pts for many months.

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