just finished week #1 of being an ICU nurse

  1. I started my first RN job last week... I am working in a community hospital's 12-bed ICU and so far I LOVE it. I have a wonderful preceptor who has already taught me SO much in just 2 shifts... and we (the new grads) are just beginning to start the new grad classes this week and next.
    I guess my question is this.. is it normal to feel overwhelmed at this point? I have been able to keep up with everything my preceptor has asked of me and I did ok with the 2 codes we had the other day... I'm just exhausted trying to remember everything... everyone's names, where the bathrooms are, how to clock in, how to use the computer charting system, I've learned about 20 new drugs already, learned how to get CVP reading, draw blood off of central lines, how to set up A-line monitoring, I've been hanging blood, learned where the lab is, was the recorder for a code (with my preceptor looking over my shoulder), had a patient with 7 JPs after he dehisced, learned how pushing Adenosine stops my heart while I watch it stop my patient's heart... but the hardest thing I did this week was watch a family being told that their loved one had died... and that's just the beginning! I am loving my job, I am in awe of my job, I seriously cannot believe that they are paying me to do this....
    BUT... am I EVER gonna feel like I know what I'm doing? There is so much to learn and I wonder how will I ever be able to handle two of these patients by myself... I know it's just my second week in the ICU as a new grad but someone please tell me I will get better at this LOL! Did you all feel this way? I really want to be a good, safe nurse...
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    About nursgirl

    Joined: Jan '09; Posts: 130; Likes: 166
    RN; from US
    Specialty: Critical Care, Operating Room


  3. by   TigerGalLE
    It will probably take a year or more to feel comfortable. Until then ask questions when you don't know, or when you are unsure. How long is your orientation?

    It sounds like you have already had quite a few excellent learning experiences. Try to be apart of every experience you can. If a patient is being intubated or coding ask your preceptor if you can go help. You learn something new from each patient. Ask to take the sickest most complex patients.
  4. by   tri-rn
    A nurse that I greatly admire told me it took him 5 years to get truly comfortable, to the point where he didn't feel worried coming in to work. I remind myself of that a lot. I've been off orientation in a combined MICU/SICU for 1 1/2 years and I still run across new things (or things that I learned then didn't use so don't remember clearly) all the time. I'm still nervous sometimes.

    NEVER be afraid to ask someone for a reminder, although pick who you ask wisely and know your facility's policies.

    I don't know if I agree with taking the sickest, most complicated patients right away....you need to get comfortable with the basics (lines, drips, etc). Too much too fast and you might just end up feeling overwhelmed and not absorbing anything.

    How long is your orientation?
  5. by   TigerGalLE
    Quote from tri-rn

    I don't know if I agree with taking the sickest, most complicated patients right away....you need to get comfortable with the basics (lines, drips, etc). Too much too fast and you might just end up feeling overwhelmed and not absorbing anything.

    You are right. I forgot she was a new grad. You do however want to take sick patients towards the end of your orientation.
  6. by   Iseeyou_RN
    In regards to taking the "sickest and most complicated patients" While you have a preceptor with you they may assign them to you anyway (they do this in my unit) so that you can be exposed to the many drips, all the equipment etc and still be safe. This is the time to have these patients, so you can see the worst that can happen. Then when you are on your own, the simpler patients may not seem so bad
  7. by   nursgirl
    Thanks so much to everyone for all of the feedback!!! Our new grad program is 4 to 5 months in length and includes classes and 2 to 3 12-hour shifts each week with a preceptor for about 2 months and then 3 12-hour shifts/week with preceptor along with occasional classes. Everyone I work with has been wonderful so far but I like that someone said to check the policy & procedure manuals as well. I guess this feeling is normal for any new grad RN because they have thrown an overwhelming amount of information our way in one week already not to mention all of the clinical opportunities I have had this week to learn... my preceptor already has had me titrating Levo and insulin gtts too... always guiding me and looking over my shoulder of course. She tells me I am doing great so far even though I feel like an imbecile hahaha. They have also already sent me to two 8-hour days of Basic Arrhythmia class as well as a DKA, CVP, Flotrac, transvenous pacing, and sepsis classes... and I know we have numerous new grad classes coming up on assessment, charting, computers, legal, etc...
    I am glad to be reminded it gets better with time and experience and I hope I never forget how it feels to be a new grad... or a student for that matter... I hereby swear I will always always always be kind to students and new grads!!
  8. by   aerorunner80
    Your week sounds just like mine!!! I've completed almost three shifts (two 12's and one 8) and feel the same as you do!

    I'm doing preceptorship in a medical/cardiac ICU so unfortunately I'm not an employee there but I'm crossing my fingers. I really want to work there!

    Hang in there and we can do it!!!!!redbeatheredbeatheredbeathe:redpinkhe
  9. by   BellaInBlueScrubsRN
    Sounds like you are learning a lot already. Those classes are invaluable. Soak it up and take lots of notes! I just busted my notes out the other day to look something up! I've been in the ICU a year and a half now. And right when I hit the one year mark of working on my own, I got switched to days! Its a whole 'nother playing field. I still feel like I learn something new everyday. Having a good preceptor makes everything better, and it sounds like you have one. After orientation, find a couple nurses that you know you can count on when you have a question. Once I felt pretty comfortable, I liked taking the sicker patients with lots going on. And working back-to-back shifts (a few in a row) helps you learn too. At least thats how I felt, because you get to really know the patient.

    All the luck to you! Its a really fun and exciting place in the ICU!
  10. by   nursgirl
    Quick update... I am well into my 2nd month as a new grad in ICU and loving it! I was able to take both patients and all their charting last week! (they were both definitely "easier ICU pts" though and it was the second day I'd had them haha) I'm learning so much everyday and so grateful I had the opportunity to go into ICU right out of school! Thanks everyone for your encouragement!!!!
  11. by   armyicurn
    Welcome to the big leagues!

    Congratulations on having a great preceptor. You are lucky. I've seen some real superstars in my time. You have been given great advice and I will not repeat it. Write down things you do not get and when you get home, review, research and make notes.

    When you have time to take a break during your shift, take it. Walk out of the unit and go for a walk around the hospital. It will clear your memory and will refresh you. Don't ever trust everyone when they tell you they prep'd the room for you. YOU need to check it yourself to ensure you have your A,B and Cs covered. I've taken report from other colleagues and have found rooms with no suction set up for the past 12 hrs!

    And keep this site handy in your bookmarks. It comes handy just to read some of the posts and learn something new
  12. by   JoyfulRN14
    I'm glad you said you were starting to feel a bit less overwhelmed after a month or so. Just curious, how are you doing now, 3 months or so in?
    I'm starting a new grad program in the ICU on July 26th and I am very excited but already feeling a bit overwhelmed on how this first few months is going to be.
    I wish I could fast forward time to about two years from now, when I will be a competent, confident nurse!
    If you get a chance - drop me a line about how it's going and any advice you have. Thanks!
  13. by   nursgirl
    congrats on your new job!!! well as far as an update... I am finishing up my orientation and will start working nights on August 1st! I am told that I will have a preceptor on nights for the first 2 weeks just to allow me time to adjust to a slightly different schedule... then I am on my own. To be honest I am really looking forward to it! I have had 2 wonderful preceptors and work with an awesome crew, this has definitely helped me to learn. Yesterday I left feeling really good about my day... but had a day last week where I felt totally overwhelmed even though I still got the job done and kept patient safety #1 and I am assured this is normal LOL

    I feel like I have learned more so far in 4 months as a new RN in ICU then I learned in all of nursing school hahahha seriously the first 2 to 3 months I thought my brain was going to explode... and it's just different than in nursing school... hard to explain but you'll see! I'm sure you will do great!!!!!! Make sure you ask ask ask questions and know that if you have a couple days where you feel like a complete moron that it's completely normal!

    I am up getting ready for work right now as a matter of fact...
  14. by   sunnycalifRN

    congratulations on your success thus far!! I'm so glad to hear that you've had great preceptors, as that can "make or break" you as many others on this site can attest. As others have said, it will be between 1 and 2 years before you will feel very comfortable in the ICU. Also, if you've done all your precepting on day shift, be prepared for a very different dynamic on nights; fewer transports and elective procedures, fewer visitors; but, there's usually fewer doc's around and when you have codes, you'll be much more involved.

    Never stop asking questions. Looking forward to your updates.