Nervous Noob

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I just moved to the ICU after working for two years on Med-Surg as a new grad. I'm overwhelmed and constantly anxious. I get so nervous that at times that I forget my basic skills. To compensate, I've simply been taking it slower so as not to make any mistakes. My preceptor is now telling me I'm too slow. I'm feeling hopeless. I am smart and competent, but I'm definitely now showing it. Does anyone have any advice?

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Specializes in CVICU.

My advice is to get your kardex/report sheet organized in a way that facilitates your workflow most efficiently. The information you will want to have at your fingertips is probably going to be different than when you were on medsurg.

I always get to work at least 10-20 minutes early so I can at least write down my meds and lab work or tests in the am. I have an area to write down totals from foley, ivs, tube feed, chest tube output, etc. I have a specific area where I write my vitals and important lab results. When I was first starting out, if I knew I had more abgs to be drawn on my shift, I wrote the normal range for all the values somewhere on my paper so I had a quick reference when I got my results from my RT.

In report I like to grab the chart and look over orders with the previous nurse so I have a quick view of what's been going on today and if I can't decipher the docs writing haha. Then I like to go in and meet the patient/family with the previous nurse so I can check lines, drips, suction, and room set up. You get a chance to eyeball your patient real quick, so it becomes easier to prioritize cares in the first hour or so of work.

I think it's helpful to make lists and write down notes to help with charting and giving report. You will find a system that works for you. Good luck and ask lots of questions!!

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Thank you for the advice! I really appreciate it. I am experimenting with different report sheets now. You're right, organizing my day at the beginning makes a big difference. Unfortunately, we pick our pts during charge nurse report at 7am so you never know who you're going to get. In other words, going early doesn't help. But I can take the time after report to better organize my day. I'm going to work on my report sheet over the weekend. Thank you, thank you.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Try a few of these....((HUGS)) it takes time....your preceptor is forgetting how overwhelming the ICU can be.

OP.......What you need a good brain sheet.......here are a few. These have been made by me and other AN members (Daytonite,RIP, made the student sheets) use them and change them as you need.

doc.gif mtpmedsurg.doc

doc.gif 1 patient float.doc‎

doc.gif 5 pt. shift.doc‎

doc.gif finalgraduateshiftreport.doc‎

doc.gif horshiftsheet.doc‎

doc.gif report sheet.doc‎

doc.gif day sheet 2 doc.doc

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Specializes in ICU.

Hang in there, once you get a set routine down and it becomes second nature, then you won't have to consciously think about what to do next and you can focus on other things. You'll get it! ;)

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Take advice from these posts and these nurses NYCRN! I myself am a freshly new graduate just recently hired in the ICU. I tell you what the CCU is like night and day compared to med-surg floors. You must find a way to prioritize your day and organize your data. Doctors will want to know details (labs, ventilator settings, ABG's, vital signs, etc) on the spot and will grow very impatient if they have to wait while you look it up on the computer. If you can not find some brains that do not work for you (looks like Esme12's brains are very well put together) tailor you own. Remember many people are in your same shoes, just ask lots of questions (ICU is not a place to keep questions to yourself), constantly educate yourself, work hard and be organized. Best of luck and good luck!

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