Published Nov 9, 2005
FloridaCCRN, CRNA
191 Posts
Hi everyone! I am starting in SICU/MICU (I work at a 400 bed community hospital with a level II trauma center) in about 3 weeks and am both excited and nervous about it- more nervous though:)
I am not a new grad (although I still feel that way somtimes), I graduated 3 years ago and most of my experience is ER. I am not a "new nurse" but I still feel new. I feel sort of caught-in-the-middle. I understand that the ER is a totally different animal from the ICU and that is where most of my concern comes from. I will get about 2-3 weeks orientation; I will ask for more time if needed, but I don't want them to think I can't handle it. I just want to be the best critical care nurse I can be. I plan to jump in there and do and see as much as possible, and I will ask lots of questions. I hope that I am cut out for this. Any advice will be greatly appreciated.
papawjohn
435 Posts
Hey Grad
Your ER experience is a great preparation for ICU. You've developed a 'feel' for someone who's subtly going downhill, and probably developed a skill at rapid assessments.
It seems to me (can't stand working in ER--don't relate to confusion!!) that the big difference is that ICU nurses go into much more depth. We wanna know what yesterday's labs were and compare 'em with today's. We follow Chest XRays day to day like I follow Doonesbury in the comics. We do wound care and then do flow sheets on how the wound looks. We worry about how long the Central Line has been in and how much came out of the JPDrain and what it looked like. When we do it really really good--it's a process that goes on day after day.
We tend to get to know the family members, learn their voices on the phone and when they're likely to call and the questions they ask. All that kinda stuff. I've heard that the ideal ER situation is to "treat 'em and street 'em". ICU nurses think that's no fun at all. We'd keep 'em around until we found SOME WAY they're really sick, then let the games begin!!
Papaw John
Thanks for responding. I'm looking forward to starting in ICU :)
Hey GradYour ER experience is a great preparation for ICU. You've developed a 'feel' for someone who's subtly going downhill, and probably developed a skill at rapid assessments. It seems to me (can't stand working in ER--don't relate to confusion!!) that the big difference is that ICU nurses go into much more depth. We wanna know what yesterday's labs were and compare 'em with today's. We follow Chest XRays day to day like I follow Doonesbury in the comics. We do wound care and then do flow sheets on how the wound looks. We worry about how long the Central Line has been in and how much came out of the JPDrain and what it looked like. When we do it really really good--it's a process that goes on day after day. We tend to get to know the family members, learn their voices on the phone and when they're likely to call and the questions they ask. All that kinda stuff. I've heard that the ideal ER situation is to "treat 'em and street 'em". ICU nurses think that's no fun at all. We'd keep 'em around until we found SOME WAY they're really sick, then let the games begin!!Papaw John
How do you go about organizing your day (or night)? I'll be working night shift. Since I have no floor experience I'm wondering if my organization skills will be up to par.