New Grad About to Start Working in the ICU - Any Tips?


Hello all. I'm a new grad and I'm about to start working in the ICU at a large hospital (Still don't know which one. We rotate through all of them before finding our "home"). I'm wondering if anybody has any tips or resources they recommend! :) Thank you. I know that starting in the ICU is a major learning curve and I just want to be as prepared as I possibly can.


3 Posts

Specializes in Surgical/Neuro ICU. Has 9 years experience.

Yay! Welcome to the ICU world. This morning in a couple of hours, I am starting the orientation of a brand new RN to the Surgical/Neuro ICU. In the past I have oriented nurses with some previous nursing experience, so this will be new to me, too.


•Ask questions...of anyone who you think can guide you to the answer. That means doctors, nurses, techs, secretaries. Their knowledge will be varied, and it will all contribute to making you a better nurse.

•Watch closely in a code. Codes can be intimidating and chaotic (often needlessly). If a code is called, get in there. Do compressions. Pay attention to the roles of each participant. You'll learn how to filter out the "extra" noises and focus on the patient and which voice you need to hear.

• Search out learning opportunities. Ideally, your preceptor will be aware of procedures taking place on the unit that, as a nurse, you will be expected to play a part in. Watch the procedure and pay attention to what role you will ultimately be assigned to.

•Open the drawers of code carts (although don't crack the only one on the floor; look through one that has been opened.í ½í¸) Know where frequently used materials are in the supply room; it will keep the frenzy at bay if you need something quickly.

•No matter what nursing school you went to, they did not teach you everything. It is okay to answer, "I don't know." In fact, if that is NOT your answer several times a shift, there is a problem. Then figure out where to find the answer, whether it is on line or a book, or a coworker.


•"Concise Review of Critical Care, Trauma, and Emergency Medicine" by Asif Anwar, MD. It's set up by system and will give you insight about what treatments may be ordered for your patient given a specific diagnosis.

•"The Ventilator Book" by William Owens, MD. It has nice large text and gives excellent explanations of pulmonary pathophysiologies and what ventilator setting may be used.

•A nursing journal. I like "Nursing 2017 Critical Care" (or whatever the current year is). It is not too cerebral and it covers pertinent ICU topics well.

•Look at your hospital protocols for each new experience or procedure. Look up every medication you are giving to a patient. Yes, these things take time, but you will increase your knowledge base, and your patient will be safe.

Good luck!


3 Posts

Specializes in Surgical/Neuro ICU. Has 9 years experience.

Great site. Thanks for posting the link. I'm precepting a brand new RN in a Surgical/Neuro ICU and have been looking for some resources for him. Good review for me, too.

Keep cheese and crackers, PB and crackers, dried fruit, other very portable, non-perishable food on your person or very close by so you can eat on the run when you don't get your breaks and are feeling faint. Keep H2O handy, too.

Best wishes.


371 Posts

Specializes in Critical Care. Has 4 years experience.

Keep em alive til 7:35

Run, don't walk, after you give report


31 Posts

Has 9 years experience.

The best advice I can give is to ask questions. And know who/what your resources are. You don't have to memorize everything (although it helps), but you do need to know where to find the answers and quickly. If you don't ask questions, you come across as a know-it-all. From my experience, it was hard to trust those people because they usually needed help, but wouldn't ask until it was too late and the whole unit was dealing with their crisis situation. It's better to seem eager to learn than it is to assume you know more than you do and cause a problem.


131 Posts

Wear clean underwear, deodorant and pack a lunch. Most important have plenty of pens and while you are orientating get up in everything that is going on. Ask questions and ask physicians why they are doing what they are doing. Just be a sponge.....don't worry so much about knowing everything at will come with time.