New grad, got the ICU! TIPS?!!

MaxAttack, BSN, RN · Oct 27, 2020

Congrats!! Ask questions and look up everything. If you have access to UpToDate, use it. The AACN has a book Essentials of Critical Care Nursing that I bought and found useful.

You're going to be nervous and feel like a fish out of water. Stay thirsty and soon enough you'll feel right at home.

Paralian26, BSN · Nov 10, 2020

Be open to what your preceptors tell you. Be nosey with other people’s critical pts. Always ask questions! Try to be a sponge and soak up everything you can. Always go to codes with an experienced nurse until you eventually become the experienced one. Don’t shy away from taking a super critical pt as long as there is an experienced person around to be your back up. I can’t stress enough that you should never be afraid to ask questions, even if you’re worried about looking stupid it doesn’t matter, if you don’t ask, someone could die. My ICU is more scared of people who don’t ask questions than the person who asks a thousand, even if some are goofy. Also, go ahead and get the Barron’s CCRN study book. It’s like $20 and has a lot of good info in it even if you can’t actually take the test yet. It’ll be really good for learning hemodynamics, which is a must in critical settings. Also, as someone else mentioned, up to date is a fantastic quick reference guide for things that is accessible right in the chart. Also, there is usually a reference link for pharm info too, at my hospital it is Lexi drugs and it’s awesome

The Seasoned Nurse, BSN, RN · Nov 23, 2020

I agree that asking questions and getting involved with the most critical patients is very important early on. I also encourage you to read the physician notes on your patients daily. The MD notes provide a broad, big picture overview of the patient’s conditions and care plans.

I’ve seen nurses pass down the same report for so many days that the diagnosis actually changed or updated and they were not aware. Of course there is some responsibility to consider from the physicians who should be communicating with the primary nurse, but we need to make sure we have all of the information anyway. You really can learn a lot from their notes.

I like the idea of finding a valuable CCRN study guide as a resource. You can read up on conditions you see in the patients you are taking care of in real time. That knowledge will be cemented once you’ve seen a condition in action.

I hope you are doing well! Best of luck!

NurseBrittRN · Feb 6, 2021

Ask questions when you don't understand something fully. Read NP/Dr notes that explain diagnosis and treatment. You can also catch stuff that way. Several times I've seen Dr. notes stating they are ordering something, or changing meds but never actually did it. Followed up with them to make sure they actually put that order in.