New Grad in the ICU

ICURN2006 · Jun 28, 2006

I'm a new grad from Dec 2005 and work in a trauma ICU. My preceptor gave us reading material to prepare us for the patients we would be working with as we went through our orientation. We were also give policies and protocols (i.e. insulin, sepsis protocols) to become familiar with. We had critical care courses as well however, they were very broad because of the nature of unit. I would suggest attending any classes that are very specific to any area. For example, we went to a neuro assessment class that was 8 hours and afterwards I felt like I could do a really thorough neuro assesment (which is critical to my units since we get a lot of head trauma). I also would not focus on certifications for a while due to the stress of learning how to do our jobs. I am almost done with orientation and still feel overwhelmed at times, but the unit I work with is very supportive, which makes all the difference in the world. And always ask LOTS of questions, never assume. I also found it beneficial to start an issue list on each of my patients with things I needed to get addressed and focus on. I hope all goes well for you!

SorenDrake · Jun 30, 2006

Get very familiar with the drugs/gtts used frequently, particularly starting doses and ranges for titrating. Also, which ones are measured in mcg/min or mcg/kg/min.

HYTIIDE · Jul 1, 2006

Hi Tooty,

My husband is an ICU RN, I used his mosby pdq for critical care to help study for my boards, he says it's a great lil book for the floors too. I just passed the boards and will also be going to ICU. I KNOW I will be using this lil book as a quick reference. Hope it helps you too. :)

Take care,

April

piper_for_hire · Jul 5, 2006

I was a new grad in the ICU and have you considered that prep is really not necessary? We're a Level I trauma and a combined MICU/SICU/Neuro ICU. The patients are so sick and so diverse that trying to prepare was really a waste of time. Just learn on the job and ask lots of questions. Before long you'll notice the repetitive nature of the work and it will start making sense. Your preceptor will keep pointing you in the right direction. Make like a sponge.

-S

Hi-
I am a new grad and started in the CVICU. Can anyone who was a new grad in the ICU tell me how they focused thier study outside of work to help get them up to speed once they were on the floor?
I am in an internship that has critical care classes so I am following what the topics are that we cover for now. I also look up stuff after being on the floor for my shift.
What kinds of things did you do as a new grad to prep outside of work?
Thanks!

rninme · Jul 5, 2006

I keep my brain organized with Fast Facts for Adult Critical Care....a reference book by Kathy White.

VivaRN · Jul 5, 2006

I'm a new grad in the Burn ICU at a level I trauma center, 2 weeks off orientation. I made my own pocket reference of stuff to know ~ the drugs we use & how to mix them, starting doses, common phone numbers when I need things... but even then, my best learning comes from having a patient & going home later & looking up what I didn't understand. Probably the biggest thing is: every patient is different!!! What is "critical" for one patient is another patient's norm, or "the best she is going to get". I agree with the person who said experience is the best teacher. Know enough to ask good questions and soak up everything you see. A lot of what experienced nurses do (ie "the tricks") is not in any book.

bonesrn · Jul 13, 2006

I'm begining to get a little skeptical after reading these posts...I am a Med/surg RN with 10 years experience, currently working in a LTACH/step down unit. We have vents, tele..no drips. Another nurse and I went to an open house at a local hospital. As I was talking to the med/surg manager the DON came over and said that with my experience she would like me to talk to the ICU nurse manager. Mind you I was there about a per diem position. I have always had a desire to get into the ICU but with kids etc it just never worked out that way. So..I talk with the ICU manager and she says "we would love to have you" I made it very clear to her that I had NO ICU experience, NO experience with drips, a-lines, swans. She said not a problem, "we do no hearts and no heads" ..so I went home excited as this is a brand new hospital, a 12 bed ICU and I thought it may be a good place to get into ICU. I called the nurse manager the next day and asked told her that I wanted to be sure that she felt confident that I would be able to get adequate orientation and then be per diem..working 36 hrs a week. I told her that I didn't want to put myself, the patients or them in a bad situation. She assured me that she felt that I could do it. They are sending me to ACLS, I just recently took the tele class for my current job. I left her a message today to see if they have a formal critical care course that they send their nurses to. I am guessing that they dont' or she would have mentioned it. The other nurse, who does have some ICU experience was told that she could have as much as 6 weeks of orientation. That doesn't seem like much for an ICU, especially for someone with NO ICU? What do you guys think. I am begining to think that maybe they are desperate for staff and I don't want to be put in a bad situtation. Of course, if I take the job I would speak up and would never do anything on my own that I did not feel comfortable doing. I think I am going to ask her if I can shadow someone a day or two to get a better picture of the unit, how it flows etc. Thanks for any help you can give me!

roana · Jul 13, 2006

Hi bonesrn;

I think you can do it. With ten years general nursing and having vents and heart rhythms down you are probably more than 50% there IMHO. Especially in a smaller hospital ICU - - - there is a HUGE difference between that and one if those Level 1 trauma centers.

Go for it!

Roana

bonesrn · Jul 13, 2006

Thanks for the encouragment! I'll keep you posted.

dorimar, BSN, RN · Jul 14, 2006

If the hospitatl doesn't have a critical care course, you can go to the AACN and take the Ecco classes. Also, many community colleges offer pretty good critical care courses. I have some concerns with the poster who thought preperation wasn't necessary. On the job experience is the key to good critical thinking and assessment skills, but strong knoweldge BASE is important.