New grad ICU

[lofe99]

Hi all, I just got offered a position in a new grad program in their ICU department!! I am beyond excited but also very scared. I currently work at a Post Acute Rehab facility and have been here 3 months now so this is the extent of my RN experience. I just want to ask for general advice when working in this unit. I know there's is so much to learn but I also do not want to fall behind and I want to excel in this unit. I currently am completing my RN-BSN online and I will be working nights. Thank you all in advance for all and any advice. All is welcome!

Thank you ?

[JRoss]

Replying based on your posting in the Neuro ICU section. First, congrats on your new job! I jumped right into my RN-BSN also while working nights. Assessment skills are vital in any nursing, especially in the ICU. Make sure you are confident in yours. Make sure you know your rhythms. I would recommend finding a good pocket guide for Neuro Critical Care or just ICU nursing in general.

Neuro checks are your bread and butter and an accurate neuro check can mean the difference in saving someone's life and them having irreparable brain damage. Don't ever get complacent with your neuro checks. You could give yourself an advantage by learning how to (accurately) perform a MEND and NIHSS exam. Learn these well. Clustering your nursing care/interventions is important in the Neuro setting to minimize stimulation and potential to increase patient ICPs.

Delirium, agitation, substance abuse, and DTs are common. Palliative and comfort care is common in the ICU. Ethical concerns arise frequently in the ICU.

Lastly, I would say to never be afraid to say, "I don't know." I can't remember how many times I didn't know the answer to something. Make sure you know where to find the answers, though. Try to stay up to date on your literature. Find a good resource person, whether it be an educator or an experienced nurse. When I first started, I would observe other nurses and always try to find what I thought their best qualities or skills were. I did my best to adopt the practices I thought were best into my own.

Good luck as you begin your ICU career!

[DCubed]

I have no advice for you, but what I can tell you is my mother was recently in the ICU. Most of the ICU nurses we encountered were absolutely wonderful and made her stay in that unit as comfortable as possible, despite the circumstances. A couple of those nurses I'll remember for a very long time. From what I saw, I think it's probably a radically tough job, but the potential to do good and positively impact lives is enormous, as well. Wish you the best.