New grad preparing for ICU

Ruby Vee, BSN · Sep 18, 2016

Not all new grads are nervous, but I have serious reservations about the ones who aren't. For one thing, you don't know what you don't know. For another, it's very difficult to teach anything to someone who is already convinced they know everything.

Start with an ACLS book. They're pretty basic, usually, and should help you with rhythms, basic ACLS algorithms and drugs. You'll be taking Advanced Cardiac Life Support certification classes later on anyway. A second book would be a good, basic CCRN review. At some point, you may want to take the CCRN certification, but even if you don't, it's a good reference.

What sort of ICU is it? A CCU? A SICU? A MICU? CTICU? Knowing the patient population will help you decide what to study. If it's a Neuro ICU, you'll want to be fully versed on that system. If it's a MICU, you'll want to know about sepsis, if it's a CT ICU the cardiovascular system, etc. (OK, I've oversimplified here, but I'm sure subsequent posters will be more specific.).

I doubt EMT training is going to help you much, nor will ECG tech. Doing the ECG is simple enough, if your ICU doesn't have techs to do them. The difficult part is knowing what you're looking at. A rhythm class wouldn't be a bad thing. But finish school and pass the NCLEX first, then worry about what to study for ICU.

LaraRN86 · Sep 18, 2016

My first job out of nursing school was in an ICU. I do not think you should do either of those programs, as it will will take away from your focus. You should study pharmacology, ensure you know vent settings, make sure you know all of the medications ACLS mentions for the megacodes, cardiac drips, A-lines, try to know lab values, and re-read your nursing school books on cardiac and respiratory patho!

brit_RN_ · Sep 28, 2016

I'm going through the AACNs critical care book now because I'm studying for my CCRN, but that would probably be a good one. Don't load yourself up too much with extra classes or training, you will get what you need in orientation. A lot of learning in the ICU takes place as you go, it's kind of hard to prepare for it ahead of time especially with no prior nursing experience. Be nervous, but be confident in yourself as well. I went straight into the ICU after graduation, and it's been hard been so worth it. Good luck!

RachelP_CRNA2B, BSN, RN · Oct 4, 2016

I started in critical care as a new grad and am coming up on my 12th week (of 12) of orientation tomorrow (AHHH!). Granted, we don't get super high acuity patients, but here are some things I feel substantially helped me out:

1. Paid attention and studied my BUTT OFF in nursing school. All those disease processes and the basic A & P you learned over the past 2-4+ years? Yah, well, now it's time to put it all to use!

2. Working as a tech. Helped me get in the swing of time management while keeping my skills fresh (and networking!)

3. Taking a telemetry class. Learn NSR like the back of your hand so that when you see something that definitely ISN'T NSR, you know it and can further investigate.

4. Getting comfortable with asking questions...like nonstop. Especially as an orientee, you're NEVER going to know the answers (or at least 95% of the time), so if you haven't already, learn to summon the courage to approach co-workers in order to get answers and information.

5. Getting my assessment skills down: Your patients are depending on it!

6. Reviewing BLS and learning the ACLS algorithms.

7. Reviewing common critical care gtts, vent settings, CRRT. art lines.

But, as stated above, remember that finishing strong in your last semester of nursing school and conquering the NCLEX should be your primary focus right now; DO NOT UNDERESTIMATE THE NCLEX, FRIEND! I passed in 75 questions but legitimately thought I failed!

Best wishes to you!

Salter444 · Oct 5, 2016

I would not go crazy attempting to prepare - that is why you have an orientation to cover the basics and then you fill in the gaps as needed. I would have a basic grasp of hemodynamics and try to understand the impact on the patient. Know norms and over time you can work on putting the pieces all together. It does not all come to you on day one or day fifty, but it is a continuous learning and relearning. You need to be comfortable asking questions and never trust someone who claims to know it all. When you are working ask physicians why they order what they order...use anyone you can to learn from and take advantage of the resources the hospital provides. As an ICU nurse your job is to keep your patient safe and recognize when the patient is making a turn for the worse. It really is a fun gig!