New Grad RN - ICU

Bluebolt · Aug 17, 2012

I've found that on 3rd shift the actual shift is not hard to get through, you will be able to stay busy most of the time. It's the "off" days that are so rough to handle. If you want to have any kind of a normal life you'll find yourself switching to day shift during your off days then night shift on your work days. I use melatonin supplements to help me fall asleep at a decent hour on my off days. Good Luck!

SpEdtacular, MSN, RN, EMT-P · Aug 20, 2012

I personally burnt out at 18 years. At 7-10 years life was good, but ICU's are changing rapidly. This new quality initiative requires way too much time documenting nonsense, and places too much emphasis on the wrong things. At the last ICU I worked, we had an "open" ICU with essentially no rules. We would have the entire family (sig other, two toddlers, and grandma), living in the patients room next to their bed. Pull-out beds were provided, and families never had to leave. It made care of the patient very, very difficult. I was never against family involvement, but not having the ability to have a family "step out" for an hour or so at a time was very tiring.
So I am now in my last few months of NP school, and can honestly say that I am really loving the office.
Take care,
Scott

You are not kidding about documenting nonsense! I feel like If I didn't have to document what I did every 2 hours I would actually have plenty of time to do it. The PCU I worked on had no visiting hours and we had families living in the patient rooms too. It's draining enough dealing with patients sometimes but they're patients and that's your job. You can say that about families and you get some families who think they're in a hotel and you're room service wanting coffee, blankets, pillows, toothbrushes, a bigger room... non stop even when you are clearly busy doing something else. We had one woman who was staying with her mother and she was incontinent (the family member) and she was continually calling for us to get her more chux pads and stuff to clean herself up with when she wet. I wish I were joking...

laroo · Aug 24, 2012

Hey! I just finished my first year in the ICU. I was slotted for 6 months of orientation 1:1 with a preceptor but ended up "graduating" at 4 months because I was functioning pretty well independently and I use my resources (staff) well. I work in a level 2 trauma ICU with neuro, cardiac, medical, surgical, etc. We do open hearts... I can take a 1st day postop heart but no fresh hearts yet until I've been there for a few years.

I had NO ICU experience at all and it was a HUGE adjustment... a whole new world! I learned fast and spent ALL of my time outside work taking the AACN course and reading everything I could get my hands on. You either float or sink, and your preceptor can make or break your experience. I had a wonderful, patient preceptor who was a fabulous teacher. Attitude really is important too- you have to be extremely humble and open to learning. NOBODY likes a "know-it-all" new nurse in the ICU and quite frankly that attitude is very dangerous to patients. Don't feel dumb about asking questions and getting second opinions. If something feels wrong, trust your instinct and figure it out.

There were times when I wanted to run run run home and find an easier/slower paced job... but I adjusted. Now when I have a "boring" moderately stable patient, I am like... bummer. Because you end up loving sick patients that keep you busy. I do often get the crappy assignments, but they like to challenge me as well. Sometimes I have to speak up and ask for a sicker assignment if I've been stuck in boringland for a while.

I love it. Just remember to be humble, be helpful, ask questions, research, learn, and work hard. Teamwork is everything. If my assignment is a little slow, I run around asking people if they need help. I love my coworkers and my ICU, I love the independence, it is just great.

Note- I work in a non-teaching hospital... I am not sure what the experience at a teaching hospital is but I have heard that we have more independence because there aren't interns/residents running around doing stuff. It is fun. We present our patients at rounds every morning and throughout my day I am constantly working with MDs/PAs to get the meds & orders I need, and I question their orders when necessary and help them figure out what the patient needs. It is neat to be the "expert" on the patient. Advocate!

californiarnbsn · Aug 27, 2012

Thank You so much for providing your experiences! I'm pretty excited to get started. From your experiences have you found any books or other study materials that have helped you out along the way? and the AACN course is that something that I could do now or do I have to already have hours working on the unit first?

AICU RN · Sep 11, 2012

I started as a new grad in a Level I Trauma ICU last November. My 20 weeks on orientation flew by and I can't believe it's almost a year since I started.

Things that I studied:

1. Vent Settings (including oscillator, bivent, etc)

2. Common "ICU" drugs and their side effects (prop, vec, succ, versed, fentanyl)

3. Brushed up on Sepsis, lactic acid, etc.

4. Got to know ABGs very, very well

5. Pressors for sure

There's more, I'll probably think of some more as soon as I finish this post.

As far as general advice (I didn't read all of the previous responses):

1. Preceptors want you to ask questions. Take advantage of this and ask even if it seems stupid.

2. You will make mistakes. Learn to forgive yourself, learn from them and move along.

3. Learn your team. At the beginning of each shift try to identify one nurse who you can go to if something arises during your shift that

you need help with who won't bite your head off.

4. Someone else said it, but a good respiratory therapist is priceless. Know yours. Ask them questions. Usually, they appreciate

someone's respect and they are really great teachers (IMHO).

5. Know your support staff. We don't draw labs unless pt's have an ALine or a central line (and sometimes not even then) so I like to get

to know our phlebotomists and one just commented the other day that she's so appreciative I took the time to learn her name and

don't just call her "lab girl." You never know how far a little mutual respect might go. One of these staff members may be able to

really help you out one day.

6. Get yourself organized. Do whatever it takes to keep yourself that way.

That's about it for now. Maybe later I'll post more about staying awake on night shift. I do love nights though :smug: .

Lin19 · Feb 20, 2013

Ok so this is so late, i know. I have recently graduated and I am looking to get hired into ICU as well. I'm very curious as to what hospital offered you the position. It seems like it's hard enough getting a job anywhere, let alone ICU. Any info would be greatly appreciated.