New Grad starting off in ICU

Specialties MICU

Published

Hello all!

I am a brand spanking new Registered Nurse that just passed NCLEX on July 8, 2009. I graduated with my BSN on May 16, 2009. I have been offered (and accepted) a position in the ICU at a Level I Teaching hospital. I am also going to be in their New Grad Residency Program. I start August 3 and I couldnt be more excited!

Now my questions to my fellow ICU nurses, how can I make this the best experience for myself and for my preceptor? Any advice? Also, what book(s) should I read about critical care prior to starting my new job? Any pointers or suggestions for a new grad?

I am excited, scared, anxious, and nervous all wrapped up in one! :lol2:

nurse2be09,

I enjoyed reading how you landed in the ICU. I completed a summer externship in the Operating Room (tried for ICU but that is where I landed). I found the OR environment fascinating and enjoyed learning about the various surgeries (especially neurosurgery and cardiac). However, after this experience, ICU was still my first choice.

Some of your comments reminded me of some the responses I have received as a nursing student.

I was chucking with the above. :lol2: I received similar comments as well from one of my clinical instructors who spent majority of her career in the Operating Room and a couple of the OR folks I worked with during my externship (e.g., pay close attention to details and asking a lot of questions). The one that was ingrained into my mind was after asking one of my "why" questions with this one scrub tech, she responded saying I was too smart to work in the OR and to look into working in the critical care setting (repeated this numerous times while working alongside her, in front of the other nurses). I was little perplexed by her statement because I know intelligent men/women work in the OR too. Anyway, similar to you, I'm too curious and want to understand what is going on with the pathophysiology, pharm, etc., and the reasons behind certain procedures/actions.

Don't get me wrong, I did learn alot in the OR, but it was not patient focused. I wanted more hands on patient focused experience. And another thing about the OR was I would have missed out on my patient contact.

And I remember asking the surgeons so many questions, like "why this or that"? And I would spend time reading the patient's chart, trying to figure out "why" they were getting the surgery, checking lab values, looking at H&P, etc. I would do this while my preceptor was charting and the surgeons and scrub techs were "shooting the breeze" about any and everything under the sun.

When I got to the PACU, I spent alot of time tending to the patients and also looking at charts and doctor's orders. I did get a chance to push some meds and remove a few foley's and IV's. I also got to do some extubations, which were cool! I seen a couple of patients put on the vent for about 30 minutes (the ones who have history of smoking and didnt take anasthesia well), then the next thing you know, they are extubated and sitting there talking and eating ice. That was my first experience with a patient crashing.

I had a bunch of great nurses to mentor me for the small amount of time I was there. All of them started off in the ICU and pretty much told me I have the "personality" for the ICU. :lol2:

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Specializes in ICU.

Interesting thread! Seems like a lot of you are studying at home...kudos to you guys! Perhaps it has more to do with personal learning style and also the type of orientation you're getting. I get 2 days a week in class with no patients; just me, two other nurses, and our brilliant nurse educater going at it for hours and hours and hours. It's absolutely fabulous. Also, when I'm on the unit, I am surrounded by co-workers who love to teach, and offer to do so at any moment. Not sure how other hospitals are doing it...anyone want to chime in here?

I agree that it takes a lot of work to succeed in this atmosphere. My days are rarely easy. It's the hardest (most rewarding) job I've ever had. The learning curve is extraordinarily steep and you will need to surround yourself with support, both in and out of work. I know there are those who will not make it, however, I don't think it has to do entirely with the fact that they don't study at home. Everyone has their own style of learning, and the fact that our profession can accommodate such differences is one of the beauties of nursing.

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great thread! Did you have ACLS prior to starting on the unit?

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great thread! Did you have ACLS prior to starting on the unit?

No, I don't. I asked about this during my interview and was told by the nurse manager I would get it by the end of the year, right around the time I'm getting off orientation.

I'm in the New Grad Residency Program for 6 months anyway.

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Thank you for this thread! I too dream of working in ICU straight out of nursing school. I didn't think it was possible so this thread got me excited & informed all at once. Congrats to all the new nurses starting in ICU. I have 2 questions for everyone: 1.) Did you graduate from an ADN or BSN program? 2.) Where are you located? Please include city & state if you don't mind. TIA : )

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Specializes in ED, ICU, lifetime Diabetes Education.

I graduated from an ADN and I live in Maryland.

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Thank you for this thread! I too dream of working in ICU straight out of nursing school. I didn't think it was possible so this thread got me excited & informed all at once. Congrats to all the new nurses starting in ICU. I have 2 questions for everyone: 1.) Did you graduate from an ADN or BSN program? 2.) Where are you located? Please include city & state if you don't mind. TIA : )

Thanks! I graduated from a BSN program. I am located in Kansas City, MO. I know several of my classmates who are also starting off in the ICU. One worked there as a tech, the others did their Capstone in the ICU and got hired directly in. I worked as a Nurse Intern on a Tele unit and was often floated to the ICU.

If you want the ICU, I say go for it! If you like challenges, love to learn, is teachable, ask lots and lots of questions, is structured, and pay close attention to detail, then you'll love the ICU.

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love The ICU Book by Marino, mentioned earlier in the thread. It is comprehesive and easy to understand, nicely formatted. I wish I had it during med surg I for some systems (alpha/beta, hemodynamic, ABGs) and really happy to have the going into m/s II, and for preceptorship in MICU. Any other texts y'all love that speak to us "newbies".

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Specializes in Surgical Trauma Burn ICU, Oncology.

BSN and im in Charlottesville, VA working in the surgical trauma burn ICU @ UVA..awesome. day 1 i got to do leech therapy on a pt's ear that got bit off by a dog! so fun. all i did was my externship during my last 3 mo. of nursing school in the STICU in charleston, nothing more. mine is a new grad residency and they demand we do the AACN...and they teach us and pay for it.

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Specializes in ICU, Informatics.

I graduated from a BSN program and live in Pennsylvania.

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When are you starting nursing school?

Wow, I swear I saw "where" the first time -- I am applying in Spring for my ADN.

With all the feedback from different threads, including this one, as well as reading a bunch, I think I should wait and concentrate on school like I have been doing, stick with my at-home job that lets me study. Just thinking about studying for the CNA test as well as doing CPR/BLS over the next few weeks had my brain spinning! I am back to studying my upcoming chapters for next semester and always time for "fun" ICU sticky's (http:/icufaqs.org is very neat with a sense of humor).

Thanks again for the responses and not asking me what the heck I'm talking about--I was way out there.

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Specializes in ICU.

I've been a tele nurse for one year, but will start in the unit one month from today (August 24th)! I just wanted to chime in that I am excited:):) hehe.

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