New Grad starting off in ICU

Cinqly, BSN, RN · Jul 25, 2009

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.

Woohoo! Congrats! :yeah:

walterp2 · Jul 30, 2009

Hey There!

I too am a new grad in the ICU! I graduated May 9th and passed NCLEX on June 17th! I have been working as an RN (without any kind of critical care intership or graduate nurse experience) in the ICU at a Cincinnati hospital. I was bummed at first that I was not going to be assigned to one preceptor for my orientation but was instead going to be bumped around from nurse to nurse. I was concerned about this at first because I wanted to be able to form a relationship with my preceptor. A month into this new career, I am so happy I am being bounced around! I have been able to form bonds with so many different nurses and see so many different organizational methods! But any way...

I have a book that I wouldn't go ANYWHERE without... Its called Diseases and Disorders: A Nursing Therapeutics Manual I LOVE THIS BOOK! It is so nice because it goes through all different diseases (and disorders :wink2:) covering demographics, assessment findings, diagnostic tests, medications, modes of treatment, interdisciplinary therapy, what to chart and even discharge planning/education! This book stays in my locker and is used all the time. I have found it has given me more confidence as a new grad in the ICU with a good reference book that I can always turn to!

CrufflerJJ, BSN, RN, EMT-P · Aug 5, 2009

Quite frankly, it frightens me to think that new grads do not find it necessary to study at home!
It's your choice. The new grads that refuse to do so are usually the ones who fail.
I still study at home.

I don't think it's a "new grad" vs "experienced non-ICU RN" type of thing. I'd hope that any nurse transitioning to the ICU would be hungry/driven enough for knowledge to spend the time needed to get & stay "on top of their game."

I'll be applying to my employer's ICU following my New Grad Residency in a couple weeks, and hope to get in.

I was reading Marino's The ICU Book for fun & interest when I was in nursing school, doing my role transition in a Level I SICU. Even as a paramedic for ~17 years, I always wanted to know WHY we did things a certain way in our standing orders.

I see it as a matter of how dedicated you are to being the best possible paramedic, OB or Peds or ER or ICU or {fill in the blank} nurse you can be. While I won't be cramming 87 hours a day, every day, I don't plan to do just enough to get by. Studying at home is all part of the process (in my humble opinion).

celclt · Aug 6, 2009

I am pretty excited for my preceptorship in the MICU (level 1 trauma center)

in Oct, what should I expect? I am taking ACLS and boning up on pathophys. Any suggestions?

CrufflerJJ, BSN, RN, EMT-P · Aug 8, 2009

I am pretty excited for my preceptorship in the MICU (level 1 trauma center)
in Oct, what should I expect? I am taking ACLS and boning up on pathophys. Any suggestions?

You should expect lots & lots of learning - both in the class, and face-to-face with very ill (fragile) patients. Besides the normal facility specific knowledge about how you handle charting/labs/admits/discharges, there will be tons of technical info to internalize. Titrating multiple vasoactive drips, insulin drips, propofol drips, CVVHD, interpreting labs, vents, rapid infusers, handling patients with sepsis, DIC, PE (& trauma, if they're admitted to your unit), mystery infections. And lots, LOTS more!

jmunrs2010 · Aug 11, 2009

Congrats to all of the new grads that are starting out in the ICU. I know this is sort of off topic but I was wondering if you all had any tips to share about your interview process for the ICU? Did anyoen get an ICU job without previous experience because alot of the posts talk about being an ICU tech. I work as a nursing assistant at Sentara in the float pool and I have rotated into the ICU a few times but I wasn't strictly there. Will this help? I also plan to do my capstone (preceptorship some call it) in the ICU this spring as class credit. It is only 2 months but will this look good for me to have? Did anyone do anything else that they felt helped them to land an ICU job as a new grad. Please offer any help because I am a graduating senior this May and I want so badly to start out in the ICU becuse the days that I worked on the floor as the tech I enjoyed it so much. OFfer any advice or help... it is greatly appreciated.

carolina4 · Aug 11, 2009

i didnt work as a tech in the icu but i was a tech on the oncology floor...i think experience working on a floor period is beneficial. however, i did do my preceptorship in the STICU

shoegalRN, RN · Aug 12, 2009

Congrats to all of the new grads that are starting out in the ICU. I know this is sort of off topic but I was wondering if you all had any tips to share about your interview process for the ICU? Did anyoen get an ICU job without previous experience because alot of the posts talk about being an ICU tech. I work as a nursing assistant at Sentara in the float pool and I have rotated into the ICU a few times but I wasn't strictly there. Will this help? I also plan to do my capstone (preceptorship some call it) in the ICU this spring as class credit. It is only 2 months but will this look good for me to have? Did anyone do anything else that they felt helped them to land an ICU job as a new grad. Please offer any help because I am a graduating senior this May and I want so badly to start out in the ICU becuse the days that I worked on the floor as the tech I enjoyed it so much. OFfer any advice or help... it is greatly appreciated.

I didnt have any direct ICU experience, but I had my Capstone in the OR/PACU, focusing more on PACU, which is some critical care. This helped alot to land me the job in the ICU.

I also worked at a Nurse Intern on a Tele floor and was floated to the ICU often.

If you are going to do your Capstone in the ICU, that should get your foot in the door. I would take every opportunity to learn as much as I could while doing your Capstone.

Good luck!

shoegalRN, RN · Aug 31, 2009

I just want to provide an update:

I am in my last week of my med-surg rotation in my New Grad Residency Program. I have learned so much and have been given 4 patients to care for on my own. I'm learning how to time management and I think this will help me alot when I got to the ICU.

This week, my goal is to take a full patient load of 5 patients. I think I'm right on target. Some nights are better than others, but it's a hectic and crazy floor. We do get transfers from the ICU, so it's interesting reading the chart and notes for the ICU nurse.

After next week, I'll be going to the ER for 4 weeks. I did meet with my ICU educator and was given 2 take home tests I need to have completed within 2 weeks. I will get paid 4 hours each for taking each of them, and I will be getting 8 hours of CEU's.

After my rotation in the ER, I will start my orientation in the ICU. I will be given 20 weeks of orientation, as well as classroom time. I will also be doing Multidisplinary rounding with the Infection control nurse, the wound care nurse, Respitory, Pre-Op (includes OR and PACU), GI lab and the Cath lab. This is in addition to my ICU orientation.

I think this has been a really good experience thus far. I think rotating new grads to different departments to develop time management skills and IV skills will be really helpful to me in the ICU.

Dreamer-RN · Sep 1, 2009

nurse2be09,

Thanks for sharing your experience. Based on your update, it sounds like your internship is going well and you are getting well-rounded experience prior to starting on the MICU. Best wishes with the ER rotation.

Two weeks to go until I start my internship. I'm ready to begin and started reviewing content. However, I'm also trying to enjoy the last bit of vacation time I have left too. :)

NtannRN · Sep 2, 2009

I graduated a bsn program may '08 and went directly to CCU (Critical Care Unit) at a local city hospital. Our orientation consisted of what they called a consortium. We went to classes (lectures) at different hospitals in the area where nurses from different hospitals also participated. We got to see if the "grass was greener". Anyway, it's been a year and it was the most terrifying, rewarding and self confidence building year. I still have tons of questions but now I'm able to answer some for other people. I don't "study" at home per say, I read nursing journals, nursing2009, critical care nursing2009, ajn, etc. I look thinks up at home when I get a patient that I'm not so sure about. I also work with a fantastic group of intillegent nurses ranging from 1yr with me to 30+yrs. I had a 6mos preceptorship on the unit, the first 5 mos on day shift then 1mos on nights where I've stayed. There are nights where you have time to ask why am I doing this, but then there are the nights where your just trying to keep the pt. alive at all costs. Honestly, I didn't want to go into the CCU right out of school. I thought everyone needed 1yr on med surg first. I was a cna/unit secretary and my nurse manager gave my app. to the ccu manager. She was not easy on me in the interview. Regardless, looking back now with 1 year gone by, it's the best job in the world. Wether you save a life or help someone pass with dignity and without pain, you can't beat it!:redbeathe

Cinqly, BSN, RN · Sep 3, 2009

Nurse2be09, thank you for sharing your progress! It sounds like your residency is very comprehensive! I am into week 6 of my orientation, and I will be spending the majority of my time on the unit. I think the 4 weeks of rotation on a med-surg unit and in the ER would be very beneficial to the ICU RN. Even with only 2 patients, I see time-management as my biggest obstacle. It is difficult for any new RN to learn to balance the responsibilites and gravity of a new career. New nurses are very task-oriented by nature, so I think a solid orientation is important. As far as my orientation, it is 22 weeks long, with the last 3-4 weeks being on the night shift. We have at least 1 day of in-class review each week, which has been helpful for the most part. I will have several opportunities to "loop" to other floors, such as ER, cath lab, surgery, etc. I don't think it will be as helpful as actually spending a few weeks providing care on those floors, but it will help to at least see what goes on. Overall I am happy with my orientation so far, and I feel that they are making a comprehensive effort to ease me into the profession and the ICU. Good luck to everyone working in the ICU! It is hard, but I hope that it will be worth all of the hard work!!