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New Grad starting off in ICU

MICU   (23,276 Views 59 Comments)
by shoegalRN shoegalRN, RN (Member) Member

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vastudent09 has 2 years experience and specializes in GICU-WE GET IT ALL.

73 Posts; 2,082 Profile Views

I am also a new grad in the ICU. I graduated a bsn program in may. Anyway, I am so jelous of these great residency, orientation pograms I am eading about. I got a 7wk orientation that involved 2-3 shifts a week and then a few classes. I really wish I had a well rounded orientation like soem of the other ones I have read about. I love it there, but I am still really nervous every day I go to work. I guess it will be like that until I have been there a little longer. Well, good luck to eveyone.

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carolina4 specializes in Surgical Trauma Burn ICU, Oncology.

65 Posts; 2,818 Profile Views

you only got SEVEN WEEKS?!!? that is not cool.

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Snakes&Wings specializes in M/SICU; Neurosurgical ICU.

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Congratulations to all you new grads who dive right in to the ICU. Yes, you must be competent in terms of normal values, dosages, procedures, etc. etc. and all the technical textbook stuff.

But here's some advice (you cant learn from a book)when you guys are on your own as primary nurse.....

1. Dont just take any assignment handed to you. If one of your pt is a 1:1 then they should NOT be paired up with another pt. You must be familiar with your hospital's and/or unit's policies if the pt is categorized as such. Check with the charge RN and/or RN youre getting report from. Examples of 1:1's

a post Code Blue pt,

a surgical pt who bypassed recovery room and came straight to you with A-line, CVP, Swan-Ganz, multiple drains, multiple gtts, blood products.....!!!!!!

Q15min BP on one or more vasoactive gtts

a confused, combative, restless pt complete with Posey vest, wrist restraints, pulling all his lines and tubes out trying to get out of bed (Arrrrggggghhhhhhh!!!!!!!!!) while pooping 5X in your shift

Our license and the Pt's well being are all on the line.......you must have some type of malpractice insurance.....

2. The essence of being an ICU nurse is to anticipate what might happen...to catch something before a sentinel/horrific event occurs...

Kind of like playing Chess-"you must think first before you move" (Whats gonna happen if I do this, What will happen if I dont?) Heres where your BEST attribute comes in to play.....critical thinking. Throw in common sense and your gut intuition and you and your Pt will make it through.....

However, there are some things we are unable to fix/help.....sometimes its just their time to go......

Hope this helps.....I can throw some more of my 2 cents later

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Dreamer-RN specializes in ICU, Informatics.

170 Posts; 5,014 Profile Views

Thanks for the advice Snakes&Wings! Please share more when you have time.

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Cinqly has 8 years experience as a BSN, RN and specializes in ICU, Med-Surg, Post-op, Same-Day Surgery.

358 Posts; 7,484 Profile Views

Congratulations to all you new grads who dive right in to the ICU. Yes, you must be competent in terms of normal values, dosages, procedures, etc. etc. and all the technical textbook stuff.

But here's some advice (you cant learn from a book)when you guys are on your own as primary nurse.....

1. Dont just take any assignment handed to you. If one of your pt is a 1:1 then they should NOT be paired up with another pt. You must be familiar with your hospital's and/or unit's policies if the pt is categorized as such. Check with the charge RN and/or RN youre getting report from. Examples of 1:1's

a post Code Blue pt,

a surgical pt who bypassed recovery room and came straight to you with A-line, CVP, Swan-Ganz, multiple drains, multiple gtts, blood products.....!!!!!!

Q15min BP on one or more vasoactive gtts

a confused, combative, restless pt complete with Posey vest, wrist restraints, pulling all his lines and tubes out trying to get out of bed (Arrrrggggghhhhhhh!!!!!!!!!) while pooping 5X in your shift

Our license and the Pt's well being are all on the line.......you must have some type of malpractice insurance.....

Hope this helps.....I can throw some more of my 2 cents later

Thanks for the advice! You are so right!!

I just have to say at my facility, though, yeah right!!!! :cry: I have had 2-patient assignments with one or two of these types of patients already in orientation. I know that patients like these should probably be 1:1, but it doesn't seem like my facility follows that logic. Just this past week I had TWO patients on q15 minute vasoactive drips (3 drips in all betwee the two patients throughout the day). I know it is risky, but what do you do if that is your assignment????! Oh, and restless, combative, in restraints and pooping 5x day...?!? I have that patient every shift in one form or another. :banghead: I hope it will get better as I become more experienced, but I can't help but wonder if it is the norm or just the downfall of the facility I chose to work at. Two year contract looking long now....:cry:

wish me luck!!

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1,338 Posts; 17,307 Profile Views

Hey everyone!

I wanted to provide an update. I have just finished up my ER rotation of my New Grad Residency Program and I will admit I LOVED it! Tonight, I will be starting my SICU rotation. I am excited! After that, it's 18 weeks orientation for my home unit MICU. Once I'm off orientation, I have decided to apply for a PRN position in the ER. Since I am in the MICU, I was told by my educator I can cross train for the ER. But for right now, I'm psyched about finally starting in the ICU! It was so interesting seeing traumas in the ER and then being stablized and going to the ICU. I will be getting those traumas in the MICU.

I also went out and purchased a book called Quick Reference to Critical Care by Nancy H Diepenbrock. I've been reading it and will take it with me every night to work.

Wish me luck!

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carolina4 specializes in Surgical Trauma Burn ICU, Oncology.

65 Posts; 2,818 Profile Views

traumas usually go to the SICU or TRAUMA ICU..not that often the MICU

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Dreamer-RN specializes in ICU, Informatics.

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nurse2be09,

Thanks for the update! Glad to read the ER rotation went well. Wishing you the best with the ICU experience.

I'm coming off classroom orientation mid-next week. Then I'll be on the unit full-time, orienting for the next 15 weeks. So far, things are going well.

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1,338 Posts; 17,307 Profile Views

Wanted to provide everyone with an update:

So I'm in the SICU and found out that's the remaining of my orientation. I've had 2 patients so far, one vented, the other a post crani with a Cardene drip and I was running all night I tell ya!

I'm getting used to the flow of the ICU, the protocols, the charting, the assessments, etc. Some nights are better than others, then it's some nights I'm sitting there bored to death, or I'm running my butt off to keep my patient from crashing.

I'm a very detailed oriented person and I can see why you need to be working in the ICU. I'm also structured and somewhat routine, but also like a little bit of chaos here and there, and you sure get that in the ICU.

The unit I was hired for is the MICU, but it's a new unit that won't be ready until mid December. I think I like SICU, because we get traumas that come from the ER and I really liked the ER when I was there. MICU get mostly the medical codes and other medical issues (DKA) that landed said person in the ICU.

So far, I'm liking it. My preceptor ROCKS! She's only been a nurse for 2 years, one year as an ICU nurse and she is very resourceful. Her teaching style is conductive to my learning style and I think it's a great fit.

I will keep everyone updated!

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studentnurse2175 has 1 years experience and specializes in Psych.

51 Posts; 2,605 Profile Views

I just got hired for the ICU at one of the best trauma hospitals in the area. Even though I have one year psych LPN experience I'm a new RN grad. Its all new to me and I'm very nervous. Thankfully I have a six months critical care program and I've been very blessed with this job.

My question is. Any tips on how to make the best impression for the first few months?

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sunnycalifRN has 6 years experience.

902 Posts; 8,484 Profile Views

I just got hired for the ICU at one of the best trauma hospitals in the area. Even though I have one year psych LPN experience I'm a new RN grad. Its all new to me and I'm very nervous. Thankfully I have a six months critical care program and I've been very blessed with this job.

My question is. Any tips on how to make the best impression for the first few months?

Uh, did you read the posts in this thread? Kind of answers your question.

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