NEW Grad starting in MICU

[L&DWannaB]

I am an LPN/RN-grad with only 8 months of experience and that experience is in the PACU.I have worked as a Cardiac Monitor tech for 2 years and an ORTHO-tech for 1 1/2 years. While in the PACU I was responsible for caring for at least 1 of our 2 assigned patients. I am confident and comfortable in the PACU setting. I know that I had a ton to learn but I was getting familiar with the Dr's and staff. When I graduated there was no openings in the PACU so I applied in the ICU. Well, I got the job! Now the stress begins. I have been in Kaplan and orientation for the last few weeks and tomorrow is my first day on the floor. I don't want to let on how intimidated I am but I'm really feeling so nervous. I am nervous because I am sure I won't know the meds, I don't know a single person on the unit. My first 3 months with be 100% preceptored and I will have an availible preceptor for the next three months. What are some things that will help me be sucessfull in this unit?

Thanks!

[boogalina, ADN, ASN, BSN, MSN, LPN]

The following website is a great ICU reference: http://icufaqs.org/Good luck in your new position.

[Esme12, ASN, BSN, RN]

index Great site! MAde by nurses for nurses.

[CrufflerJJ, BSN, RN, EMT-P]

What are some things that will help me be sucessfull in this unit?

Congrats on getting into your ICU!

You will learn the meds, and your unit's people. Don't worry too much about that part.

One big thing I'd recommend to help you be successful is ASK QUESTIONS.

One of the :uhoh21:scariest:uhoh21: things for ICU preceptors is to have a preceptee who doesn't ask questions. It's far better to ask a question (or two...or three...) than to make a nasty mistake out of over-confidence, possibly hurting your patient. If in doubt, please ask. That being said, once you ask, please don't keep asking the same question over & over.

Be very willing to help your coworkers/neighbors in your unit. If you see somebody doing a bath, and you have the time, offer to help. This goes a long way at building teamwork.

Good luck!

[CT BSN student]

I was a new grad hired directly into the MICU. It has not been an easy introduction into the world of nursing. I have a great preceptor, but my lack of familiarity with CC interventions on patients requiring rapid and repeated assessments, immediate delivery of care, and multiple changes to the POC hour-by-hour leaves me exhausted at the end of a 12-hour day.

1. I would recommend asking the unit's pharmacist for a list of the most-often ordered meds to review for indications, max dosing, titrations, warnings, etc...

2. Take time to do a thorough orientation to WHERE supplies are kept. Occasionally, someone frantically asks me to grab something they need during an unstable admission or a code and I absolutely cannot find it ANYWHERE, which is a poor situation to be in during an emergency.

3. Make a list of things that were unclear to you each day when you reflect on the shift and what didn't go smoothly that you can review with your preceptor(s). Nothing is as frustrating as having to repeatedly encounter a problem and STILL not know how to most efficiently resolve it (meds not stocked, equipment not working, materials not ready when a pt has to travel, labels needing to be reprinted, etc...). Unfortunately, I have found that there is seldom time during a shift to address these issues, and then I am so exhausted when a shift ends that I don't have the focus needed to review questions immediately. They usually occur to me when I'm in the shower before turning in for the night.

4. Look things up that are new or interesting to you that you encounter, especially research about nursing interventions/protocols. Anything you can add to your unit to improve pt outcomes will be appreciated. New grads sometimes have more exposure to the latest EBP trends that could be helpful to share.