New ICU nurse, need advice please???

[ICUnurse201]

In January 2012 I will have been an ICU nurse for a year, I came straight out of nursing school. When do you finally feel "ok" about your job? Bc right now every time I work, I feel like Im not doing enough. When giving report to the next nurse Ill tell her something about, for example, the pts labs being slightly abnormal (not critical) and she will say that its because of this or that and that I should have called the doctor....I just HATE feeling stupid

Any advice? pointers?

Thank you!

[victo019]

I prececpted in STICU and then took a job there when I graduated. I made a yr of being on my own this past week. I feel that I have learned a lot. Although at times I still feel like I don't know enough. You have to remember that those RNs that u feel stupid around were once only a yr out...feeling the same way. Each shift you just have to take one thing away and learn that one thing. If you do this, over time you will be a great and competent nurse. Unless you just suck. Lol. J/K. I think everyone goes through this. We are taking care of some really sick pts. Just be safe and look to those you trust for help when u need it. If you are unsure about something or if something just doesn't feel right....SPEAK UP. Don't ever not ask a question about something because you don't want to sound stupid. That stupid feeling may save your pts life. You can also brush up on topics that you come into contact with while at work. Nursing is life long learning. I hope this helps and encourages you to go far. Good luck!!!

[papawjohn]

Hello, fellow ICU nurse!! I've been at this over 30yrs now and still find that giving (and to some extent, getting) report is sometimes the most stressful part of the 12hrs. Isn't that nuts!!

Think about it for a minute. You've watched your patients rhythm for an entire 12hr shift and there's not been a single ectopic beat. Then the AM labs come in and his Magnesium is 1.4. OK, so how serious is that? Your person experience says -- not so serious. Eh?

You place a call (maybe -- and if you don't, so what?) to the answering service @ 0630 because you have to report 'critical' labs. You don't get a call back....

And soon you're giving report and mention that the next RN will be giving MgSO4 so you've gotten the 'Protocol' out and put it on the chart but the MD hasn't called back.

And that next RN makes you feel like you've been leaving your patient in grave danger all night long and what the H#LL do you think you're doing leaving up to them to correct that horrible electrolyte imbalance!?

Let me tell you -- the problem is the expectation of that next shift nurse.

Our patients are badly broken people. You, doing the best and most work that one person can do in 12 hours, cannot 'fix' them. We always pass 'broken' patients to the next shift. That's why they have ICUs and that's why they keep them working 24hr/day. '

If you had IDENTIFIED a particular problem for that next nurse -- THAT'S the important thing!! You have assessed and treated and re-assessed and you are giving them the distilled knowledge of 12 hrs of dealing with the patient and you're alerting the next RN to sudden problems that have turned up. That is your job.

It is NOT your job to turn over to the next shift a Pt without problems.

Keep up the good work and

Stay vigilant

You'll do fine.

PapawJohn

[sunnycalifRN]

What I love about working in ICU is that you will always get challenged with new situations, new syndromes, new diseases, that you've never dealt with. Even our most experienced ICU nurses (35 yrs+ on the job), don't have all the answers. But, to answer your original question . . . I felt pretty comfortable after 2 yrs.

[Biffbradford]

You're doing fine. 1 year? You're still a newb. It all takes time, so just take it in stride cuz as you learn more, you get more complex patients and it only gets worse!

[hodgieRN]

Took me a year or two to really on top of my game. I still learn something everyday.