New ICU Nurse

[ddd2012]

I just received a job offer for a PRN icu position at my local 86-bed acute care hospital. The ICU is general with 8 beds, one pediatric but rarely gets filled. Orientation is Sept 5th. I've been a nurse for a little over 2 years now but never in a hospital setting. I have 15 months in long term care, and currently am working with home health for 8 months. My home health client is a 19 month trach/vent patient, which is the total reason I got the icu job. Any advice for working in a general icu?

[icuRNmaggie, BSN, RN]

This may sound harsh but please know that what I am about to say is in your best interest.

You should receive a six month preceptorship before being allowed to function independently and count as staff.

Anything less is a recipe for disaster.

Starting out in med surg or telemetry as a per diem would be much safer at this point in your career.

[ddd2012]

That's what they have planned for me so far.

[icuRNmaggie, BSN, RN]

That is wonderful. Congratulations. That is a lovely picture but you really should protect your identity on a public forum.

The key factor is for a new nurse is having a very experienced, knowledgeable and responsible preceptor. Speak to your manager if you need to change. In a community hospital you will see AfibRVR, symptomatic bradycardia, GI bleeding CHF, Resp. Failure, BiPAP, mechanical ventilation, ARDS, Acute renal failure, Hepatic failure, Hypertensive crisis, a lot of DKA, Severe alcohol withdrawal,Seizures, Sepsis and abdominal surgeries. Know these disease processes. You will see these limited number of situations over and over again in a Community Hospital ICU.

Get your ACLS and a dysrhythmia course.

You and your preceptor need to take the sickest patients every single day.

Learn your vasopressors, and rapid sequence intubation drugs.

Know your hospital protocols for sedation using Fentanyl, Precedex Propofol and lorazepam and their concious sedation policy.

Know your IV drug compatibilities.

Know your hospital's policy for infusion of blood products.

Most of all you must be committed to studying, reading and educating yourself on anything that is unfamiliar.

We love a new nurse who has the initiative to look these things up and form an intelligent question.

The BKAT or basic knowledge assessment test for Critical Care will help you to identify the areas that you need to focus on. LTC experience is valuable and you probably know a little more than you think that you do.

No gossip, be friendly and helpful to others, no using the cell phone except in the break room.

best wishes,

Maggie

[ddd2012]

Wow thanks! I actually had went last winter and got ACLS and PALS trained, just need a refresher lol