New job in MICU

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Hi all,

Since before I was even accepted to nursing school, my dream was to be an ICU nurse. However, after doing my preceptorship in a CVICU, I got intimidated, and decided to do Tele first. So, I've been working on a Tele floor for 20 months now, and have been trying to get into the ICU. Well, I finally was offerred a job in the MICU and will start in a few weeks.

I graduated at the top of my class and I'm good at understanding Patho. I can easily handle 6 Tele patients and my patients are very happy with the care they receive from me. I went to school with a couple nurses who started out in this particular ICU unit, and they recommended me to the hiring manager as being "really smart" and my current manager told her "she is ready", which is why I think I got the job. The hiring manager made me feel good, said that she could tell I had a good attitude and willingness to learn, and that they could teach me what I need to know. The only thing that bothers me is that the manager said she would give me 4 weeks of orientation, which really only equates to 12 shifts, plus a 4 hour class on hemodynamics, and a 4 hour class on vents. Does this sound reasonable? I am considering asking for 6 weeks of orientation.

I have printed out all the ICU policies and procedures and reading them, reviewing cardio and respiratory systems, and reading anything I can think of to prepare myself as best I can in the next 3 weeks. I'm starting to freak out a little bit though, second-guessing whether I truly am ready. I had our rapid response nurse make a comment to me tonight that "Wow...you are moving to the ICU fast" being that I have only been a nurse for 1 1/2 years. But, then I think about my fellow students who started there with NO experience at all, versus me now having 1 1/2 years, and wondering how she can say that.

So, I guess I'm just looking for some reassurance that I truly am ready. What else can I do to prepare myself in the next 3 weeks? Any good links or references I can review? Suggestions?

Can someone "talk me down"? HAHA. :D

Thanks.

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I'm sure you're getting the shorter orientation due to your prior tele experience. I'm sure that you've mastered EKG's. Learning the vent's is no biggie. If you're a pathophys whiz, then hemodynamics and drip titration will be no problem for you. If you're not comfortable after three weeks, you can always ask for an extension of your orientation period. If you've already printed out all policies and procedures, you're way ahead of most of the ICU's nurses I know. We usually look up stuff as we go. You're gonna do fine!!

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Specializes in NICU.

4 weeks seems too short to me. I've been working on a medsurg floor for 3 years and next week I'll be starting in the MICU. They are going to give me 12-16wks of orientation. Including dysrhythmia, hemodynamic monitoring, CRRT, and vent classes.

I'd ask for more.

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What about CRRT, IABP? Seems like 4 weeks to learn "basic" ICU patients plus CRRT and IABP isn't long enough. My unit has a 3mo orientation, give or take a little if you are new to ICU or previous ICU experience. Central lines? Road trips with ICU patients? Reading about how to titrate pressors and seeing how they actually work in your patient(s) are sometimes totally different things...education cannot substitute for experience...and a longer orientation gives you the opportunity to get exactly that...more experience...before you fly on your own. A longer orientation gives you more time to work with a wider variety of the patients that your unit will see...and it's always less stressful to learn when you have the benefit of your preceptor right there, because even though you have a resource/Charge nurse, some are better than others. You sound very motivated, and as such I'm sure you will be successful. Best of luck!

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A couple of you mentioned CRRT. The manager said she would wait to give me any of those patients for about 6 months. She said they only occasionally get cardiac patients, so not sure how often IABP would be an issue. Most of those go to the CCU. I think 4 weeks is not enough....that's only 12 shifts. I'm going to ask for at least 6 weeks. Anyway, thanks for the words of encouragement.

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Specializes in Critical Care.

TangoLima, you have far more experience than many MANY of the nurses who are entering ICU now. You also seem to have a bit of humility (oh my imagine THAT) and a very level head. You are totally appropriate in being apprehensive about going into ICU. MICU---these patients are very often extremely multi-faceted, combining medical with surgical and cardiac. Toss in a bit of oncology and you're on your way.

CRRT? You'll be trained for that when you're ready. No need to fret. And although it may look daunting it's really quite a piece of cake. Some of my easiest shifts have been with CRRT patients.

Balloon pump? The new IABP machines damn near run themselves. I won't bore you with stories of manual pumping when the helium ran out, LOL. Your tele experience will serve you well with these patients. You'll get the training when you need it.

Personally, I think you'll do just fine. From what I am seeing (and I am seeing it from a vantage point of over 30 years experience) I think you're ready.

Advice? Take note of the nurses who really know what they are doing and watch how they do things. They might not have the title of "nurse educator" but they are your teachers. Grab hold of them and they'll be your anchors in the storm---and there will be storms.

Firm grip on the panties, head into the wind, and don't look back.

Best of luck to you.

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