New position in ticu.. Any advice?

[ksm23]

Hi all! I've recently been offered a position in the trauma icu at a level I trauma center. I am still contemplating accepting it, but most likely I will. I have 4.5 years experience, working on med/surg. Although my unit recently became primarily orthopedic patients. We used to just get a mix of surgical and ortho. Anyways, I'm just ready for a change. Any good advice you guys could give me on making the transition to critical care? Anything you wish you knew before starting? Any books you might recommend.

[MYSTICOOKIEBEAR]

Congratulations! Be ready to learn, and be ready to have your mind slammed with a lot of information. Don't be afraid to ask questions because when you are in a high speed situation your base of knowledge can either save or kill a patient. Become very familiar with rhythms if you are not already well versed in them. I transitioned from a CVT stepdown into a Cardiac/Transplant ICU and felt like I knew nothing! It is going to be scary and very intimidating, but if you want to grow, continue to better yourself as a nurse, and open doors of opportunity for your career, this is a very good step.

[lassenlake]

Most level I trauma units will be among the most fast paced units. Plan on learning skills which respond to hypovolemia and how to use a level 1 infuser. IV access, changes in skin color and tone, frequent labs and going to and from surgery are frequent in that type of unit. Skills to focus on are assessment of vascular volume, differentiating types of shock and when to sound the alarm for changes in vital signs. If you see neuro trauma patients know the various modes of checking ICP. You must be on top of your game as unlike many ICU's trauma demands frequent emergency assessments and interventions. If the bp falls is the sedation or loss of volume? Hundreds of questions. Stay focused on the top 2 things that can kill your patients and address those continuously throughout your shift.