New to SICU Advice?

[tinysnailRN, BSN, RN]

Hi all!

I’ve got a question regarding adapting to a new to speciality role in the SICU. I’m coming from just over a year experience in med-surg/tele and to say the least, I feel that working in med-surg did not help me develop any critical thinking skills. Med-surg always felt task-oriented to me and fast-paced that I felt like I never really got to “see the bigger picture” for my patients. I am now lucky enough to be orienting in a new to SICU role and am learning to critically think. My problem is I am having trouble remembering what I’ve learned as I’m trying to absorb lots of information at once and then applying it to my practice. I’m still struggling to see the bigger picture. Because I’m focused on trying to remember everything I’ve learned, I forget the smaller details and things that I should already know and therefore make small mistakes I shouldn’t be making. I’ve also noticed that in some cases, I’ll know the information about procedures & diagnoses in my head, but in actual clinical practice, I blank out. I’ve been self-studying and bought critical care resource books as well as my notes from my didactics, but I just feel as lost as I did when I was a fresh new grad.

Most of my preceptors have told me that they have faith that I’ll do well on my own, as they said that I ask lots of good questions and can see that I’m trying to critically think. They’ve also told me that I can effectively communicate with doctors and that my time management is great. However, I can’t shake the feeling of not being able to learn information quickly, retain it, understand the bigger picture, and apply it to my practice ? Any advice to adapt or improve my performance?

[MaxAttack, BSN, RN]

First off, welcome. It should be reassuring that your preceptors think you're on the right track and have faith in you. Critical care can be overwhelming. My first year I thought for sure I was going to kill someone. It takes a while to get into your groove and it sounds like the people surrounding you believe you're getting there.

My biggest advice would be to don't stop asking questions and don't stop learning. I will still years in go home and research new things I've learned or have questions about. If you find yourself forgetting things, write them down or do whatever works for you. I found compiling things into a reference document is what helps me. Then later on I can always go back and look if I need a quick refresher.

[tinysnailRN, BSN, RN]

On 8/15/2022 at 11:30 AM, MaxAttack said:

First off, welcome. It should be reassuring that your preceptors think you're on the right track and have faith in you. Critical care can be overwhelming. My first year I thought for sure I was going to kill someone. It takes a while to get into your groove and it sounds like the people surrounding you believe you're getting there.

My biggest advice would be to don't stop asking questions and don't stop learning. I will still years in go home and research new things I've learned or have questions about. If you find yourself forgetting things, write them down or do whatever works for you. I found compiling things into a reference document is what helps me. Then later on I can always go back and look if I need a quick refresher.

Thank you so much for your advice! Hopefully I'm on the right track. Just today, one of my preceptors was saying that she was using me as an example to her other preceptee as I always ask "good thought-provoking questions that make her stop and think" and she said one of my other preceptors agrees. I also carry a small notebook with me to work and I write down things I want to remember or look up every shift. I've started a reference document on my laptop, much like you said. Thanks again! ?