Pre-ICU Jitters

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Hello all,

I just finished my first year of a two-year BSN program in Philadelphia. I did okay academically, averaging about a 3.5, and somehow landed an externship in a neuro ICU with a few others students from my class.

My first shadowing experience was pretty low key but I have to admit the whole thing is very intimidating for me, with equipment and routines that I've never learned or been exposed to in my clinicals. Friends and family are telling me this will be a great experience, and fortunately I don't have much else going on this summer except making the most of this externship and making some $$$. I'll be working my first two 12 hour shift next week, a day and night shift (7a - 7p, 7p - 7a)

Does anyone have any tips for how to stay level about this whole thing, learning new skills, staying motivated over 12 hours, "getting my hands dirty", and having a healthy perspective of what jobs to aim for? I've been told getting a RN job in this ICU out of school is close to impossible, but not unheard of. For some quick background, I'm a 28 year old guy with experience working in an ER, as well as a unique situation where I took classes in med school but ultimately decided it was not for me (about 5 years ago). It's complicated, and I've worked a lot of odd jobs, but this externship opportunity is building my confidence.

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Congrats on the externship opportunity! I hope it is a wonderful experience for you :)

Just off the top of my head I'd say definitely try to see and experience as much as possible (I know that sounds like "well yeah, duh" but I've seen people who didn't go in a room to watch a procedure or whatnot because it "wasn't their patient"...sometimes the good stuff is in another room and as long as you make it known that you'd like to watch and/or help with something usually people will cover your patients so that you can get the experience).

I keep a notebook with questions or things I want to look up/read up on when I get the chance. After I read up on something if I still have questions I write them down to ask when we have a minute to do so.

Learn where the resources are at. Know where you can find the policies and procedures. Become familiar with where things are stocked. I spent a solid couple of weeks taking the time to stock rooms on each of my shifts so I knew where to find what.

There are some great resources under the ICU forums in the FAQs sections, if you're interested.

Good luck to you! :)

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Specializes in Neonatal Nurse Practitioner.

***If you don't know, ask or go find the answer if you know where to find it.***

As soon as you get the chance, go around to the nurses, introduce yourself, and ask if they have anything interesting they could show you. Even if they don't right then, they'll probably remember you and come find you when something is going on.

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Thank you both for the words of advice. I will definitely check out the ICU forums mentioned.

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It is a change in pace from ER. I have worked ER myself but primary experience is in ICU. Just be open minded, ask questions, be proactive in seeking out opportunities to learn.

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Specializes in Critical Care.

I just completed a preceptorship in the ICU! It was a truly amazing experience, I saw and experienced more in my first two 12 hour shifts there than I had in two years of nursing school. I'm not sure how your externship works, but my preceptorship was basically me acting in the role of the charge RN and caring for whatever patients my preceptor was assigned to. My advice is to ask questions, act eager, and ask to see whatever cool stuff is going on. I told my preceptor that I want the sickest patients and that I wanted to see any cool stuff she heard about, so one day she sent me over to the CVICU to observe a bedside surgical procedure on a patient who was actively crashing (the blood pressure was something like 40/35... crazy). Another time, there was a patient on ECMO on the unit and she took me over and explained a lot of stuff about it and showed me how the machine worked. I went to all the cart calls in the hospital and it was just really amazing. One thing I did to get the most I could out of the experience was to look up every single procedure, medication, and disease that I didn't know about and I went over all of it with my preceptor. I introduced myself to all the nurses, volunteered to help them with their turns, oral care, ambulation, etc., and was rewarded with opportunities to sit in on the emergency bedside procedures that went on. Hustle as hard as you can the whole time and ask questions about everything you see!

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You are not going to be alone! Whoever you are "shadowing" is aware that you are new and have a lot to learn. Be honest about that. Don't try and sell what you know, try and learn what they know. They are probably a well oiled team who knows each others strengths and work from that perspective in a crunch and you may feel a little like a fifth wheel but remember; they were all once where you are now. Listen more than you talk and be willing to help wherever you can. Everything will become routine and manageable in time. Good luck to you! Its a hard, hard job but its worth everything it costs you!

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Specializes in Critical Care and ED.

Congrats! I recommend to anyone that is unsure or unfamiliar with anything ICU to go to YouTube and search for videos. You'll find absolutely everything on there, from physical assessment to placing a Swan Ganz to ICP monitoring.

I also recommend this page for ICU newbies. Lots of great information on there.

ICU FAQS: index

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