I just started a residency program in med/surg ICU, 18 beds, day shift. WOW! I was an excellent student in nursing school, so I assumed it would be scarey but not too bad...I was wrong. As a student, we can go to our preceptor, or whatever, we are under their license..BUT as a licensed RN, we are 100% responsible for everything we do. Very overwhelming. We graduate from nursing school prepared to learn how to be nurses. We know the information from the books, but now we need to learn how to apply it. By going directly into critical care we are learning basic nursing and critical care nursing at the same time, it can be a bit of a sensory overload. BUT! I am encouraged. Every day I learn something, and every day I get a little better. One of the nurses I work with reminded me that there is a HUGE learning curve when starting in the ICU, as well as a very steep comfort level curve. I was not used to feeling so lost! Do not be afraid to ask questions, and learn to develope a thick skin. This will be YOUR practice, be your own advocate, dont let older nurses deter you from learning to be the best nurse you can be. For me, studying didnt stop after graduation. You will need a good critical care book, and be willing to spend time reading it, along with journal articles to keep yourself up to date with evidence based nursing practice. And finally - this site is a blessing. You will find encouragement and great resources here! Good luck!