Agree with most of the above.
- Read, read, read.
- Listen to everyone (nurses, RT, specialists, ccm), but don't act on every suggestion, or that's all you will do all day. You have to sort and filter the input you get, and with time you get better at triaging whose advice to listen to and act on immediately. It takes a long time to develop your own instincts.
- Err on the side of caution, always, particularly with invasive procedures. If you can check something twice, ensure that they are acting safely, do it. If you ever get a bad, sinking, gut feeling - ask your CCM for help. There's often a valid reason you are worried.
- The seasoned ICU nurses need you stat? Go. They have probably already tried several interventions, before they ever even thought of calling you. This is good and bad. But be warned that if they need you, they generally REALLY need you.
- There is a high turnover of ICU RNs because it is very demanding and not for everyone. Be supportive of the RNs, teach where you can, but don't get sucked into a beginner RN's paranoia. Listen to their concerns, explain what they should be watching for, and leave it.
- Treat the patient, not the numbers or data. It's easy in ICU to collect infinite labs and numbers and values- these are irrelevant if the patient looks perfect with a paO2 of 54, or crap with a paO2 of 100.
- Don't forget to ASK THE PATIENT or their family stuff you don't know. ie. what year they had such-and-such done, why they are on this med, how long this has been happening. So often people now rely on the EMR, which is only as good as whatever the past people entered.
- Use the available resources. SCCM membership is a must, use their website and get involved where you can.
- All your collaborating intensivists may tell you a different way of doing something. Don't get too attached to a particular way, or say "but so and so said xxx". Just listen, ask why they do it that way, try it their way - and when you are more experienced, you can take pieces of each advice and come up with how you prefer doing things. Just collect information and skills as a newbie.
- Don't try to be an ICU nurse. The transition at times can be tough, and sometimes to engender collegiality, you have to jump in and reposition a patient, or help with some "nurse duties" - continue to do so, but don't forget to delegate non-APP tasks too.
There's not much you can totally learn before starting - its a constant learning process to work in critical care!