WorldDay

After graduating from nursing school, I went straight to ICU (10 bed) and got myself trained. Like you, therefore, I have very lucrative ICU experience, so it was very easy to find Agency job. when I was full time staff RN in an ICU, I hated employee meeting, group, must involvement in the Unit, various pet projects, FORCED overtime (they fire people who don't show up in off days), nasty performace evaluation, and I hated all of them. Now that I only work for Agency as per-diem, I can work as many as 36 hr. to just once a week. It is so great not having to deal with management completely.

I think being comfy in ICU will come to you after 12 months of waking up/driving home thinking, "Oh God, I forgot that," "Oh God, I forgot to tell them that." What pathology and what you need to know will come naturally because you get same types of patients over and over including dying one after an arrest and dealing with family and departing loved ones. Cut yourself a lot of slack and if you are not in supportive environment, you should switch hospital because some ICU is very toxic.

My answer would be no b/c policiy dictates that act level has to be at certain point and PTT has to be less than 45 or something. But this RN says that cardiologist told her to run Integrin until MN and pull sheeth before that. I was wondering because I woudln't imagine pulling sheeth out of PT with heparin running. It has to be stopped. Wait for 4 hours then check PTT then pull, femstop for 4 hours then PT can bend.

Recruiter for me first talked about ICU placement only in Metro areea only, then wondered toward less populated area (1hr drive I live 15 min walk from 4 major hospitals) then mentioned LTAC on vent. Guess what happened? I went to less than popullated, sorrounding area hospital ICU (definately not trauma 1 center) then later on found myself booked to teeth at LTAC on Vent PT. Money was good at LTAC b/c I made $7000 / month. But Recruiter who actually have working relationship with area hospital is easy to spot because they don't dance around, they don't take RN who does not satisfy criteria to teeth, and they send you to Trauma 1 straight up and expect you to perform 110% T:LDR So if you feel like your recruiterr is dodgy, get a different one.

i remember a preceptee was doing this in ICU and the charge told her to "push it, you are acting like med surge nurse ."

i was taught to "go big or go home." if my pt's map is truely 40, i would go 20-25 watch the 5cc goes in the pump then back off to 15-20 then quickly titrate down to something reasonable. last thing i want is stroke but so is aki needing dialysis just because protocol says so. go by your clincal assessment of pt state - protocol s not written to cover all pt. i rememberer running eip at incredibly high rate during code b/c thats only drg pt responded.

like...4 month

Depends on where you work, and their culture, you might winded up getting pick on because those with MS skills mastered knows certain things, and they (ICU RNs) have to teach very basic of nursing. So, they will do their hardest try to get you written up and get to expelled from the ICU.

Yah I never recieed EPIC training and figured it out all by myself how to chart. Protocols are similar so I just check with charge and make sure my understanding is correct. It gets lonely but I am used to lonesomeness and not having to be part of clique and gossip are great perks of being an agency RN. No up and down performance evaluation based on customer satisfaction either.

Remember 1st, you are in a toxic work environment; not all ICU is like yours, and there are many ICUs with supportive staffs, they welcome new RN with open arm and willing to do anything to help. My RN job started out that way and I did not know any better. So I concluded that they were right, I suck at my job, I am new grad who went straight to ICU and that was wrong. Well well. It just so happn that I work for different hospitals now (Agency) and I discovered that the difference was night and day. Even when you make mistake, or trying to be proactive and ask question before doing something stupid, people line up to help you out. No gosship at all.. They are all about team work and help each other (well in ICU you kinda have to) and there is no "Oh god it's that new girl again, what does she need help with." Make sure you do not get a job from this ICU. Find another one. If you have more opportunity, talk flankly to your clinical instructor and ask for different assignment in different ICU/hospital. Culture in the unit could get so ridiculously toxic it is not worth fighting. If anyone make you feel like you are slow, remember that they werer even more slower (I bet) when they got started. Don't let other people's judgement be your own self evaluation. Remember that what your struggle stem from something situational.

It's true, you can get block schedule (some place if they like you, they schedule you counting you as core stuff) and work full time. Good part about being agency with less years of experience is the pay. Whenever I switched agency, I got $10 raise in my hourly rate and I am in a good place where I only work Per-Diem yet make enough to pay rent buy food with lots of free time. But I also encourage you to explore full time position in Chicago's teaching hospital. It will be a great boost to your resume and experience you gain is immeasurable. Maybe you could find tele job next in Chicago. I know right now in my area, ICU experience is most sought after, ICU nurse always have shifts, and hard to travel with MS 1 year skill.

it will be like onc/med-surg busy shift on steroid.

sometime its jut the culture of unit. if you worked in a different unit, they would have just said, "that was bad," or "oh god it was ugly" without attributing fault to any person. so remember at least it was just that nurse making inappropriate comment about your competency. sounds like you did what any nurse would have done. I also want to remind you that sense of "have I done something wrong," that nagging sense in a gut goes away as you get more years of experience in ICU. A year from now, the same thing happen and you won't feel the same way anymore. You just know from your experience that you've done everything accordingly so what happened was not your fault.

ICU learning was easier when I was in BSN at the same time. I am sure your education RN could give you some advice. If nothing else then go for it (while you are alive so hard to get started when you are oos for 3 yr.).

I was wondering if you eat regularly at all. Sometime all someone needs is proper break and eat (protein carbs and caffeine). You will be amaze how easy time management becomes and how much more left over time you got yourself and always ahead. You never have to do over time again!