palaviccinim

Just apply for some ICU jobs that interest you - my unit hires new grads all the time. I did a year of med/surg before ICU and I will sa that other than time management and a knowledge of different insulin types, nothing in my first year of nursing translated all that much into ICU - it's kind of like starting over.

Hi! I am a new-ish grad (2 years out of school) with 1 year of med surg experience and am about to hit 1 year of Neuro Intensive Care Nursing.. my highs and lows obviously vary greatly depending on the situation (brand new trauma admit often has more lows than highs, but other days i take care of patients who are close to outpatient rehab centers, etc., which often bring more highs). Here are the highs and lows of my most recent shifts: Highs - a gracious family who appreciated my weak attempts to speak spanish in order to communicate with them :) It's embarassing but helpful!, A family who brought homemade ceviche as a thank you for taking care of their 15 yr old girl, identifying a key but subtle neurological change in a patient that prevented further complications. Lows - poop. all the poop. SO MUCH POOP. and doctors who want things done right away, even though they've just placed new orders on both of your patients at the same time. Neutrals - lab draws, taking patients to CT/MRI, IV Starts, dressing changes, etc. I will say that when I first started in ICU I thought everything would be adrenaline pumping madness... In reality, there are definitely some adrenaline pumping moments (yesterday a patient vomited almost 1 liter of blood all over his bed for no apparent reason, then proceeded to aspirate on the blood and was emergently intubated)... but by and large, my days are "assess, turn, clean, feed, meds, repeat." :) Lots more things ot monitor, but not everyone is CRITICALLY critical. :)

The above poster has som great thoughts - for your first couple weeks, it will be most important to familiarize yourself with the anatomy of the brain and the Monroe Kellie doctrine. EVERYTHING WE DO in Neuro ICU revolves around this doctrine. If you know it inside and out - you can walk through the rest with relative ease. Know how to do a neuro assessment on an intubated patient - I am not talking whether or not they can smell peppermint to check cranial nerves - I mean KNOW your Glasgow Coma Scale, we use it daily. Know a good motor assessment and what it means, understand the different types of head bleeds (epidural, subdural, subarachnoid) and what the various treatments may be (watch for evolvement, evacuation, aneurysm coil/clipping). You are a student, so no one will expect you to be an expert (hell, no one expects anyone to be an expert - brains are tough!) but if you want to be able to really engage in conversations with your preceptor and the doctors/residents around you, having a good handle of GCS and different types of bleeds, etc will be really important. We do see occasional Myasthenia Gravis and seizures and such, but I work in a NSICU in a Level 1 Trauma center, so most of what we get are TBIs and head bleeds. Good luck!!!

I agree with not needing to start in Med/Surg before ICU, but it really depends on YOU. If you have great time management skills in school and are confident in your abilities to think critically, you will be fine in ICU. I spent 5 boring months in med surg, and while I feel that every single nursing job has its challenges, med surg just wasn't for me. I started in a Neuro ICU over a year ago and I can say that as long as you are confident in what you know, good with time management, and KNOW WHEN YOU NEED HELP - you'll be fine. Nothing worse than an new ICU nurse who thinks they know EVERYTHING.

Congratulations on graduating! I also graduated with my BSN in 12/12. I got a job at the unit I worked as an assistant on right out of school. After 4.5 months, however, my husband got an engineering job which forced us to move from Florida to New Mexico! I began applying for jobs in April, and applied to about 25 positions. I received 3 interviews and 2 job offers before deciding to accept one in a Neuro ICU here. My biggest piece of advice is to find a way to communicate in your application the reasons you left your last job after only 4 months. Many hiring managers asked me why I left my job after 4 months and were "relieved" to find it was for my husband's relocation, and not because I couldn't "hack it". As new grads, a first job quit within 6 months typically is seen as a new nurse who was in over his/her head. Make sure you make it clear that you had no problems with your job duties, but simply did not gel well with the organization and it's mission. Secondly, follow up on your applications. Call the nursing recruiters at the hospitals you are applying in and just let them know you have applied for a few positions and would like to know if there is anything else they need from you - be polite, respectful of the process and not overly pushy. One of my job interviews came about directly from one of these phone calls - often times the nurse recruiters will find other job postings waiting to be put online that you are suitable for, and give your resume to the hiring managers. finally, present yourself well at any interviews you get. Remember, just because you aren't in the meeting itself does not mean you aren't being interviewed! be polite to everyone - the lady washing her hands in the bathroom beside you could be your new boss. good luck! you will find something.