huadring

I haven't been in the game long, but when a student on the West Coast, I got used to seeing dopamine, dobut, propofol. Now on the East side, I almost primarily see Neo, Vaso, Epi, Milrinone, and Cardene. We start insulin and dex soon after arrival. We have a insulin drip protocol which after 3 q1 hour checks we check q2hours while they are on the drip to maintain glucose 80-110. Tight control as the key. The pt may get to go to Q4 if they have a normal level 4 times in a row, but this is pretty rare. Usually don't get off the drip until they leave our unit.

Hi! I actually just started working in mid-September as a new grad in the CT-ICU at a large teaching hospital. The hospital had set up an ICU New Grad orientation program which involves a 6 to 9 month orientation, numerous classes, the computer course ECCO (essentials of critical care orientation), and so on. I am just now finished with orientation and I'm only qualified to take care of the basic pt population. I will need to go back on orienation for short stints to later take fresh post op hearts, work with balloon pumps, new transplants, and VADs. Even after 7 months of orientation I feel like there is still so much to learn, but I don't regret going straight into an ICU. I think the most important thing is whether or not you feel like there is enough support to help you when you don't know what to do. Does the staff seem to work together, are there NPs on the unit, etc. Although I worry about being on my own, I'm constantly being told that I'll have the support if I ask for it, which makes me feel better. A lot of the knowledge needs to come with experience, so although I get frustrated with myself at times for not knowing as much as everyone else, I know I'll get there in time. Good luck with your new job! If you think you want to work in the ICU then you should do it.

We practically only use Dex for our CT surgery patients. Although I have seen some pts get a little hypotensive it usually doesn't happen. They are awakable but subdued. It is a great alternative. We've definitely had some patients on it for weeks, and a few larger people at doses up to 1 mcg/kg/h. A lot of times the nurses will suggest it to the CCU residents who usually have never heard of it.

Hi. I am trying (with much difficulty) to decide between accepting a job offer at a major university-affiliated cardiac ICU or a smaller community Cardiac-Thoracic ICU. I shadowed at both and am having difficulty choosing, partly because I am unsure what I will need and want further down the line. Both hospitals seem to have great staff and management. The community hospital mainly sees post CABGs, valve replacements, etc. The major medical center also works with transplant candidates on VADs (at least 5 different brands), post transplants, and much more. As a new graduate (who had an extended ICU internship during school), I know I would have a lot to learn at both hospitals for quite some time. I feel as if the community hospital may be more nurturing and manageable due to its small size and limitations in the types of patients they receive. However, the medical center will definitely keep me on my toes and provide learning opportunities for a greater period of time. Any input on this topic would be appreciated. Thanks!

Thanks for all the replies. I'm still on my extended honeymoon but will be back in the states very soon and heading out to Rochester. All of the posts are making me excited about the new adventures ahead, in both life and nursing. I'm also glad to hear about the ethnic diversity and of course, the great food!!!

Hi. I am a new grad moving to Rochester in August (from Oregon) and I would love any information and/or comparisons as to the different hospitals and the Rochester area in general. I am looking for a position in the critical care setting and have been in contact with RGH and Strong Memorial. Are there any other hospitals with CCU/ICU's? Can anyone give input on these 2 hospitals? So far my only contact in Rochester has been with nurse recruiters, so I would love to hear from actual nurses!