NewICU

I work in a medical ICU, and we (the primary RN or charge RN) transport our patients any time they leave the unit. They are switched to the lifepak monitor, and we are expected to monitor them throughout any procedure. We have no central monitoring, so we have to make sure that we can see the monitor at all times. We actually have a new policy with an algorithm that is supposed to determine how many other people (RN, RT, tech, etc.) should go with us on our trip and forces a sort of cost/benefit analysis of how stable the patient is and how important the off-unit procedure is. This policy was added about 2 years ago after a sentinel event occurred. My biggest concern when I leave the unit with a patient is the monitoring of my other patient. We are often short staffed, and while another RN will look out for my other patient, I know that they don't know them nearly as well as I do and probably aren't watching as closely as I would.

So, I'm fairly new to the ICU environment. I am a somewhat new grad, and I have worked in an ICU for almost a year now. There are some things that are happening in my unit that are driving me a little crazy, and I'm hoping to bounce them off of some experienced ICU nurses to find out if I'm being overly critical or if this is a legitimate concern. I'm also wondering if this is happening in other ICUs. So, here is my issue. When a new patient is admitted at night, we generally try to get our CHG bath knocked out within the first half hour. Our policy requires us to CHG bathe our patients within 12 hours of admission. Management has been getting on us pretty hard as of late, since our numbers are rarely 100%. The issue I have with this is that many nurses seem to focus on the bath as part of the admission over getting them onto the monitor. Patients are generally admitted to us because of a serious issue that will impact a vital sign...as such, my focus is on getting them on a monitor as soon as they are in the bed and developing a game plan for abnormal vitals as soon as possible. Are my priorities in order here or am I being overly dramatic? In my thinking, a patient can be absolutely stay dirty until I get a monitor on them. Why are these nurses okay with bathing the patient and getting the dirty sheets from transport out from under them while they are off the monitor? I feel like I must be missing something. Is this only happening on my unit or is this common elsewhere?

Hi BeautifulDisaster! I don't have any advice to offer, since I am a new grad about to start in the MICU also, but I just wanted to say hi and wish you luck! Excited to start on this journey also!