Question:ICU

Rise Against · Dec 15, 2009

Everyone goes through that hump of being scared. Just make sure its something you really want to do. No sense in putting in all the time and effort to learn unless you plan on staying. But they say in ICU about two years of experience to feel safe and handle most situations.

medicrn13 · Dec 15, 2009

How many weeks did you have in the ICU with actual patient contact and a preceptor to guide you? I work nights on a Cardiac Care floor and I oriented on 6 weeks of days, 6 weeks of evenings with a preceptor before finally moving to the night shift.

It may seem like a lot, but I felt I was extremely well prepared when I hit the ground running on my own. It seems to me that to have a 6 week orientation with less than 2 weeks of actual patient contact with a preceptor, in an area where you will see high acuity patients, is not enough. However I don't work in your hospital and am not sure of their policies/procedures or average pt condition.

It's only natural to be fearful when starting in a new position, that being said, I agree with the above, if this is something you truly want to do, it will come to you with time. Are they giving you high acuity patients right out of the gate? If so I'd explain to your charge nurse your fears about your position, ask them to start out slower with patients who aren't attached to 1500 different monitors/tubes.

All that being said, I believe after you get some experience you'll be fine, good luck in your new career!!

ittybabyRN, RN · Dec 15, 2009

6 weeks? I am working in a Level 3 (including surgical/ecmo/cooling/nitric) NICU and I am in month 4 of a 6month orientation, I have had 4 hours a week of class time and a full 36 hrs a week of patient contact with a preceptor. I still do not feel anywhere ready to be on my own yet. Six weeks does not seem long enough but I wouldnt get down on yourself yet or give up if ICU is something you really want to do. I have also heard that it can take up to 2 years to really feel "comfortable" and even then the seasoned nurses have told me that a little fear is always a good thing because it keeps you on your toes. Good luck!

denise2010 · Dec 15, 2009

Oh my gosh, this site really works. It helps to speak with people who understand. While on day shift with classes I worked the floor on days. Which was not good to combine classes with work because I was focused on getting through the classes if any. Then I went to nights and really only had two weeks to put things together and learn the policies of the facility. Yes, we do have critical ill patients. That's what bothers me. I have discussed it with mentors and charge nurses and the same comment is we are here to help, feel free to ask me questions. Of course, you have different situations when in orientation and out. I wanted to be in ICU, it wasn't just a light bulb that clicked on and said I am going to be an ICU nurse. I have thought of this before an during school. My other choice was ER but they were not excepting anymore grads. Don't get me wrong everyone has been inviting and confidence booster.

So far my patient load to me seems as though it was a bit much. I think the assignment could have been choosen a lot bitter. Last time I worked I got a patient whom I started the shift of with K runs and bed changes because she constantly had diarrhea. No wonder her K was so low. May I add we like have no aids on nights most of the time and we give baths at night. Thank goodness she had a fecal mgmt bag. My other patient was in surgery had a small bowel repair. Whom I could not really pay attention too because my other patient was busy. I kept assessing his sx site and paying attention to his vitals. Then I noticed a bulge in this flank area called the resident for him to tell me oh thats ok its just his intestines pushing out. Then I noticed some ST elevations , since it was so late I conversed with some nurses and we put an order in for cardiac enzymes with the am labs. Then he refused to be stuck from being tired of being stucked over the course of days. So, he refused. Afterwards, I was going to do a 12 lead. I had to give report by that time and i felt as though I could have done better then that because I could of. His monitor through out the night at times at least three said non sustain V tach. I would rush in a check on him, he was moving around. What else does that indicate and could I have done anything differently. Please give suggestions. I go back tonight too. Wonder how this will go. I am willing to give it some time but you less than 12 week orientation is not good especially when your preceptors are not the same.

The only thing that saves me and at least make me feel somewhat confident is the med surg experience and the feeling of knowing something is wrong. I wonder if day shift would work out better since more resources are around, although that means more docs. Heck at night its like pulling teeth for orders and call backs. I am sorry this is so long but there is so much on my chest. Please advice Thanks.

Virgo_RN, BSN, RN · Dec 15, 2009

At one week off orientation, you should be scared. It will get better with time and experience.

On a side note, there is a fine line between helping and supporting new nurses, and hand holding them. When you ask for help from your coworkers, do you think the problem through first, and present your thoughts as part of the question? If you don't, and are always asking what you should do or how to handle something without even having thought it through for yourself first, then your coworkers will tire of this. You have a brain in your head. Use it!