Question for new grads in ICU


  • Specializes in ICU, Ambulatory Surgery. Has 9 years experience.

Hi, everyone!

As a new grad in the ICU, what are your biggest challenges and frustrations?

Anything you wish was taught in nursing school to prepare you for the real life in the madhouse that the ICU can be?

Or maybe there are resources you are currently using that you find tremendously helpful?

I'm on a mission to find the biggest problems new grads face so I can come up with a solution to help them fare better, even in a small way.

Thank you! :)


21 Posts

Following, as I am a brand new grad that will be starting out in ICU in two weeks.

EllaBella1, BSN

377 Posts

Specializes in ICU. Has 8 years experience.

I'm a new grad who is now 8 months into my ICU nurse residency in a large medical/neuro ICU. To be completely honest I feel like my challenges and frustrations related to being newer are pretty well managed at work- the rest of the staff is super approachable and always willing to help me out when I question anything. So I guess you could say that my biggest resources are my co-workers. I think that my clinical decision making and assessment skills are still evolving, but like I said, coworkers/my nurse manager are always approachable and willing to take a second look at something that I'm not sure about. Plus when I look back at where I started compared to where I am now it's crazy to see how far I've come.

If I had to pick something I would say that my biggest challenge is learning to use all of the equipment that I had never seen prior to starting in the ICU. When I started I barely knew how to set up an art line. It would be helpful to have had a 'crash course' so to speak to go over all of the things you really only see in the ICU like EV1000, Bis monitors, EVDs, lumbar drains, CRRT, train of 4, etc. Even basic things like how to set up the a-line/cvp, assisting the MD/NP with central line placements, or how to manage chest tubes (which I barely ever saw in school).

I also think that mock codes would be helpful, but only if they are semi-realistic. We ran a few mock codes among our group of residents with our nurse educators when we first started and it was kind of useless because we were all still a little clueless, and it was all very "Oh, now your patient is in PEA, now they are in AFib"...i.e. no real critical thinking skills utilized. It would have been much better to have unit-wide mock codes with one or two new grads mixed in in specific roles- it feels way different when you're surrounded by experienced nurses who know their roles and you're trying to keep up. Way different learning experience. Plus I had been in a few codes while on orientation, but I was TERRIFIED that I would have no clue what to do when my own patient coded for the first time when I was off orientation. I still remember the name of my first patient to code. That's gonna stick with me forever. I don't know if I would have felt more confident/been less nervous about it if we had run more realistic mock codes, or if the fear would have still been there. Needless to say it wasn't as nerve wracking as I expected it to be, lol.

If you have any specific questions I can answer just let me know!

Also following! I was here looking for some advice. I am a new graduate starting in an ICU. Currently in classroom orientation to start on unit next week. Almost positive I will have a ton to contribute to your request. :nurse: No guts no glory!


144 Posts

Specializes in Cardiac/Transplant ICU, Critical Care. Has 5 years experience.

Hello ladies and gents, I thought I would chime in since there are a few new to ICU RNs in this thread. I have made a few videos that help as a review for seasoned ICU RNs but I really have it tailored to the new kids on the block.

As new ICU Nurses you will definitely be doing your fair share of endotracheal intubations/extubations so hopefully this helps!


434 Posts

Has 5 years experience.


Amazing resource. Written in an easy to read format, much like the way a preceptor would talk to a new ICU orientee. You can order it in book format as well but all the resources are free on the website. Helped me out a lot when I started as a new grad.