Questions about what to expect

MB37 · Nov 12, 2008

I'm only a few weeks into my orientation, and I'm in adult ICU and not NICU. I'll still try to answer from my experiences so far, and hopefully some will appy to your situation!

During orientation am I shadowing my preceptor or do I have my own patients?

Where I work, it's neither. My preceptor and I share her assignment, which is typically less complex patients until I'm further along in orientation. I do all the things I'm comfortable with (passing meds, drawing labs, etc.) and she helps me out with less familiar stuff (central lines, etc.) and is available to quiz me and to answer any questions. She also does her own assessments on "my" patients and we compare notes, to make sure I'm not missing any changes. You might do more shadowing your first day or two in NICU, but I'm sure you'll be expected to actually do things pretty early. My preceptor follows the, "watch one, do one, teach one" philosophy, which seems to work pretty well.

How much am I expected to know, as far as what to do?

Not much that's unit-specific, although you should know basic principles of pt safety and general assessment. There are people in my new grad group that didn't learn anything in school re:critical care, and according to my preceptor she's had many orientees in the past who were completely unfamiliar with the drugs we use, vents, central lines, etc. I'm expected to know how to look things up and to ask questions if I don't know something.

How do I know if I will be a good nurse?

That I can't answer. I think I'll be a good nurse because I'm putting my mind to it, studying in my off time, and asking as many questions as possible. I treat my pts as well as I know how and do the best job I can - hopefully that's enough.

What is the best way of acclamating and making myself a part of the team?

Don't act like a know-it-all. Ask questions, and don't "correct" your new coworkers. If they do something differently than your textbook says to, don't be confrontational about it. Say that you learned it another way, and nicely ask for their rationale - they may have a better or more current method of doing a particular skill, or it may be unit policy. Also, be on time, be polite, and always help out your coworkers if possible (fix a beeping IV, get a family member coffee if they ask - anything you're comfortable with).

What's the best way to make friends with the other nurses?

I haven't made "friends" with anyone else yet, but I'm getting along with them. I'm following what I said in my last answer, and I'm chatting with them behind the nurses' station if we have downtime and in the break room when I take lunch.

How do I help without getting in the way?

You're out of school now - it's not about helping or getting in the way anymore. You're actually expected to function independently in a few months, so you start doing things alone. This is still hard for me to get used to - I have to consciously stop myself from asking my preceptor if she'll watch me pass meds or draw blood. If you have a good preceptor, he/she should be able to guide you.

I have heard that nurses dont get any breaks not even to go to the bathroom. If you are working a 12 hr shift at night is it really that bad. I know in school i didnt always get lunch which is fine but i could pee if i needed to.

So far, I definitely get to pee as often as I need to (except occasionally having to hold it for a few minutes, if something acute is happening). Lunch I've taken every day - my preceptor makes me, even if I think I'm too busy. It's not always right at noon, and there may be days once I'm on my own that I don't get to take more than 10 minutes, but on my unit everyone takes lunch daily.

futurenicunurse2008 · Nov 12, 2008

I'm only a few weeks into my orientation, and I'm in adult ICU and not NICU. I'll still try to answer from my experiences so far, and hopefully some will appy to your situation!
During orientation am I shadowing my preceptor or do I have my own patients?
Where I work, it's neither. My preceptor and I share her assignment, which is typically less complex patients until I'm further along in orientation. I do all the things I'm comfortable with (passing meds, drawing labs, etc.) and she helps me out with less familiar stuff (central lines, etc.) and is available to quiz me and to answer any questions. She also does her own assessments on "my" patients and we compare notes, to make sure I'm not missing any changes. You might do more shadowing your first day or two in NICU, but I'm sure you'll be expected to actually do things pretty early. My preceptor follows the, "watch one, do one, teach one" philosophy, which seems to work pretty well.
How much am I expected to know, as far as what to do?
Not much that's unit-specific, although you should know basic principles of pt safety and general assessment. There are people in my new grad group that didn't learn anything in school re:critical care, and according to my preceptor she's had many orientees in the past who were completely unfamiliar with the drugs we use, vents, central lines, etc. I'm expected to know how to look things up and to ask questions if I don't know something.
How do I know if I will be a good nurse?
That I can't answer. I think I'll be a good nurse because I'm putting my mind to it, studying in my off time, and asking as many questions as possible. I treat my pts as well as I know how and do the best job I can - hopefully that's enough.
What is the best way of acclamating and making myself a part of the team?
Don't act like a know-it-all. Ask questions, and don't "correct" your new coworkers. If they do something differently than your textbook says to, don't be confrontational about it. Say that you learned it another way, and nicely ask for their rationale - they may have a better or more current method of doing a particular skill, or it may be unit policy. Also, be on time, be polite, and always help out your coworkers if possible (fix a beeping IV, get a family member coffee if they ask - anything you're comfortable with).
What's the best way to make friends with the other nurses?
I haven't made "friends" with anyone else yet, but I'm getting along with them. I'm following what I said in my last answer, and I'm chatting with them behind the nurses' station if we have downtime and in the break room when I take lunch.
How do I help without getting in the way?
You're out of school now - it's not about helping or getting in the way anymore. You're actually expected to function independently in a few months, so you start doing things alone. This is still hard for me to get used to - I have to consciously stop myself from asking my preceptor if she'll watch me pass meds or draw blood. If you have a good preceptor, he/she should be able to guide you.
I have heard that nurses dont get any breaks not even to go to the bathroom. If you are working a 12 hr shift at night is it really that bad. I know in school i didnt always get lunch which is fine but i could pee if i needed to.
So far, I definitely get to pee as often as I need to (except occasionally having to hold it for a few minutes, if something acute is happening). Lunch I've taken every day - my preceptor makes me, even if I think I'm too busy. It's not always right at noon, and there may be days once I'm on my own that I don't get to take more than 10 minutes, but on my unit everyone takes lunch daily.

I am actually not in the NICU yet (itsmy long term goal im in an adult critical care stepdown) Thanks for ur tips :nuke:

kgmiller1 · Nov 14, 2008

Best way to be part of a team is always be available to step in and help another nurse. As far as getting bathroom breaks, etc, I think it helps to know the nurse to patiet ratio and that may help determine how busy the unit is...Good Luck.