Published Mar 21, 2009
littlecandle
11 Posts
Hello,
I wasn't sure if I should post this under students or here. I am starting me preceptorship in the ICU next week which I am very excited about it and hope to get as much from my experience there as I can. My goal once I graduate is to hopefully get a job in a SICU or MICU. I was wondering if people had suggestions on how to gain the most that I can. I've already met with my preceptor and she seems tough but wonderful! I have started reviewing some things on hemodynamic monitoring and ECG's. I have been reviewing meds and was also wondering if there were particular ones I should be paying more attention too.
Thank you in advance!
Mommy_of_3_in_AL..RN
214 Posts
I also precepted in SICU,and just landed a job in MICU!! I would suggest being very familiar with ventilators, as well as the pressor meds, cardiac meds, and narcs/sedatives. Be aware of what labs are abnormal, and at what point you should worry about them. Know that each patient is different, and just because you were taught a value for lab or vital sign in school is "abnrmal",remember, that may be that persons normal. Also, be confident and proactive about getting experience where you need it. Do not allow them to put you off to the side because you are a "student", and give you the easy patients that do not require much. (My preceptor always gave me challenging patients, but some of my fellow students were not so lucky). Good luck!
Thanks! Congrats too!
Sarcolemma
69 Posts
to add to what others have said
PACEP.org is a free site that will completely run you through hemodynamics from basic to super-advanced if you have the patience for it. Video lectures, pre and post tests.
it focuses on pulmonary artery catheters, but the concepts extend far beyond that to general ICU practice/critical thinking. if you do it you'll be far above and beyond anyone at your level, or many people above your level.
TemperStripe
154 Posts
I did a full-time summer internship in a SICU and was recently hired to work there as an RN. (I graduated in December.) I am actually have a different opinion about preparation. However, let me first say that I loved my internship and had a wonderful experience and learned a TON. I feel so lucky to be working on my unit now, because I already know "how things work" around there, so I don't have to figure that out while also learning to be a nurse. Additionally, my unit is incredibly supportive towards new grads.
Now, regarding the internship; I did not do any extra reading or studying. None. I was taking a class and a clinical at the same time, so there simply wasn't an extra hour in my day to study vents, EKGs, ABGs, etc. However, I asked tons and tons of questions. I looked stuff up all the time during my shifts. And because the nurses on the unit are so supportive of interns and new grads, they were happy to teach me all kinds of things. I wrote down "key words" to look up later, if I wanted even more information. After a few weeks (it was a full time internship during the summer) of getting to know people, I felt comfortable enough to advocate for myself. If there was a cool procedure going on, I'd ask the nurse if I could look in. If there was a code, I'd ask my preceptor if I could go. I was never told "no," that I can remember. Pretty soon, the nurses would come and find ME if something interesting was going, although our unit is fairly small, so it's hard not to notice the giant crowd of people forming outside a room. :)
Although I never studied ICU information outside of the ICU, I studied hard in Med Surg II, which was basically a critical care course that I took before the internship. That seemed to pay off, as one of my prouder moments as an intern was when I was able to recognize my post-CABG patient going into a-fib (the beginning of a long series of complications.) My nurse let me call the resident, have the conversation, and take care of the problem. (Obvioulsy I was supervised.) It was very gratifying. I thought, "maybe I CAN do this!" However, I didn't have a lengthy EKG class behind me. We had simply studied a few of the most common rhythms in Med Surg II.
My feeling is that because you are a student, you really shouldn't spend time bogging yourself down with tons and tons of highly specific information that you will most likely forget between graduation and working. Your job as a student nurse is to see, do, hear, and feel. Practice being safe. Go to codes. See every procedure you can. Ask millions of questions. If you decide critical care is your thing, you will have (or SHOULD have) a huge orientation to help you begin to learn the rest of the stuff, or at least begin to understand what's important. Rome wasn't built in a day, and the same goes for being a critical care nurse. :)
Enjoy every second of your experieince!
Caroline
louiemed5
42 Posts
I am in a similar situation. I was just hired into the IMU (Intermediate Care Unit-sister to our MICU), after being out of school for nearly a year! I'm very nervous, but confident that if i ask a lot of questions and just keep my eyes and ears open things will work out. Although, if anyone else out there has any other bits of advice for new R.N.'s on the units, please PLEASE fill me in!!
thanks! :)
Thanks! Unfortunately my time in the ICU is very limited so I wanted to be able to get as much as I can from it. I think the most beneficial thing for me as been my attitude about being there. I get there early and nurses from the day shift are always quick to try and get me involved with things till my preceptor arrives. I have learned so much! I guess my advice for any one else in the same situation as me would be to make sure you know your electrolytes and imbalances cause that has saved me so much time as well as acid base balance and how that can affect medications. Thank you all!
netglow, ASN, RN
4,412 Posts
Had a short ICU rotation, and I am sure most posters will give me a big "duh!" but... watch your IVPs do them right, look them up if you need. I saw fast pushes on meds that need slow pushes as well as slow NS flush after pushing, and maybe one or two little problems because of incorrect pushing.:wink2:
mmutk, BSN, RN, EMT-I
482 Posts
Don't forget to go to the ICUFAQs website too
Thanks! I just checked it out. Thats a great site. Lots of information.
I have a great program on my iPod Touch that allows me to look everything up really quickly. I stand in the back while the docs round and just tap away, looking up all the meds and diseases and whatnot. Really helpful. Today my preceptor and I spent 15 minutes looking up/discussing acid base stuff. Tons of fun. A good attitude is key! Good luck in your rotation, hope you love it!
Thanks! I have a PDA that I need to update with nursing stuff (-: So my friend and I that are both precepting in the ICU have the same problem. On the unit I hear the alarms and bells that go off for my patients and there not that many but as soon as I leave the unit all the way till I get home and go to sleep I still hear them! Its like my minds has forgot that I left. Any one else every experience that? :imbar