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Surviving ICU/nursing...Seasoned nurse advice for novice?


-To make a long story short....how do you become better at multi-tasking and prioritization while starting in ICU while not compromising quality of care? I would really like to tap in to the wisdom of seasoned nurses...how is this measured most effectively in the novice nurse (is this an innate ability or how is this best measured?)

-Another question (if you are willing to read on) is how would you suggest someone who is naturally more introverted/ slow to warm type personality blend in to a staff that is clicky and favors extroverts? Can one make it in icu if more introverted? This is something I have always struggled with...even growing up.... befriending the "in crowd". I was and still am the nerdy/quirky type, even growing up I often dealt with gossiping/verbal slurs ...small rural communities can be that way). But I can sit down and read a medical text book cover to cover and I often find sanctuary with those that tend to be "misfits"...I am fine with talking with patients though....I enjoy caring for them but when I feel an atmosphere is judgmental/ gossipy especially when I need to depend on others to learn... I shut down become very anxious and struggle to reach my full potential (something that is slowing my progress down as a new nurse). I am also not shy to ask questions...but I've been told that by asking questions it makes me look like I don't know what I'm doing/unconfident (to be honest as a new grad in ICU I do not know what I am doing at times...another relatively new nurse does not ask as many questions, meshes well with the staff, and is super confident however, I would be absolutely terrified to have her as my nurse since she is not conscientious with care...but she is very fast).

-Basically how can one that has a hard time meshing with the "in crowd" survive when progress for this particular facility (same rural town) is based off of what others say about you? Is that typically how ppl are evaluated in terms of judging prioritization/multi-tasking in nursing? And also how can someone become better with these skills? Eg. Pt 1 paging you for pain medication, pt 2 on nitro drip Bp 200/100, pt 3 you're currently in this persons room helping them to the bathroom while the nurses aide is tied up.... And you're to manage this as a new grad independently...any suggestions from seasoned RN's/LPN's?

As a new grad in ICU there will be very canllenging moments as u are still learning how to be a nurse. To address the first part of ur post, the ICU can have very strong personalities; remember u don't have to like ur coworkers or they may not be folks u would ever befriend, BUT you all must depend on each other. I worked weekend nights on a small unit and we all depended a great deal on each other. I had confidence in them and they me and when it comes to patient care especially when one is going bad, this is imperative. I didn't really are for anyone on a personal level, but professionally I respected these people very much.

I was a preceptor for new grads and my advice as far as asking questions - "know what you know, and know what you don't know" I strongly encourage you to ask questions. The most dangerous nurses are the ones who don't ask questions! You arnt expected to know everything and I promise your coworkers don't either- but your responsibility is to ask if you don't know and ask for help when you know ur over your head! If your coworkers give you flack about it, you may want to discuss with your manager. ASK, ASK, ASK!! Collaborate with your coworkers and learn from their experience.

The sinarios you described, if there is any way you can grab someone to help with the PT on the BSC while u tend to the BP that's great. However if that isn't an option, you must think pt safety first and get ur patient back to bed, then tend to the BP. The pain meds would be my last priority in that sinario. Hope this helps! Good luck!