Transition to ICU

[rumpsticker]

I have recently transferred to work in the ICU in the hospital I have been working for just a year now. I previously was a LPN for many years and became a RN about 18 months ago. As that was the situation I thought that a specialty area such as ICU would be good for my resume and a new challenge with an opportunity to learn a lot more. I have attended several classes and have several more to complete but as an old Med Surg nurse who is used to a patient ratio of 6 to 1 or at least 5 to l I am finding it difficult to adjust to only 2 patients and time on my hands I attempt to study a Critical Care book when I am not busy. What should I do to help with this and what can I do to enhance my CCU/ICU experience?

[meandragonbrett]

Look at labs and look for trends over the past week and see how that relates to what is currently going on. Do they match the clinical picture? Look at vent changes when compared to the ABG....how did that change affect their ABG? Look at fluid resus and the changes in lactic acid trends. Learn about hemodynamics..... pacep.org is the site for pa caths. Grab a PASS CCRN book and go through it to help you review some basic A&P, pharm, and pathology of every system that is routinely seen in an ICU. You didn't mention, but is your ICU a specialty ICU or just a general ICU?

[RNperdiem, RN]

My policy with free time(unless I have had a crazy day and am sitting down for the first time) is to go around and ask the other nurses and ask if they need help.

I like to invest a little time assisting the other nurses if I am having a slow day.

[DeLana_RN, BSN, RN]

Consider yourself lucky! "Only" 2 patients! Have you not been there long yet? ICU nurses I know tell me that 1 or 2 critically ill pts can keep you busier than a whole med/surg team ever would. It will happen. In the meantime, enjoy the "slow" times and use any minute you have to learn and - as pp said - help your fellow nurses.

Best of luck to you!

DeLana

[JomoNurse]

Having only 1 or 2 patients is an absolute dream. Sure they are sicker, but you have the tools available to you to get the job done. It's also nice that you're right in front of the patient's room so you don't have to do a lot of walking. I've noticed there is a LOT of down time in the ICU. Lots of nurses pay their bills, or read magazines, just anything to keep them busy.

Having 6 patients in Med-Surg is a physical nightmare. You're constantly walking all over the place. I prefer ICU any day of the week.'

But to answer your question, If I'm having a very slow night I'll ask the other nurses if they need help. If they don't, I go to sleep.

[CABG patch kid, BSN, RN]

Having only 1 or 2 patients is an absolute dream. Sure they are sicker, but you have the tools available to you to get the job done. It's also nice that you're right in front of the patient's room so you don't have to do a lot of walking. I've noticed there is a LOT of down time in the ICU. Lots of nurses pay their bills, or read magazines, just anything to keep them busy.

Having 6 patients in Med-Surg is a physical nightmare. You're constantly walking all over the place. I prefer ICU any day of the week.'

But to answer your question, If I'm having a very slow night I'll ask the other nurses if they need help. If they don't, I go to sleep.

HA! Well where I work, we rarely have "lots" of downtime and 9 times out of 10, if you have a light pt load (stable vent, tele pt waiting for bed, etc.) then I bet one of your coworkers has her hands full and could use some help. In my short experience, there is much more teamwork in the unit because when one nurse has two pts crumping at the same time, there is no way that nurse will be able to handle it all by herself. This just happened to me over the last week and thank God I had two other nurses helping me or one of my pts could have been seriously injured.

[PostOpPrincess, BSN, RN]

If you feel you need to enhance your experience, try a hospital with sicker patients. Trauma Level 1, transplants, teaching hospitals, etc.,