Transition from medical floor to ICU

[lisajtrn]

Hello all

I am new here but have cruised around a few times before.

The hospital I work for has recently finished building a brand new facility and closed the old building that I have worked in for over 13 years. In doing so they have broken up the 63 patient medical floor into 4 different areas. I had stayed on this medical floor simply because of the people I worked with and not the back-breaking job that it was.

I have now gone to ICU and have been there for 4 months since we moved into the new building.

Just wondering how long does it take to get comfortable in such a role change? I am not totally uncomfortable but some things are foreign to me and I don't like not knowing exactly what to do. For example during a code blue, I have participated in many, usually doing compressions or bagging, now my role in that has changed and I find some of the code blues very crazy and confusing.

Just want to be comfortable in what I am doing again.

Any advice?

[Mully]

Are you ACLS certified?

[Altra, BSN, RN]

The move to a new building and reorganization of your old unit has little to do with it -- the bottom line is that you went from a med-surg unit to an ICU environment. If you have never worked in critical care before, there is definitely going to be a learning curve, and it's going to take some time. Make the most of your orientation, and plan to spend some of your down time looking up / reading / studying -- just as you did as a new nurse.

[lisajtrn]

Yes I have ACLS certification. I understand the roles and what needs to be done but when you have an overabundance of people in the room ,as was the case with the last code, there were about 10 people in the room, it becomes very chaotic.

[lisajtrn]

Thank-you for the reply. Many years ago I spent 3-4 months in ICU as a student and when I first graduated I did the odd casual shift there, so it wasn't totally foreign to me. The move to the new building and a different unit mostly affects me in the fact that I miss my old co-workers.

Guess I am just hoping for some encouraging words from people who have made the same transition.

[nrsang97, BSN, RN]

I have made that transition and it just takes time. Almost the same amount of time it takes to become comfortable as a new nurse. So give it about a year.

At least that was how I felt.

[lisajtrn]

That is what I was thinking, about a year to settle in. Glad to hear from someone who has made the same move. Thank-you

[JonM_RN]

The average seems to be a year for someone without critical care experience, sometimes less if you have experience on a monitored unit or a step down unit. Don't feel bad. Continue to participate in as many experiences as you can. Be present at all codes or rapid responses if you're able to. Try to follow the habits of a good, experienced nurse that you trust. If you are the nurse of the patient that is coding and you think there are too many people in your room, tell them to get out! It may seem rude, but once you have your confidence level up learn how to assertively take charge in a code situation. When a code is first called, everyone and their mother usually swarms in - attendings, intensivists, anesthesia, respiratory, residents, nursing, etc. There are ways to professionally tell people that enough help is being provided. When too many people are in the room for a code, that's also how accidents happen. I've seen people trip and fall, and even had one nurse get whacked in the forehard while someone else was removing a head board to use as a CPR board under the patient. She passed out on the floor and we had to send her to the ER.

[lisajtrn]

Thank-you for the words of encouragement. In my 13 years on an acute medicine unit I attended and participated in many codes but there were never that many people at them, Just the 3 or 4 nurses that are on the floor and at least one of them usually went to care for the other 30 patients while the rest of us and the code team were working on the one that coded. I usually did compressions or bagged people and really didn't pay a lot of attention to what the code team was doing so now I am looking at it with a different perspective. I do believe the last code was so confusing because I was trying to keep track of what everyone was doing and with so many people in the room.

I hope for a more calm, organized environment next time.

Thank-you again.

[Dianas1086]

You're going through a lot of changes at the same time, which is tough. New building, new coworkers, new floor! I agree with the one year time frame before you start feeling comfortable. If you made it through 13 years as a medical nurse, I have no doubt that you'll succeed in your current role.

[lisajtrn]

Thank-you. I am looking forward to the day that I am as comfortable in my new position as I was in my previous one. One year seems to be the general consensus. Medical nursing has provided me with organizational and prioritizing skills that is helping immensely.