Transitioning to MICU, any advice?

Posted
by onconewgrad (New) New

Hello everyone!

I have 1.5 years experience on an oncology/tele/medical surgical floor and I was recently hired for a position in the Medical/Surgical/Trauma ICU. I will be primarily in the MICU but I was also told it was very likely to be floated to the other areas and that if I have an open bed, I may get a surgical/trauma patient. I am nervous (of course) simply because I know it will be completely different world for me. Any advice? Also, what do you guys use for your report sheet? Any organization tips that work well for you? Anything at all will be greatly appreciated! Thank you!

Here.I.Stand, BSN, RN

Specializes in SICU, trauma, neuro. Has 16 years experience. 5,047 Posts

Congratulations!!

You'll want to learn your vasoactive drips really well, because in emergent situations (e.g. rapidly declining septic or cardiogenic shock pts) you'll have to get them up and running fast. Sometimes we can't even wait for the pharmacist and have to mix them ourselves.

Invasive monitoring and vent modes, VAP/CAUTI/HAPU prevention are basic but important. I'm guessing rhythm strips are old hat coming from a tele floor, but those are v important as well.

Do you know what (if any) the hospital's big populations are? It seems like my hospital's MICU gets a lot of renal failure, DKA, and drug overdoses. A hospital I used to work at would get a lot of severe HF -- pts even flown in from neighboring states -- so lots of pressors, lots of invasive monitoring, lots of LVADs (although that's a surgical intervention), status 1a on the transplant list, lots of VA ECMO, etc. Anyway, when you find out definitely read up on those pt populations' needs.

Do not ever be afraid to admit you don't know something. You cannot let your pride interfere with pt care, and there WILL be times you will feel in over your head.

The ICU can be a pressure cooker full of strong personalities.

Expect that it will feel overwhelming for a while. It doesn't mean you won't succeed. You do need to be humble and teachable.

Enjoy this new opportunity, and know that they saw something special in you to trust you with it! :yes:

nutella, MSN, RN

1 Article; 1,509 Posts

Hello everyone!

I have 1.5 years experience on an oncology/tele/medical surgical floor and I was recently hired for a position in the Medical/Surgical/Trauma ICU. I will be primarily in the MICU but I was also told it was very likely to be floated to the other areas and that if I have an open bed, I may get a surgical/trauma patient. I am nervous (of course) simply because I know it will be completely different world for me. Any advice? Also, what do you guys use for your report sheet? Any organization tips that work well for you? Anything at all will be greatly appreciated! Thank you!

Brush up on meds/drips.

Get a small notebook you can fit into your pocket and that you have handy to take notes. That way you can write down important things in the beginning ... also always shows you are eager and prepared.

Be willing to learn, take advice from experienced ICU nurses, try to "make friends" - offer your help to reposition or hold the ET tube or what not even when you are in orientation - that will give you some insight into working with other people from the team and they will prob appreciate it ...

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 16 years experience. 224 Articles; 27,608 Posts

Your thread has been moved to our MICU forum to elicit responses from experienced critical care nurses who can provide helpful advice. Good luck to you.

ProgressiveThinking, MSN, CRNA

Specializes in Anesthesia. Has 7 years experience. 455 Posts

Read what's posted on the ICUFAQ website. I felt like his articles helped me the most. I also refer to the ICU book by Paul Marino. I think that's the #1 book I see lying around on the unit at work. The Pass CCRN book and test questions will help a lot too, plus you will be prepared for CCRN.