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Discussion

What should I know

I graduated last May and was hired onto a step-down pulmonary unit. We took patients who where vented/trached, we did some drips (dopamine, nitro etc). I worked there for 7-8 months and recently got a job in a SICU. This SICU gets traumas, open heart pt. basically any type of surgery or trauma. We do IABP, ICP monitoring...everything! I have been on the floor for three weeks and know absolutely nothing or at least feel that way. I just was wondering how long does it take to feel like I actually know enough to take care of these pts? Any tips on learning how to put everything all together, I am trying to study stuff that I see but I feel like I am not doing a good enough job. HELP!!

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Check out http://www.icufaqs.org it is a good starting point. Use the other nurses in the unit for help. What kind of orientation are you getting to the unit?

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Well the orientation is 18-24 weeks...which when I got hired I thought "Oh that should be plenty." But I feel totally lost and I've been on the floor for three weeks now. I try to go home and read about the patient and the drips and lines that they had but it seems like everytime I feel like I have it I get to work and am back at square one. My preceptor says "It's your patient" but I don't know how to trouble shoot, what drip should I turn up? Should I call the physician? For example...my pt was on an epi gtt, his pressure was hanging in the low 80's so I thought I would turn up the epi gtt, so I said to my preceptor...I'm going to turn up the epi and she says no give him some albumin. I guess this just comes with experience but I hate going to work scared everyday. Should I just read and try to absorb anything for anyone who is willing to give me any pointers?

Yeah, some of it does come with experience. Did your preceptor explain the rationale for not increasing the epi and giving albumin? Ask for rationales, always ask why for EVERYTHING. If you really want ICU, hang in there and work hard. It's not easy.

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