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Thread: New Grad in ICU

  1. #1

    Question New Grad in ICU

    Does anyone have any suggestions for me? I am a new grad starting the ICU. I am looking for any and all advice I can get! We have 6months of training but I would like to go over anything I can ahead of time! Thanks!!

  2. #2

    Smile Re: New Grad in ICU

    The ICU can be an intimidating place for a new grad, even after 6 mos of orientation. However, you will learn volumes & will be a better nurse for it. The most important thing I think I learned was-#1 time management, but #2 know your drips!!! I work in a Surg/Trauma ICU and we use a lot of drugs that I wasn't familiar with prior to coming here (I worked ED previously). The ones we use frequently are: Neosynephrine, Levophed, Vasopressin, Dopamine, Dobutamine, etc. Those are the vasoactives that we use a lot in trauma. Also, it may be a good idea to buy a critical care reference book. I use one called "Fast Facts for Critical Care" or something like that. You can find it at It's definitely worth the money. Just remember to not get overwhelmed & ASK QUESTIONS!!! Don't ever be afraid to ask if you don't know something. You & your patients will fare better if you do. Hope that helps a little. Good luck!!!

  3. #3
    Junior Member
    Join Date
    Dec 2006

    Smile Re: New Grad in ICU

    Hey new grad,
    I'm fairly new to the icu scene myself. Ive been working the icu for 2 years now and have picked up alot of knowledge in the last 2 years. A few things that have helped me out--Check out this book by dale dubin Rapid interpretation of EKGs it's one of the best for learning your heart rhythms. The book is read like a story and not just boring information, a little comedy thrown in to make it a good read. Another key piece of advice is to learn your drugs, I.E., nipride, dopamine, epinephrine, atropine, etc. Totally agree with rockinrobyn, asking questions is a must! Learing PA catheters is a little difficult - takes a lot of practice! Take an acls course and practice what you don't know and you will do great!

  4. #4
    Junior Member
    Join Date
    Aug 2009

    Re: New Grad in ICU

    I am also a new grad who may begin my career in the ICU. i wish you luck and maybe we can share stories as we grow in the field of nursing. By the way RockinRobyn RN the website is call but thanks for the info. I will definetely look into it.

  5. #5

    Re: New Grad in ICU

    I was exactly in your shoes three years ago. Here are some advice and tips I have that may or may not work for you....
    1) try to get your practicum or leadership course with an ICU nurse. Exposure i think is key.
    2) don't ever throw your critical care courses notes away. You never know what kind of training you are going to get from a facility so keep them. You don't always get the same kind of patients and generally icu beds are non-discriminatory esp. if it the last icu bed avail.
    3) of course not only know all your drips (make cheat sheets in a note book, and I made one to go on my badge as a quick reference of the dose ranges for the drugs and how they are given:
    ie. mcg/min, mcg/kg/min, mg/min, units/min, units/hour... etc.
    Ask the nurses where you work what are the typical drugs used. The fist ICU i worked in was CICU, then I oriented and picked up in CVICU. The drugs here are pretty similar. THen i moved, and now I work in a Trauma surgical ICU-where the meds, situation are completely different for every patient because every scenario is different.
    4)Get your ACLS.
    5) If you are having a code situation. Watch. Be the recorder. Do not be the person to push or pass drugs. ONce you get acclamated to the crash cart its contents and what the drugs do.
    6) Try to find a hospital that offers critical care classes to nurses transfering to ICU or new nurses. My first job, on top of my orientation I had ICU classes. We did cardio for several weeks, resp., GI/GU, Neuro, then we did a miscellaneous equipment class that went over different things like setting up pressure lines, the swan set up in our facility. We were a very large hospital and we had a very sophisticated manequin that they could make do just about anything from increasing his icps and that to him going into vtach it was an awesome thing... (too bad I moved).
    7)Don't think you know everything ever! (This is a dangerous attitude) Noone ever does. I learn things new everyday. If you don't get the extremely difficult patients at first don't worry. Get your things caught up and ask the nurses to do to show you something you may or may not have seen or what they need help with.
    8) always keep up with your charting. although difficult at first, but i see nurses out there that chart everything at 5 am/pm and rush around at the end of the shift. what if something actually did happen and you had nothing charted. If nothing else, keep a dry erase marker. most icus have glass windows to write on. if you can't leave the room mark events and meds on the glass so you will remember to chart it later when you have a minute.
    9) you can do this. many people criticize that all new nurses should do med surg or tele first to get time management skills. my mom has been a critical care nurse for over 30 years. she said the biggest waste for her was going to an intermediate care first. it's a completely different set of time management skills than in icu as well as a completely different set of technical skills. my answer to this is become a nurses aid or tech while you are still in school or waiting to take your boards. this is where you will get good at basic patient care that can take up a lot of a nurse's time if you don't have a lot of experience doing it.
    10) always prioritize! almost always one of your patients are generally sicker and more unstable than the other. take care of the immediates right now tasks with the sicker patient ie bp, resp, etc. get your more stable patient assessed and situated, meds given so you can devote more of your time to the needier, sicker patient.
    11) always remember as a nurse, it is a continum of care for the patient. if the nurse before you didn't get to it ie. bath, other trivial aspects of care that are not in need of immediate attention. don't gripe just get it done. the icu is 24 hr care and you never know what happened the night before (really sick patients, code, admissions) be nice! pick up where they left off. it's ok to bathe and brush teeth and change the sheets at different hours than a set time. a dirty sheet isn't going to hurt them.... get my drift. THis however does not always apply becuase some people are inherently lazy and leave their rooms in shambles and patients filty. just rise up and do nursing care how it should be done and your care will shine through as a nurse.
    12) ASSESSMENTS are the most important part of your career. a thorough knowledgeable assessment is key. if you worry about technical skills rather than a good assessment you are not going to be a good nurse.

    If you have any other questions feel free to PM me.

    Hope this helps.


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