Published by Sean on 07 Apr 2008 at 07:49 am
Lessons From the ICU
1. Working in the ICU will expose weaknesses in your practice, and fast! We all have weaknesses, and spending just a few shifts in the ICU will quickly put them in the spotlight for you, your preceptor, and everyone else to see. At the same time, it gives you the opportunity to work on these weaknesses because you simply can’t hide them or work around them.
2. Residents in the ICU have a tough life. Perhaps it is similar to nursing in that starting in the ICU is a very humbling experience that puts their weaknesses on a platter for everyone to devour. During rounds when everyone has finished their spiel, and the attending turns to the resident and says, “So! What’s your plan?” I cringe. I feel bad as the resident stammers through guesses, wrong answers, and moments of brilliance.
3. Starting in the ICU is challenging in that you have to find a balance between leaving what you know behind–starting with a clean slate, and bringing what you know forward. It’s hard when you discover just how many bad habits you have–especially when you thought you didn’t have any. But at the same time, you do have a deep pool of knowledge that is very relevant.
4. If there are no crashing patients on the unit, no code blues in the hospital, or no new patients coming in by helicopter, the ICU can be a fairly tedious and slow placed. Yesterday, a patient that was in a car accident and was EXTREMELY sick was coming in by helicopter. Everyone’s mouth was watering, craving the excitement. Then, everyone seemed a little sad when word got out that the patient had died in the OR. Back to monitoring waves and tipping urinals on the hour (ha! I make is sound so simple!). ICU nurses are adrenaline junkies.
5. ICU nurses are extremely particular, controlling, and anal-retentive. But, all in different ways. And all in very important ways. So, as a new nurse, it’s extremely difficult to go from one preceptor to another and try to interpret each of their quirks. There’s nothing like finally figuring out someone’s style, only to go to a new preceptor and being told that everything that you are doing is completely wrong–and that you need to conform to her/his style.
6. The following words will echo through my head forever, “In the ICU, you can’t do anything nonchalantly. Everything is done with precision and intent.”
7. My biggest weakness is that I do a lot of tasks nonchalantly without precision and intent.
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QuietusLeo on 07 Apr 2008 at 6:47 pm #
When I began my ICU rotation during my residency I invented the Resident’s cocktail:
1 benzodiazapine
1 SSRI
1 cup of Maalox: shaken, not stirred
Sean on 07 Apr 2008 at 8:18 pm #
Can I borrow that recipe for myself?
QuietusLeo on 08 Apr 2008 at 10:22 am #
Be my guest.
Nurse Sean (dot) com » Change of Shift: Volume Two, Number 21 on 16 Apr 2008 at 7:15 pm #
[…] wrote a post about things I have learned as a new ICU nurse, and another post about preceptors in the […]
Rollernurse on 17 Apr 2008 at 4:41 pm #
Wow you sound just like a ER nurse:)
We do EVERYTHING nonchalantly without precision. I am not sure what the intent portion of that quote means.
Keep your head up…get through this and know that you have a great future as an ER nurse, not to mention great experience.
linda-lou on 18 Apr 2008 at 4:51 pm #
That was a great post. I am trying to get a job in the ICU and I will take your words to heart!
mo on 18 Apr 2008 at 10:21 pm #
Whoever told you that quote was full of bs. I do not empty the catheter bag with wild eyed dramatic intent, maybe some precision though.
I have been in the ICU for what feels like a hundred years and honestly all that intense feeling about what you are doing goes away or you go nuts.
Eventually you just get really,really good at your job just like every other job anyone does over time.
I really wish that we could stop making the ICU sound so damn scary all the time. It freaks people out and when you are freaked out you have a hard time thinking logically.
I have always called ICU nursing recipe medicine. Once you figure out your patients particular recipe for survival it’s all just a series of tasks to keep them cooking.
It doesn’t have to be scary and preceptors who get all drama queen and make the student terrified of making a mistake make me nuts.
ICU nursing is all about taking action according to your recipe with independence, If you are anxious all the time about making a mistake you will never develop the self assurance you need to get through a shift.
I have seen really good nurses fail their orientations because they became paralyzed and couldn’t make a confident decision. I blame the culture of the ICU and the preceptors who willfully overdramatize everything we do.
Sean on 19 Apr 2008 at 5:06 pm #
Hmmmm…do you come in a pocket size? So I could take you with me to work every day? You make a LOT of sense!
I can’t wait to look back and laugh at how nervous I was when I started in the ICU