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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