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Who You’ll Hear
Kati Kleber, MSN RN – Nurse educator, former cardiac med-surg/stepdown and neurocritical care nurse, author, and speaker.
Melissa Stafford, BSN RN CCRN SCRN – highly experienced and currently practicing nationally certified neurocritical care nurse.
Elizabeth Mills, BSN RN CCRN – highly experienced neurocritical care nurse, current Stroke Navigator for a Primary Stroke Center.
What You’ll Learn
- Open Mind
- Typical Characteristics
- Initiative
- Advocating
- Orientation
- Organization
- Alarms
- Downtime
In this episode, we dive into 8 tips for new grads in the ICU! We discuss the characteristics of the intensive care nurse, normal expectations, critical thinking, advocacy, communication, and more. This episode is hosted by 3 CCRN nurses, which is a critical care specialty certification granted by the American Association of Critical-Care Nurses.
8 Tips for New Grads in the ICU
#1 Come in with an open and actively engaged mind
- Expect to be overwhelmed for awhile (at least 6 months)
- Fight the “I want to be perfect” mentality; while it’s admirable, it’s not possible – setting yourself for more stress and disappointment with that expectation
- Nursing is a practice – you’re never going to be at a point where you don’t make mistakes or be perfect. There is an art to this. The skills in nursing school aren’t the only ones you’ll need.
#2 Be aware of typical ICU nurse characteristics
- Assertive, direct, business-like attitudes, detailed-oriented, anticipating things ahead of time, know protocols inside and out, intense, autonomous (very familiar with protocols, able to enact orders/protocols independently and then discuss with MD).
- You are still bringing something to the table, it’s just different than what the others who bring to the table who are already there.
#3 Show initiative
- You’ll have to be assertive yourself – go home to learn and understand more
- Invest time into making yourself better in the off time
- Round with MDs, seeking out learning opportunities
- Introduce yourself to others
#4 – Know yourself and be your own advocate
- Know your learning style and communicate this to your preceptor
- Know your limits / what you don’t know so you can fill in the gaps
- Please don’t be the new grad know-it-all
- Find the balance between not knowing anything and being so obvious about that people question your ability to be a safe care provider, and being the know it all who continually acts like they do not need to be educated
- Find a mentor!
# 5 – Own your orientation
- Orientation is truly an extension of nursing school without formal grading
- Ask for help when you need it – sometimes your preceptor cannot always pick up on times when things aren’t clicking
- Advocate for yourself!
- Work through the process of orientation; it’s a marathon and not a sprint
#6 – Keep an organized routine throughout your shift
- Have a systematic routine way of assessments, your day, meds, etc. otherwise you will miss somethings
- This helps get through the shift and not miss things.
- Stop and get organized first before starting your shift so you start on a good note.
- Resource: Anatomy of a Super Nurse, The Ultimate Guide to Becoming Nursey, chapter 7
#7 – Learn your alarms and use them to your advantage
- Have a love/hate relationship with alarms.
- If there is always one going off, you’ll never know when it’s real…turn yours off if it’s non-actionable or adjusts threshold per policy.
- Use them to remind you so you don’t forget.
- If you change a pump, add volume, silence an alarm, or whatever for another nurse – let them know!
- Do you hear what I hear? Combating alarm fatigue – American Nurse Today
- Alarm Fatigue: A Patient Safety Concern – American Association of Critical Care Nurses CEU (free for members, $10 for non-members)
- Alarm fatigue; a top patient safety hazard – NCBI
#8 – You need downtime
- Becoming a critical care nurse straight out of school tough and exhausting, take care of yourself
- Again, advocate for yourself
- Take time off for yourself, make time for yourself – no one will do this for you
Resources for newbies to critical care
- How to Manage Your Time In Critical Care
- Tips for New Grads in the ICU
- The FreshRN Podcast
- Nursing.com Podcast
- ICU Time Management Tips
- The Ultimate Guide to Creating an ICU Report Sheet (for new critical care nurses and nursing students)
Nursing.com also has quite a few great resources for nursing students and new nurses. There are various courses on Nursing.com. You can even get a 3 day trial of the academy for only $1!
Want to get ahead of the game and ease your anxiety about your first nursing job?
The FreshRN® New Nurse Master Class is the first-ever self-guided holistic nurse residency program. This comprehensive program was specifically created for the ambitious newly licensed acute care nurses who want to get ahead of them and build both their confidence and their clinical skills - all while learning how to adjust to the unique lifestyle of a nurse.
Thanks for the great article!
I was a new graduate in the ICU initially. Unfortunately, due to unforeseen circumstances, it wasn’t the right fit for me as a new graduate with no experience but, it was hard. I wish that I had come across this podcast and your website before I entered that new graduate program, I think my experience could’ve been completely different. A lot of the areas I struggled in are things that you talked about in this podcast. Thank you for talking about this because it is so important. I personally would not recommend ICU for most new grads but for anyone tackling that challenge, this is a great resource for understanding what the best way to approach ICU is.