8 Tips for New Grads in the ICU

by | May 8, 2018 | Podcasts, Critical Care, New Nurse | 2 comments

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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
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#7 – Learn your alarms and use them to your advantage

#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

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!

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Picture of Kati Kleber, founder of FRESHRN

Hi, I’m Kati.

Kati Kleber, MSN RN is a nurse educator, author, national speaker, host of the FreshRN® Podcast, and owner of FreshRN® – an online platform created to educate, encourage, and motivate newly licensed nurses in innovative ways.

Connect with her on YouTube, Pinterest, TikTok, Instagram, and Facebook, and sign-up for her free email newsletter for new nurses.


  1. Leah

    Thanks for the great article!

  2. Elizabeth Vander Weide, BSN, RN

    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.


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