Top Tips for New Grad Nurses in ICU

by | Jul 20, 2023 | Critical Care | 0 comments

If you’re looking for top tips for new grad nurses in ICU, this post is for you. Many graduating nursing students are heading straight into critical care upon graduation, and this blog post will give you an overview of what to expect as you start that first job.

Top Tips for New Grad Nurses in ICU

This blog post outlines the top tips for new grad nurses in ICU, directly from a highly experienced critical care nurse and current nurse practitioner!

Top Tips for New Grad Nurses in ICU

Nacole Riccaboni, MSN, APRN, AGACNP-BC, FNP-BC, CCRN-CMC is a critical care nurse practitioner (ARNP) in Orlando, Florida. Her passion is nursing and all things critical care related. She considers herself a life-long learner and graduated with her Master of Science in Nursing (MSN) in 2018. Nacole has certifications as both a family nurse practitioner (FNP) and an adult-gerontology acute care nurse practitioner (AGACNP) as well as her Master of Business Administration (MBA). Nacole loves nursing and being a caregiver. Each day as a nurse practitioner, she is able to touch the lives of people in her community and make an impact.

Just a heads up: This post is quite long. If you’d like to check out the highlights and head to a specific section, just click on the table of contents below.

Goal of the Intensive Care Unit (ICU)

The intensive care setting is a unique environment with many opportunities for learning and professional growth. Each patient and each shift is an adventure, filled with complex issues that require critical thinking on multiple levels.

With that being said, the goal of intensive care nursing is to stabilize, trend, and transfer (STT). What does that mean exactly? Well, when anyone is admitted to an intensive care unit, they are unstable and critical in some fashion. Whether it’s an airway problem (BiPAP or intubation needed) or circulation concern (hypotension refractory to fluid boluses), and/or there is instability (in one body system) that requires intensive care monitoring and management.

Once these acute concerns have been properly managed, it is then time to trend and evaluate the interventions. We implement and assess, just like in nursing school. After the therapy or intervention has been trended as successful, and the patient has recovered to the best of their ability – it’s now time to transfer them to a lower acuity nursing floor (medical floor).

Again, the goal of intensive care is acute management of critically ill individuals with a focus on airway, breathing, circulation, and disability (A, B, C, D). Once those areas have been stabilized, we must make room for other critically ill individuals.

ICU Orientation Considerations

The learning process can be very frightening, but don’t let it overwhelm you. During orientation, your critical thinking skills and techniques will be tested. You are expected to know a minimal amount of information regarding common concepts.

As the orientation progress, you will fine-tune your nursing skills and critical thinking processes. Know this – you will not walk into this situation knowing all the answers. There will be patient populations unknown to you, diseases you are unfamiliar with, and that is the norm.

Focus On What You Can Control

You can’t control what occurs. What you can control is your mindset.

In orientation, remain open to learning and stay positive. Anyone can learn technique, but attitude can’t be taught. Understand that learning means you get some things wrong, and that’s okay. You are not your errors or miscalculations. You are an individual learning something new. Accept the imperfection of the learning process and go from there. Setting realistic weekly goals for yourself will keep you on track and positive throughout the experience.

Time Management for ICU Nurses

Another matter to consider during the orientation process is time management. In nursing school, depending on your program, you might have had ample amounts of time to investigate your patients. This time was uninterrupted in some nursing programs. So, when some individuals enter orientation, time management can be challenging.

When beginning the orientation process, understand that it is a new environment with unknown dynamics and expectations. You can’t see the obstacles or common missteps new nurses encounter. Take the time to set down and your unit’s management, preceptors, or mentors and request suggestions on how to properly care for patients. This doesn’t need to be formal, just a quick conversation seeking advice. Each nurse manages his or her day differently. Find out what systems work best and then customize said systems to fit your situation.

If you want some time management tips, check out the Nursing Time Management episode of the FreshRN Podcast.

ICU Nurse Gear

As a new graduate, you shouldn’t spend $400 on nursing gear, in my opinion. You are a novice who is at the beginning stages of learning.

Nurse Gear

You don’t know what should or will work as you lack exposure. Starting with a dependable, reliable, sturdy stethoscope is best. The goal is to find a proven manufacturer that has excellent reviews and a great warranty.

My favorite manufacturer is Littmann, and I would recommend either the Classic or Lightweight stethoscope lines. Both are amazing and have different features based on patient populations. If you can only get one nursing product, a quality stethoscope if a must! The goal isn’t to find that one that matches your scrubs or looks cute. The goal is the quality of the device – a device that you will use every day throughout your nursing career. I don’t care about glitter accents if I can’t hear anything. Focus more on functioning and performance.

(If you’d like to see a full list of Kati’s recommended nurse gear, check out the nurse gear master post. And if you’re curious about digital stethoscopes, we discuss that in-depth here. )

Nursing Education For ICU Nurses

In regards to intensive care education, I recommend two books: AACN Essentials of Critical Care Nursing and Critical Care Nursing Made Incredibly Easy. These books will give you the proper background needed to care for the many disease processes presented in the intensive care setting.

They provide you with the appropriate nursing considerations, along with expected interventions.

You will learn many things during orientation, but understand that you are learning on-the-job. You will not have time to run and go read about atrial fibrillation at work. These books will be the nursing bibles that you read while you are at home in your free time. The goal is to help your learning curve, filling the many gaps one has when entering the intensive care setting.

At FreshRN, we also have a comprehensive resource for new ICU nurses that goes over everything from meds, to equipment, report, codes, patho, and more. To learn about it, click here!

Working With Intensivists and Advanced Practice Providers

When you enter the intensive care setting, you will encounter multiple providers. From intensivists to advanced practice providers (APPs) to code team members.


Intensivists are specially trained physicians to treat the critically ill. They typically only care for critically ill patients and are staffed on the ICU unit 24 hours a day (depending on the size of your facility). You’ll work closely alongside them.

Advanced Practice Providers

Advanced practice providers come in the form of nurse practitioners or physician assistants. They work with the intensivists and are typically the first person you chat with when needs arise before calling the intensivist.

The Code Team

The code team (or rapid response) members are an assortment of team members, all trained in managing unstable patients throughout the hospital. These are the individuals you will frequently work with while in the ICU. This team often consists of critical care nurses, emergency department nurses, respiratory therapists, or others.

Communicating Changes With Your Team

A change in a patient’s condition occurs non-stop in the intensive care setting as the patient population is medically unstable. As the nurse, you will be expected to notify the team and communicate any changes (like assessment changes, labs, or hemodynamics) and provide background information.

Changes vary based on prior interventions and the patient’s compensation or decline. The goal is to trend the progress, which will require constant assessments by the nursing professionals (you). You are the eyes and ears managing the patients in their time of vulnerability. Although this is a team effort, you are the front lines and others will be depend upon to see those crucial changes.

The common thread with working with these team members is prompt and timely communication. No one expects you to be able to diagnose a brain bleed, but charting a blood pressure of 80/15 x 5 hours is a concern and should be communicated within 15 minutes, not 5 hours later.

Critical care can be a very emotional environment. You are caring for people at their most vulnerable, both the patient and their family members. There will be tough conversations… ones they never dreamed they would need to have. Naturally, there will be times where legal documentation will be an element of your nursing practice. Let’s review living wills and HCPOA.

A living will is a directive, a document that informs medical providers what someone wants in terms of end-of-life medical care. Living wills are provided in cases when patients become unable to communicate their decisions directly.

On the other hand, a healthcare power of attorney (HCPOA) is a specific document that appoints an individual to be a health care proxy for a patient who can’t speak or communicate their wishes. An HCPOA is different from a POA (power of attorney). A POA document designates a person as an agent on someone’s behalf regarding business and legal matters. HCPOA is not POA, and POA is not HCPOA. A living will is neither.

Sounds confusing? Let’s summarize.

A living will (a document) disclose a patient’s instructions regarding their medical care preferences and choices should they be unable to make decisions for themselves.

An HCPOA is an individual designated to make decisions when the patient is unable to do so. Either legal selections can include directions or instructions regarding cardiopulmonary resuscitation, mechanical ventilation, tube feeding, dialysis, antibiotics, palliative care, organ or tissue donation, and/or body donation.

Kati’s story:

Once I had a patient in neurocritical care recovering from neurosurgery. He was completely alert and oriented, although slightly grumpy. I didn’t really notice because most people a mere three hours after major surgery aren’t usually in the best mood anyway. His daughter was pretty anxious, but he was medically doing great. She unexpectedly came out to me at the nurse’s station saying he was being very irritable and mean and asked if I could sedate him. She said, “It’s okay, I’m his health care power of attorney,” to which I had to let her know that doesn’t actually kick in until he can’t make his own medical decisions. Again, he was completely oriented and mentally sound. She was pretty upset with me because she thought that if she was his HCPOA, she was the one who made his medical decisions for him at any time. She was unaware that her ability to do that was only active if he became incapacitated. (Not to mention the fact that it’s just medically inappropriate to sedate someone simply because they’re frustrating you!)

Nursing Report in ICU

The idea of giving someone bedside nursing report can be daunting, but don’t let the idea overwhelm you. Think of it as telling a story, and here is some advice to help you tell your story in a synced format.

Nacole’s YT Video of Giving Report:

Giving Nursing Report

When giving the report in most intensive care settings, nurses appreciate getting head-to-toe presentations. Meaning, start from the top and working your way down (literally, head to toe) – neurological, cardiovascular, respiratory, gastrointestinal, genitourinary, etc. The goal is to present each body system, and since its up and down, you shouldn’t miss anything. When nurses don’t present in this manner, significant body system concerns can be skipped during the reporting process by accident.

Kati’s tip: Think of giving report like a golf swing. Do it the same way every single time so you don’t miss a step.

Intensive care nurses are infamous about wanting to know why. Their critical thinking skills are always on and working to help their patients to the best of their ability. If you say, “The patient vomited,” You will likely be asked follow-up questions such as, “What happened? Color? Was Zofran given?” If there is a problem, a critical care nurse wants to know the full story.

Unresolved Issues – Communication is Key 🔑

Also, ICU nurses want to make sure everything has been handled in a timely fashion. These patients are very vulnerable. Any delay in response could potentially cause a backslide in that patient’s improvement. Don’t get comfortable presenting a change in condition or concerns without seeking leadership help or contacting a provider beforehand.

If you attempt to give a report with unresolved issues, you will definitely hear about it. We are a team, but time is also a factor in a patient’s deterioration. Waiting can’t happen in the intensive care setting.

Nursing Report Resources for ICU Nurses

Additional resources ➡️ We have a free mini-course that goes over nursing report. While it’s geared towards a med-surg nurse, the overall concepts are applicable to an ICU nurse as well. Click here to learn more and sign-up. We also have an entire section on report in our comprehensive course for new ICU nurses where we provide sample report sheets and audio files of nurses giving report on ICU patients so that you can practice at home! Click ⭐️ here ⭐️ to check it out.

ICU Patient Equipment

As an ICU nurse, you’ll be dealing with a lot of equipment. Here is a brief overview of the most common things you’ll be using on a day-to-day basis. If you’d like to learn even more about these devices, check out a few FreshRN® Podcast episodes, Intensive Care Devices Part 1 and Part 2, featuring Sean Dent, a critical care advanced practice provider

Bedside Monitor

The bedside monitor tracks (in real-time) a patient’s hemodynamics. It gives instant information regarding the patient’s internal cardiovascular and respiratory abilities (with limitations) such as heart rate, blood pressure, oxygen saturation, and respiratory rate. The bedside monitor can display vitals only or include invasive numbers such as PA or CVP data.

ICU nurses hook every single patient up to these and run them. Below is a video of Kati walking through the basics of a bedside monitor.

@freshrn What all the numbers on a bedside montior mean #nursingstudent #nursingschool #newnurse #newgradnurse #nurse ♬ original sound – FreshRN


A ventilator is an advanced airway used to provide positive-pressure ventilation to patients who have compromised airways and can’t successfully oxygenate and/or ventilate on their own. There are many modes based on lung injury or overall medical goals. In many ICU settings, respiratory therapists manage the ventilator in terms of setting evaluation and adjustments while nurses ensure it is connected properly, running appropriately, and the patient is tolerating it well.

Physicians, APPs, or respiratory therapy take care of intubating the patient, decide the ventilator settings, and get it situated, while the ICU nurse manages the patient and ventilator after its been set up.

Central Lines / Central Venous Catheters (CVCs)

Central lines are placed in various locations (e.g. internal jugular, femoral, subclavian) with goals of providing direct venous access to those who need it. Direct venous access is required for certain medications (e.g. vasopressors), for dialysis needs (e.g. CRRT / HD) or in emergencies where a patient will need multiples lumens for resuscitation and treatment.

Physicians or APPs will insert these lines, ICU nurses will take care of maintaining them and discontinuing them when they are no longer necessary.

Arterial Line (“Art Lines”)

Arterial lines are placed in various locations (e.g. radial, brachial, axillary, pedal) for constant, real-time blood pressure monitoring when titrating vasopressors, when a patient needs frequent arterial blood gases due to ventilation management, or when the patient requires very tight blood pressure control. The blood pressure displayed changes in real-time, presenting a waveform, not merely a number (like traditional blood pressure cuffs, which are also called Non-invasive Blood Pressure Cuffs, NIBP).

Physicians or APPs will insert these lines, ICU nurses will take care of maintaining them and discontinuing them when they are no longer necessary.

Central Venous Pressure (CVP)

CVP monitoring is used (through central line access) to obtain hemodynamic information in terms of a patient’s fluid status. The pressure in the superior vena cava also called the central venous pressure (CVP), is equivalent to the right atrial pressure (RAP). It is used to measure preload and volume status.

If this monitoring is ordered, the provider will place an order to say the parameters they want the patient to stay within (like 6-12 for example). They may ask to be notified when/if the patient begins to go outside of the ordered parameter, have PRN meds/interventions for when this happens, or they may simply want the data to be recorded and watch the trend.

The provider inserts the line, the ICU nurse manages it and this monitoring.

Foley Catheters

Foleys are indwelling urinary devices used to monitor a patient’s urine output or placed when there is urinary retention or a significant wound in their genitourinary reason. The goal is to monitor urine output or bypass any bladder barrier or restriction. One nice feature of the foley catheter system is the ability to measure a patient’s core body temperature with the device in place.

The ICU nurse inserts, maintains, and discontinues this device.

Feeding Tubes

When a patient is intubated, is unable to safely swallow, has gastric complications, or has gastric dysfunction, feeding tubes are used as nutrition devices. Types of devices include nasogastric and orogastric (both gastric), and post-pyloric (small bowel) feeding tubes – these tubes are temporary. Examples are nasogastric tubes (NG tubes) and Dobhoff tubes (DHT).

If the acute insult becomes chronic, the patient requires permanent nutrition pathways such as percutaneous endoscopic gastrostomy (PEG) tube and gastrostomy-jejunostomy (GJ) tubes. The goal is to feed the gut and maintain gut integrity.

The ICU nurse inserts, maintains, and discontinues NG and DHTs. A provider inserts any permanent tubes like PEG or GJ tubes, while the nurse maintains it (administering meds through it, monitors for signs of infection, cleans it).

Code Blues and Other Codes

First, it’s important to know that there there also also different types of code.

Types of Codes

A code blue tends to mean a respiratory or cardiac arrest, while a rapid response code tends to mean someone is rapidly declining and needs urgent intervention. A code stroke indicates that a patient may be experiencing a stroke, while a code STEMI is related to a heart attack. We dig into the differences between these codes in this podcast episode.

Handling Code Blues as a Nurse

Code Blues are very real events that often occur in the intensive care setting due to the vulnerability of the intensive care patient population. When it comes to codes, you must remain calm and take it one step at a time. By this time, you should have your BLS/ACLS training.

Don’t get overwhelmed by the number of people in the room. If this is your patient, focus on finding the intensivists or advanced practice providers, and give them as much information as you can about the patient. If this is your patient, you should have a general idea of why the patient came in and what brought them into the intensive care unit – present things such as the patient’s medical history, any recent changes you noticed in the last two hours, etc.

You are the only person who can advocate for this patient in terms of information. During codes, knowledge is power, and that power to help advocate for your patient. Don’t hide, be available, and have the information ready for those who need it to make medical decisions. Just because it’s your patient doesn’t mean you need to hop in and be the leader. Your top priority is giving a concise and accurate clinical picture to the providers to enable them to make fast decisions.

And if you’re in the room solo and the patient starts to code, the most important thing is to get on the chest and start compressions STAT while yelling for help.

Emotional Considerations

As far as emotions go during codes, try to keep yours managed during the event itself. But understand, we all have had our fair share of crying in the bathroom after a code doesn’t end optimally. We bond with our patients, we care but during the code isn’t the time to unravel. Efficiency is essential. Process those feelings after your patient has had the opportunity to overcome.

Most Common Disease Processes for ICU Patients

Common disease processes seen in the intensive care setting include:

  • DKA/HHS (acute hyperglycemic events)
  • Sepsis (infection, various origins)
  • Acute respiratory distress or failure (HHFNC, BiPAP, and mechanical ventilation needs)
  • Blood pressure dysfunction (hypotension, hypertension)
  • Heart rate dysfunction or rhythm disturbances (bradycardia, tachycardia, arrhythmias)
  • Brain disorders (CVA, TBI, seizures)

Now, there are specialty intensive care units such as cardiovascular and neurology, but the above is general reasons patients are admitted. Patients may be dealing with one of the below, a combination, or something less common that’s not listed. If you need a patho brush-up of these, we go through all of them in our ICU nurse crash course.

Acute Hyperglycemic Events

In regard to DKA/HHS situations, you will be treating patients with an insulin drip and fluids, along with frequent electrolyte monitoring and replacements.


Sepsis is a unique creature because it is initially treated with fluids (normal saline / lactated ringers) and broad-spectrum antibiotics. The goal is to treat the suspension until you find the exact bug that is causing the system dysfunction and then alter care based on said findings (through cultures). Please know that the research and guidelines surrounding sepsis are changing rapidly, so know your hospital’s latest policies and procedures very well!

Respiratory Issues

Respiratory concerns in the intensive care setting come in the forms of upper-level oxygen support (heated high flow nasal cannula, non-rebreather, BiPAP, CPAP, mechanical ventilation). These devices are used until the patient’s respiratory system recovers, and oxygen support can be weaned off. You’ll manage these devices together with RT.

Hemodynamics and Cardiac Issues

Blood pressure dysfunction is treated by supporting the cardiovascular system in the form of fluids or vasopressors (norepinephrine, phenylephrine, vasopressin, epinephrine). We discuss all things drips in this free mini-course for new ICU nurses.

Heart rate dysfunction or rhythm disturbances are managed with antiarrhythmic agents (amiodarone, Cardizem) or anti-hypertensive agents (Cardene, cleviprex). If you need more help in cardiac nursing, check out Cardiac Confidence.

Neurological Concerns

Brain disorders require confirmation through imaging and can be treated in various ways (surgery, drains, medications or monitoring). There is no exact track other than frequent neuro assessments and monitoring.  If you need more help in neuro nursing, check out Neuro Wise.

Top IV Medications ICU Nurses Need to Know

While there are quite a few medications you’ll be administering, here are some of the most important ones to know how to safely give.

Treating Hypotension

As hypotension is a big one, let’s focus on vasopressors that treat hypotension. Most of these drugs stimulating α-adrenergic receptors, which leads to vasoconstriction.

Common vasopressors include norepinephrine, phenylephrine, vasopressin, and epinephrine. The goal is to increase blood pressure with side effects related to its vasoconstriction and include hypertension, arrhythmias, low urine output, and necrosis.

These medications require CVC access as they will cause vein dysfunction and subsequent collapse and permanent injury. If your patient suddenly requires vasopressor support and does not have a central line, it is your responsibility to notify the provider and get one ASAP.

Treating Hypertension

The alternative to vasopressors is anti-hypertensive agents that are used to treat hypertension. These drugs include Cardene, nitroprusside, labetalol, and esmolol (IV infusions).

These drugs are in various drug classes with an overall goal of vasodilation with side effects, including hypotension and bradycardia. When it comes to anti-hypertensives, you want to closely monitor the blood pressure and decrease the blood pressure slowly, as rapid drops can cause a stroke.

Now, most hypertensive urgencies or emergencies are treating with infusions, but they can also be treated with oral medications as well.

Antiarrhythmic agents are used to convert arrhythmias (such as atrial fibrillation or atrial flutter) and can include amiodarone and Cardizem. That goal is to restore the patient’s rhythm to normal sinus rhythm, as some arrhythmias can lead to the production of clots that move and cause a stroke.

Nursing Time Management in ICU

As a nurse, task prioritization is essential. You have 12 hours to care for multiple individuals who are critically ill. You have medications due at certain times, procedures your patients must be transported to, and care you must provide. All of this can’t be done randomly. There has to be a method to the madness, and that comes in the form of task prioritization.

Nursing Brain Sheets to Facilitate Time Management

Most nurses have a brain sheet, which is where they took report. They may also have a separate document they use to keep their tasks on tracks (like a to-do list), or they may write it on the back of their report sheet! However you choose to do this, you must have a plan, a way to organize your day based on your patient’s needs.

My to-do list was broken down into hour increments and I would write what needs to be done in each slot. This form kept me on track and allowed me time to find pockets for breaks and lunch if nothing was upcoming in the next 30 minutes. You have to care for patients but you can’t run on empty, don’t forget to eat and recharge. (We’ve got our favorite ICU report sheets in our crash course for new ICU nurses.)

Asking For Help

When it comes to you drowning or falling behind, you must communicate the need for assistance. Nursing isn’t a contest, it a team effort, and we all need help. You are one person with 295 things to do in one shift. Don’t torture yourself. Ask for help if you need it.

Oh, and don’t assume people will see you “needing help.” Nursing is an around-the-clock, constant profession that requires your full attention with all your cylinders functioning at 100%. We each have our own to-do lists and might not see you stressing and drowning. You will have to speak up and communicate your concerns and needs. Give your colleagues the best chance to provide support, and give yourself the best chance to receive it.

Asking for help doesn’t mean you’re weak, it means you’re human. No one expects you to be this robot who constantly performs at maximum efficiency. So don’t beat yourself up if you couldn’t simultaneously titrate a Nicardipine drip, treat a blood sugar of 23 while answering a phone call and rounding with an intensivist.

Nursing Documentation in the ICU

Documentation if one of those things most nurses find annoying, but this is the legal aspect of our profession. What you did or did not perform is all right there in your documentation or lack thereof.

Don’t ignore this aspect of your job. It has to be completed. There is no situation where ignoring this aspect of the job ever ends well. People deteriorate and can, sadly, have negative medical outcomes, which can lead to legal ramifications for parties involved. Skipping, omitting, and minimal documentation will cause serious professional dilemmas.

If you have the same approach with each patient, you won’t have to “remember to do things correctly.” Documenting per policy, assessing per floor standards are all things you should always implement. These actions are you evidence six months from now of what occurred. No one wants to hear you did something, but the documentation reflects something otherwise. You are a critical care nursing professional. This aspect of your job is just as important as knowing what ventilator does or what the side effects of beta-blockers are.

Nurse Nacole’s YouTube Video on Documentation:

Oh, and there are time-stamps in most hospital-based computer systems. The closest to real-time charting you can get, the better it is. Back-dating entries after a patient have expired doesn’t look good. You will never “have time to catch up later” or “do it when things settle down” – none of those statements are compatible with intensive care nursing, haha.

Nursing Documentation Tip – From Kati

I’ve been an expert witness in litigation before in which I analyze nursing charts to see if the standard of care was met. I cannot overstate the importance of appropriate documentation. This does not mean you need to have every little box filled out. This means you need to have an accurate representation of the care you provided, when, and provider response that meets the standard set by the policies and procedures of your organization. Do not copy and paste documentation from the previous nurse. And definitely do not document exactly on the hour every hour. While that might look nice and pretty in the chart, it’s not real. People know you weren’t in each of your patient’s rooms at the exact same time, every single hour, all shift, for all of your patients. That essentially negates the reliability of your charting. Chart what you did and when.

People tend to get hung up on the orders and making sure their documentation matches that, even if that’s not what they actually did. That’s a major issue… it’s like cheating to get the A+ on the exam. You didn’t actually learn anything, you’re just making it look like you did. It’s also falsifying documentation. (Remember, just because your preceptor is doing it doesn’t mean it’s right.)

Documentation vs. Real Life

Bedside nursing is not like the textbook. Emergencies will occur. You won’t be perfectly on time with every little thing. Make your best effort to follow the given orders, but know you won’t always be able to – and that’s okay. Be able to speak to why – and if it was something that is out of your control (you know, someone was coding, you were down 3 nurses, your other patient became unstable – whatever it may be) rest in the reassurance that you were doing the best you could with what you had at the time, document what really happened, and leave it at that.

It is much better to have real documentation that might be off by a few minutes, than clearly inaccurate documentation that technically fits the orders. Maybe you’re late for a reassessment, but it’s because you were in with another patient for a very real and necessary need. Chart when you actually did the reassessment, don’t “time it” for when you should have been in there.

Chart like you’re going to be reading it in a deposition in five years. So if you’re in a boardroom with a bunch of lawyers around you and they ask you if for 12-hours straight you actually were turning the patient every hour, doing oral care, and range of motion while you also had two other patients, or if you just charted that because you thought you were supposed to, be able to speak to it confidently and without guilt or remorse.

Quick Nursing Documentation Tip

If something happened that required an incident report, make sure you do not indicate that in the patient’s chart. Objectively chart what happened when, and that’s it. If you mention an incident report in the chart and it does go to litigation, that incident report will then be able to be requested and evaluated as well.

Step-Up Your ICU Nurse Game

While there is a lot of focus on developing the clinical and analytical side of becoming an awesome nurse in the ICU, developing your emotional intelligence, soft skills, communication, and managing your expectations is just as crucial.

The goal isn’t just to get through orientation. The goal is to thrive through orientation and become the nurse you always envisioned you would, without great cost to your own mental and emotional well-being. After all, you are a person outside of the hospital and you don’t want your life at work to consume you so much that you can’t enjoy the rest of life.

Managing the incredible amount of stress is not intuitive, even though we think it should be simply because we are nurses. If you’re getting ready to start in an ICU and want to really get mentally, emotionally, and intellectually prepared, check out Breakthrough ICU, a crash course for new ICU nurses.

Breakthrough ICU course cover

It’s a self-paced 100% online course that you can complete in the comfort of your own home so that you can be at the top of your game during orientation, impress your preceptors, and provide phenomenal care. (And it comes with contact hours!)

More Resource for ICU Nurses

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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.


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