Accountable Healthcare - Advice For New ICU Nurses
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December 7, 2020

Advice For New ICU Nurses

The ICU is a very overwhelming place to start a new job. These four pieces of advice for new ICU nurses will help you succeed through your first month on the job. 

Are you just starting out in the ICU? Or are you planning to become an ICU nurse in the near future? Even if you are already well into your way through orientation, these tips will save your sanity and help you thrive in this fast-paced job. 

Sanity-Saving Advice For New ICU Nurses 

Do more than just get through orientation. With this advice, you can thrive and love your job as an ICU nurse. These are the four most important pieces of advice I can give you as a former ICU nurse myself. 

1. Learn How To Be Assertive 

The very first tip I have for you is that you must learn how to be assertive. This means you have to know yourself and learn how to confidently stand up for yourself, even in very nerve-wracking situations. 

It’s a fact – being around other ICU nurses and critical care physicians can be intimidating. Things get very serious very quickly. You’ll go from joking at the nurse’s station one minute to saving someone’s life the next. 

This can be a little jarring if you have never been around people that can go from joking to matter-of-fact in an instant. 

You just have to get used to situations like this. It’s perfectly healthy for you to stand up for yourself if you think people are treating you wrong in these situations. If you don’t understand something, ask. You must speak up for yourself or you will just get trampled on. 

2. Lean Into What Is Hard And Scary and Conquer It 

Next, stop avoiding the things that scare you and lean into them. The ICU is a very confusing place for new nurses. At some point you will be faced with the things that scare you, it’s better to attack them right away and learn about them early. 

Here’s an example of why this is so important and how to do it. 

I had a friend that was new to ICU and was very intimidated by ventilators. He decided to befriend a respiratory therapist and asked to learn more about them. He took the initiative to fill in the knowledge gap that made him nervous. 

Then, when he had to use a ventilator, he had confidence and knowledge. It was a game-changer for his job. 

That’s what you need to do. Find whatever makes you the most nervous – whether it is talking to doctors or equipment and codes – lean into that. 

Conquer this fear during your precepting period when someone is watching behind you and giving you that space to figure things out before you are out on your own. 

Do not avoid the things that scare you. Avoidance might get you through the shift but it won’t help you in the long run. You will have to face it eventually if you avoid it for too long, you won’t know how to use it when you have to.. 

3. Set Realistic Expectations For Your Development As An ICU Nurse

Next, you need to give yourself grace and allow yourself time to learn it all. This is a really stressful place and it will take you a long time to learn it all. 

Lots of people get into ICU as a new nurse thinking, if I just show up and do what my preceptor tells me, then I’ll get through orientation and be fine. I’m going to ace this! Then reality hits them and they feel like a failure because it’s really hard. 

The truth is, learning how to be an ICU nurse is incredibly overwhelming. It is intimidating because it has such high stakes. There are patients who are dying, who are coding, you are responsible for talking to providers, and having end-of-life conversations. 

It takes time to settle into this highly-skilled position. If you can have realistic expectations for your development it will help you keep your morale high. 

I do not expect someone that is starting out in the ICU to know what they are doing in 3 weeks or even 4 weeks. 

I know the confusion first-hand. When I started in ICU in 2012 I had 2 years of experience in Cardiac Med-Surge and stepdown. I was even a Charge nurse, I was so confident that I had this. Boy, was I wrong! When I started in the neuro ICU I felt like a new grad all over again. 

That doesn’t mean you weren’t ready for this role. That’s just the natural learning curve for this incredibly complex specialty. 

Having realistic expectations will improve your morale. Give yourself grace. Good morale will help you focus on improving on each shift and you will get so much more out of orientation. You’ll be in a better mindset to learn from your mistakes. 

Ready to Feel Like a Confident ICU Nurse?

Or even an ICU guru? My comprehensive Breakthrough ICU course focuses on the skills you can learn at home so you’ll feel confident as a nurse in the ICU.

4. Learn While You Are At Home

My last piece of advice for new ICU nurses is to save the bookwork for when you are home. While you are at the hospital, you will need to focus and learn everything as it is happening. 

Take time at home to dive deeper into things like medication, mechanism of action, and disease processes so that when you are at the bedside, you are learning things you can only learn at work. You’ll need to learn things like where instruments are and what they are called among so many other things. 

Here’s an excellent example of someone I knew that did this correctly. 

I had a new grad in Neuro ICU. I was impressed with her because even though she wasn’t perfect, she focused on improving every shift. She had to give Mannitol one day and was not familiar with it. She went through the motions and gave the patient the meds and then that night went home and read a bunch on Mannitol. She didn’t have time during the shift to learn about what this medication is, but at home, she read about it so that she’d understand more when she had to give it to another patient. 

The new grad that tries to learn everything at work runs out of time at work. There just isn’t time at work. There is just so much you have to learn and there is no way to do it all on the clock. 

Final Thoughts

When you go into the ICU with the correct attitude and invest in learning while you are at home, you will thrive as a new ICU nurse. Give yourself grace – this is one of the most overwhelming places to start a new job.

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