10 Tips for New Grad ICU Nurses: From a Nurse Who Was In the ICU

In this article, we’re going to talk about some tips for new grad ICU nurses. Because we’ve all been new before and it can be very difficult.

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As someone who started out in the intensive care unit (ICU), I understand how difficult it can be.

When I first started, I originally wanted to do the ICU because I was wanting to become a certified registered nurse anesthetist (CRNA).

As some of you might know to get into CRNA school, you need some experience in the ICU or the ER.

Unfortunately, I didn’t stay in the ICU too long, and I ended up moving along to another nursing area.

I’m looking back now trying to figure out why I ended up not staying.

I decided to come up with some tips to help other new grad nurses with dreams of working in the ICU last longer than I did.

Tips for New ICU Nurses

1. Seek Out a Good Preceptor

Your ICU nursing preceptorship matters. I honestly can’t stress enough how much your preceptor can make or break your career in the ICU.

This might surprise many, but your preceptor is the one that’s going to help you start building up your foundations as an ICU nurse.

More importantly, your foundations as a nurse. Tips like what to do or what not to do in a given situation.

How to call the doctor (what you should have already done and what you should ask for).

Or whatever the case is.

Not to mention long after you’re done with your orientation, they’re supposed to be a great resource you can keep coming back to.

What you’ll find out at some point or another is not all preceptors are the same.

Some are really good, and some aren’t. Some are outstanding teachers, while others are not.

Something else that’s often overlooked is your preceptor might be an awesome preceptor (good nurse, good teacher, patient personality), but not the right person to be precepting you.

I say all of this to get to this point. You need to make sure the preceptor you have is going to help you succeed.

If you don’t think you can connect with the current preceptor you have, it might be worth a conversation with your manager to see where the disconnect is.

Or if there’s somebody else, you can learn from.

2. Come with a Teachable Mentality

I went on above about how a bad preceptor could set you back. It’s worth mentioning you could set yourself back.

You need to be teachable and show up to work eager and ready to learn.

Don’t show up with an arrogant know it all personality. It’s a good way to be disliked, and you won’t learn as much.

3. Learn About Common ICU Nursing Principles Before and After Work

Like any nursing specialty, there’s going to be terminology you’re probably not going to see anywhere else.

To help manage some of those confusing moments, try to learn about common ICU principles or terminologies beforehand.

You don’t really need to buy anything you can easily just search the information online and get your information there.

If you’re wanting something that has all the information curated already check out Critical Care Nursing: Made Incredibly Easy (on Amazon).

The book was made as a resource for passing the NCLEX, but I did find the illustrations and explanations were very helpful.

Something else I find useful Is using reference cards you know kind of like the ones you can put on your badge real.

They look something like this…

You can get the nursing reference cards on Amazon.

You don’t have to get these since you can pretty much find all the information online.

But it is nice to have them all neatly packaged for you.

4. Pay Attention to ACLS, PALS, BLS

I think we can fall into the trap of taking certification tests like the BLS or ACLS for granted.

The thing is in the ICU your chances of running into codes is exponentially higher.

Codes do follow the ACLS algorithm, so make sure to put effort into learning it.

5. Ask Questions

Seriously ask questions. There’s going to be so much you’re going to learn in such a short period.

Part of your growth as an ICU nurse will depend on how well you ask questions, and how well you listen.

6. Try to Get a Routine Going

I don’t know about you, but I work a lot better when I have a routine set.

  • I’m more organized.
  • Tasks get done faster.
  • All I’m less likely to forget something.

It’s not going to happen overnight, but you should be working towards getting your workflow down. Some questions you might ask yourself is…

  • What am I going to do when I walk on the unit?
  • What am I going to do before getting report on my patients?
  • After getting report on your patients than what?
  • When are you going to do your assessments on your patients?
  • When are you going to pass meds? Don’t forget about charting. What’s going to be your flow of charting?

Learning your flow as an ICU nurse will help you prioritize what’s important.

7. Stop Thinking About the NCLEX

What you’ll quickly realize is the NCLEX world doesn’t really help you much for real-life practice.

In real life, doctors are not readily available, and your patient has a ton of comorbidities.

You’re unlikely to get a patient that only has left side heart failure.

Nope.

Heart failure could be just one of many illnesses they’re struggling with.

This isn’t to say anything negative about the NCLEX or about nursing school.

Nursing school’s job was to prepare you to pass the NCLEX. The NCLEX is supposed to test for minimum level of competency.

8. Find a Mentor

In an ideal world, your preceptor would be your mentor as well.

Unfortunately, we don’t live in a perfect world. Preceptors move or change jobs.

You might not work the same shifts as your preceptor, or they’re not good mentors.

Regardless of what your situation is make a habit of forming new bonds and relationships.

There will be days when it literally will “take a village” for you to make it through the shift.

On the same note, I want to stress…

9. Form Friendships

Let me clarify a couple things about this. I’m not saying you have to become best friends with your nurse co-workers.

I’m not saying you have to hang out with your coworkers outside of work.

I’m not even sure if you really even have to like them. But you should be able to work with them.

Be kind to them. Be helpful.

On slow days when you’re not really doing a lot, and your patients are stable see who else needs help.

If you see someone else struggling help them out. If you don’t help them out, you shouldn’t expect to get the help yourself when you need it.

And there WILL be days you’re going to need it.

10. Find a Way to Manage Your Stress

You’re going to be under a lot of stress. You’ll be stressed from being a new nurse in the ICU.

Your patients are going to stress you out. The doctors are going to stress you out, and your nurse coworkers will stress you out.

We haven’t even talked about what the hospital administrators are going to do that might stress you out.

There are the patient’s families and of course what’s going on in your personal life.

Most of these probably won’t happen at the same time, but it is a lot of stress to try to manage.

We wrote an article about how to manage nurse burnout because it’s a big deal, and it’s something new grad nurses need to be aware of.

11. Be Mindful of ICU Nurse Personality

For the record, these characteristics are prevalent in other areas of nursing; it just so happens it’s a lot more commonplace in the ICU.

So, for example, characteristics like assertiveness, bossiness, and detail-oriented are a lot more prevalent.

Because of the nature of the ICU, those nurses tend to be more aware of facility protocols.

So, for example, one of the hospitals I worked at had a protocol about how diabetes was going to be managed.

Unlike other areas where you were calling the doctor for every little thing related to diabetes.

There you were expected to follow the protocol and take care of it.

12. Do Not Work Crazy Hours

As a new nurse, you might get caught up in how much money you could make working some extra shifts.

When you add shift differentials and bonuses (depending on facility) for picking up extra shifts.

The temptation to pick up a lot of shifts is going to be high. I’m not going to say don’t work a lot of shifts.

But what I would say is be mindful of what your limitations are.

If you give hospitals an opportunity to work you like crazy, most will probably do it. You have to be your own advocate and know your limitations.

13. Be Your Own Advocate

Lastly, be your own advocate. This one is really short, sweet, and to the point.

Make sure you’re taking care of yourself. Make sure you’re looking after your best interest because if you don’t do it.

Nobody else will.

New ICU Nurse Resources

Below are some more resources to help new nurses stepping into the ICU.


Conclusion

Picture of equipment in an icu room.

Hopefully, you found these tips helpful.

Please take a moment to share or pin this article to help us reach more new nurses.

Do you have any advice for new grad nurses you think we might have missed?

Let us know in the comments below.

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