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Nursing School Tips: Things I Wish I Learned for ICU RN Life

Written by Tien Duong

As a new grad ICU RN, I have realized that there are millions of strange things that nursing school didn’t prepare me for. As I venture into this journey, I discovered how challenging and how overwhelming it can be. With all honesty, I wish I had the right mentality and had known some knowledge before accepting this position and entering this field.

To enumerate, here are the things I wish I could have learned from nursing school:

1. Basic Treatment Procedures: Nursing programs and National Council Licensure Examination (NCLEX) provide students with the basic information and knowledge, which can be applied to acute care conditions like med-surg units. However, the intensive care unit (ICU) is a whole other world where health care professionals need to remember each disease, labs, or medication by their abbreviation names. There, you need to remember all “basic” procedures like Computerized Tomography (CT) scan, Computed Tomography Angiography (CTA), Magnetic Resonance Imaging (MRI), Angiography, Echocardiogram, and other different treatment procedures relating to your patients’ conditions.

If you want to be an ICU RN, I strongly recommend you do your homework about the specialty you are entering. It is important to relearn the A&P, basic procedures, treatments, and common diseases happening within the unit.

2. Critical Thinking and Problem-Solving Skills: As a critical care RN, you are required to have critical thinking skills. When we are still nursing students, we use our critical thinking skills through exams. However, in the ICU field, we use our critical thinking skills in a life or death situation especially when we see how fast a patient’s condition critically changes.

It is hard to just stop and think of the whole big picture at the time. I often have patients whose heart rate, blood pressure, oxygen saturation, and temperature levels were within normal range but suddenly, some of them fluctuated. I can truly say that I have been at my most fast-paced self whenever I’m inside the ICU, but there are moments when I must stop myself and look at what was really happening to my patients. I have learned how to immediately seek out a second opinion and decide what I could do next. So, here’s one thing we should put in mind: Just always remember to stop and think first! 

3. Acknowledge Mistakes: Accept it when you make a mistake! Everything is so new and fast, and it is so easy for you to make mistakes. Some new grad RNs I met before made huge mistakes that can cause more harm than care for the patients. They cried in front of patients and their families’ members when their preceptor pointed out their errors. That’s when you know that the critical care environment is not for them, or they are not ready.

We must handle our mistakes professionally. Even if your preceptor is a nice person, human beings will always be human beings. They can get upset with you because you forget something they mentioned one time. But even so, you should not take it personally, but rather learn from the smallest mistakes and make it a learning opportunity — you accept it, drill it in your head, and move on.

4. Accept Challenges: Lastly, being an RN is challenging. The first year of residency is the hardest, but do not let it discourage you. You still have another 20 to 30 years ahead so keep going. Things get tough but always remember the reason why you choose this career and look back on how many lives you have been touching. It is always when you get back to your core and purpose that you realize it’s all worth it!