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First Day on the Floor: ICU Clinical

Galen ADN student Sonia Lisee looks back at her clinical experience on an ICU floor, and describes how it helped her build confidence and taught her how to start thinking like an RN.

Working in the ICU was one of the most beneficial experiences I had during clinicals. On my first day, I was assigned to a helpful nurse (we’ll call her Nurse C) who had been in ICU for 27 years. Admittedly, I was a little intimidated at first because telemetry is not my forte! Seeing patients connected to multiple tubes and machines – not to mention all of those beeping sounds – did nothing to ease my nervousness, but I was determined to overcome my fear and gain confidence as a new nurse. Nurse C asked me to tell her a little bit about my background, and we discussed my strengths and weaknesses, and things I would like to work on.  She also asked if I would be willing to perform the entire care for one of her patients, under her supervision, of course.

So, the day begins. After we did rounds on all three of her patients, Nurse C assigns me to a patient on a ventilator, in congestive heart failure, on telemetry with a foley and a PEG. I did the head-to-toe assessment as thoroughly as I could since ICU patients require a more in-depth assessment. I asked Nurse C to guide me through it because I was not yet confident enough to do the cranial nerves assessment on my own. She was thankfully more than willing to do so, and explained everything in detail. Medication pass for my patient was due and she quizzed me on the use, side effects and labs to watch out for on each. Things were going pretty smoothly.

But, as most hospital floors tend to do, the pace quickly changed. (Pro tip: Never think to yourself that things around your floor are calm, because they will not stay that way for long. Trust me on this!) Not too long after we evaluated meds, the ventilator alarm starts to go off in my patient’s room. My heart is racing and my body surges with adrenaline. I have a moment of panic and almost freeze, but Nurse C came into the room and sprang into action, spurring me into action with her. As she worked, she explained ventilator settings and allowed me to suction the patient after verifying that I knew how to perform the procedure.  A sigh of relief; I’ve totally got this.

Around noon, that patient’s sister came by to visit and was very upset because the patient was still in ICU instead of a step down floor. She was rude and using choice words with Nurse C, but I was amazed at how gracefully the ICU nurse handled the situation. By remaining calm and respectful, she was able to deescalate the situation until the family member calmed down. I learned so much from her just in this interaction, and I will carry that with me throughout my career. Treating each patient and family member with as much dignity as possible will ease a lot of tension and help them communicate more calmly.

ICU clinical was absolutely one of the best learning experiences I’ve had had in my nursing education. In one day I was able to overcome my fear of working on a telemetry floor, accurately read my patient’s telemetry strips, understand from experience what a high pressure ventilator alarm meant, and practice deep suction. I am so grateful that I found the courage to practice skills I had learned in theory, and was in turn able to feel confident practicing what deep down, I already knew I could do.

An added bonus? Through my unique clinical experience, I was able to discover that I really enjoyed OR nursing and anesthesia, and now I have an idea of where I should be applying once I pass my boards!

Overall, the clinical experience really does make it all come together, and all of the things that you learn in theory make more sense in a clinical setting. Theory gives you the knowledge you need to prepare for those real-life situations, and Clinical helps you develop the confidence and technique. I realized that I was using the nursing process, thinking critically, and lab results were beginning to make sense.

I was finally thinking like an RN. I began to understand that I am prepared and that I can do this! And this was just after Day One.

Instructor shout-out: I know that I wouldn’t have had an experience as meaningful as this if not for my wonderful clinical instructor, whom I will never forget – Mrs. Glower-Meyers. She helped me rise to challenges I was unsure of, and helped me conquer hurdles I didn’t think I was ready for. Her experience, knowledge and support were without a doubt a major contributor to my success this quarter.

Best of luck to everyone in clinical this quarter, and remember – You are prepared, and you can do this!

Sonia Lisee
Galen ADN Program Student

Sonia Lisee is an ADN Program student at the Tampa Bay campus, and soon to be Galen Grad and RN!

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