5 Tips To Help New ICU Nurses Who Feel ‘Stupid’

By Wali Khan, BSN, RN

Follow @wali_khann on Instagram 

I remember my first week in the trauma ICU a wave of emotions hit me every day of my orientation and most days I left feeling “stupid” and overwhelmed. The transition from a new graduate “floor nurse” was anything but smooth. If you’re a newer nurse who is struggling with feelings of self-doubt and failure, know that you are not alone. These feelings are totally normal. 

Believe me when I tell you this, self-doubt and feelings of failure resonated deeply within me when I was starting out. 

For starters, I felt like a child in the land of giants, who was ill-prepared for what was to come. All the nurses in the unit seemed so knowledgeable and experienced!  

• I was new, the pathophysiology was new and so was everything else. 
• The pharmacology was nothing like I had seen on a general medicine floor ( drips, pressors, sedatives, paralytics, etc.) 
• Not to mention, I had never seen most of the equipment that was to become my daily arsenal (CRRT, ventilators, PICCO Catheters, etc). 

With just a little over a year of experience taking care of actual patients, the ICU had already presented itself as the greatest challenge to my career to date. 

Next Up: 20 Key Steps For An Organized Start To Your ICU Shift

Image courtesy of @wali_khann Instagram

The day I learned what the “A” in A-Line Means

I remember one day my preceptor asked me to grab the cable for the “A-line”. 

Not wanting to seem "stupid", I made my way to the utility closed in search for the cable I knew nothing about. After several minutes of me missing and not having returned, my preceptor came to my rescue. She found me puzzled and confused in a seeming maze-like clean utility closet. I embarrassingly admitted that I did not know what the "A" in A-line stood for nor, did I know what or where the cable was. 

We shared a laugh and that day I learned what an arterial line was and its purpose. 

A Lot Can Happen In 2-years

Image courtesy of @wali_khann Instagram

I look back and It's surreal that just two years ago, I was a new graduate med-surg nurse with absolutely no critical care experience. For as long as I could remember, all I ever wanted was to work in an ICU and to master that domain. Since then, I've come to realize that this goal is ever changing and lifelong. 

Though I've personally made many mistakes along the road, I've also been corrected, protected and redirected by some amazing co-workers who've become my mentors and guides on this beautiful journey. 

5 Tips For Transitioning Into The ICU

If you are a recent graduate or someone looking to transition your career to the ICU, here is my best advice to help you prepare for the journey ahead. 

1. Read about common ICU principles you will come across before you start work. Brush up on the basics of the ICU. This includes: Intubation and ventilators, pressors, paralytics, sedative drips, and common disease processes

2. Obtain your advanced cardiovascular life support (ACLS) and pediatric advanced life support (PALS). But don't just check them off your certification list, understand them! Every code follows these algorithms!

3. Seek out specialized training certifications and licenses as stated above, we are always growing and expanding your knowledge is necessary. A few popular ICU certifications include CCRN, TCRN, TNS, TCAR, but, there are many more.  

4. Remember, you know nothing! Be an open bottle and let the knowledge flow in. Trust me on this one.

5. Be patient. ICU is an art. The more you see, the more you realize this. 

You Are NOT Stupid 

Image courtesy of @wali_khann Instagram

So what is the point of all this? To tell you that we all share the same experience, the same fears, the same insecurities, but also the same strengths as we embark on new roads in our professional lives. 

The reason I became interested in writing an article on this subject was that I noticed an overwhelming amount of messages that I received in my direct messages were about new nurses and their lack of confidence, knowledge, insecurities, and uncertainties. Having been on the receiving end of those emotions I can tell you that they are absolutely 100% normal, warranted, and to be expected. 

You are NOT stupid. You just haven’t learned everything and the beautiful thing is, you never will. That’s what will keep you humble and hungry. 

It's a journey of a single step every day, consistently. But in retrospect, when you look back at all the steps you’ve taken, you’ll be left marveling at the distance you’ve traveled. 

Back when I was a new grad I never imagined in a million years that I’d now be the experienced nurse I am today. But here we are, always growing, always learning. 

Remember, you’re better today than you were yesterday, you just haven’t stopped to realize that yet. 

Next Up: The Main Difference Between ICU And ER Nurses