Plug & Play: My First 3 Shifts at the Medical ICU
- Patrick Callang
- Apr 10, 2023
- 3 min read
Welcome back! In my last post, I wrote about my first week of work. Most of that week involved orientation, modules, and touring the hospital. You can check out that post and others here!
OTW to my...
Two days after my orientation and tour of the hospital, I was scheduled for 3 shifts in a row on nights. Prior to coming to this assignment, I was already used to the night shift schedule. I did request to transfer to days, however, that wouldn’t happen for this contract. After speaking with the assistant manager, I was told that my first 2 shifts would be orientation shifts with their staff nurses. As a new traveler, I thought this was pretty generous. I’ve heard of other hospitals only providing 1 shift or a few hours of orientation for travelers!
As I mentioned in my previous posts, I used ride-share apps to get around. Lyft has a nice feature where you can schedule pick-ups ahead of time. (write a post about how I got used to night shifts and how my routines changed…) Although our place was a 5-10 minute drive away, I always set my pick-ups at 6:15 PM in order to give myself some leeway in case emergencies or accidents happened. For the most part, I rarely had issues getting to work on time. With my meal prepped, Hydroflask filled, and work bag ready I was on my way to the first shift of my assignment!
...first shift experience
After getting dropped off, I made my way to the MICU to check in with the charge nurse. This unit, and the other ICUs, all held huddles before the shift. The huddle usually started by 7 PM and would only last about 5-10 minutes. Within these 5-10 minutes, we would go over important unit updates, policy changes, or events that may affect the unit. We would usually end the huddle with patient assignments. The best part about this is that we got to choose our own assignments! However, since this was my first shift on orientation, I would follow whatever assignment my preceptor would pick up.
With some brief introductions out of the way, my preceptor and I made our way to the unit and got report on our two patients. Having only worked at one hospital prior to this assignment, I was worried that giving and taking report would be different at this hospital. Luckily, report was pretty standard. They did however try to incorporate some bedside report as we verified medication drips, ventilator settings, endotracheal tube, and other line placements.
A couple of things stood out to me while I got myself oriented to the rooms and equipment. My patients were both ventilated and on sedation, however, the ventilators were a model that I wasn’t familiar with. At my old hospital, I was trained to manage Avea ventilators, but this hospital used Hamilton ventilators and the settings were labeled differently. Normally, I’m used to seeing settings such as volume AC, SIMV, PSV/CPAP. These ventilators used setting labels such as CMV and S-CMV. Additionally, the type of capillary blood glucose monitoring device was different from what I was used to.
If there’s one characteristic that I would contribute my success to, it would be my adaptability. Along with adaptability, I would include flexibility. Being able to adapt to this new situation, new routines, and new equipment allowed me to work quickly and efficiently. Flexibility helped as I kept an open mind to how the unit worked, and how they utilized their equipment. Instead of getting stuck on how I used to work, I remained flexible and adapted to the way the nurses worked and collaborated with the rest of the healthcare team.
These two characteristics eventually showed the team that I was a strong and competent travel nurse and that I could be left alone to work independently. This also helped the unit at the time since other patients were more critically ill and required more hands-on help from other nurses. Being able to handle my patients on my own within a few hours allowed my preceptor to step away and be the extra hands for the unit. As she put it, she had a lot of fires to put out.
I’m proud to say that the training and experience that I received from my old hospital definitely set me up for success. Despite all the new equipment, the new environment, and the new workflows, I was able to care for my patients confidently and competently. By the end of my shift, my preceptor checked me off on a few of their checklists required for travel nurses and I was ready to return for my next two shifts. Come back next week and read about how multidisciplinary rounds work and what the usual workflow consists of for night shift nurses on this unit!
Until next time! Salamat and si yu’us ma’ase!
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