Visit the ward before you start
This gives you chance to meet your mentor and ask if there’s anything specific they would like you to read up on beforehand. You can have a look around the ward and see some of the machines you will come across on your time there. This was the one placement I didn’t manage to get to before starting and the first day nerves were ridiculous!
Do some reading before starting
I say this about every placement but I feel like a critical care placement really does need some pre-reading. Even if it’s just brushing up on your a&p knowledge! My placement had a student pack that contained common equipment and common medications used, as well as a list of reasons why a patient would be transferred to HDU/ITU which I found really useful as it gave me a little insight before starting. You can see my critical care series here.
It’s normal to be worried or terrified, I was!
Critical care was my first placement of second year, after spending the whole of first year in a community hospital on an elderly rehab ward. I hadn’t been on an acute ward before critical care. I loved it from day 1 and really thrived there, it developed my confidence so much! I walked in on day 1 terrified, feeling that I would never know what I was doing. This is normal I can promise you that. Trust your own skills and knowledge and know that the nurses there don’t expect you to know everything about the area, it’s too specialised for that. Just go in eager to learn and you cannot go wrong!
Develop knowledge of normal anatomy and what happens when it becomes abnormal
You may already have a good understanding of a&p, enhance this by reading up on pathophysiology. This is the explanations of how conditions develop and progress. It can really help your understanding of why patients are in HDU/ITU and what the treatment plan is.
Ask questions, utilise the knowledge that the nurses and doctors have in this area
The nurses and doctors in this area are so knowledgeable and in my experience, more than happy to share all this knowledge with students who are willing to learn. There are no silly questions and you will get to see some interesting things on a critical care placement! I watched intubations, extubations, trachestomy insertion, ecgs, sedation breaks and experienced my first arrest situation (which is very different in a critical care area because you can see it developing before it actually occurs). Remember to talk through things you see with your mentor and write reflections on any relevant experiences you have on critical care.
Learn the names of equipment used
When I was managing my own patient, in the afternoon I would take the time to fill the bed space trolley up with the essentials. If you know the names of the equipment used, it can really help your mentor and show your own initiative to fill the trolley up in quiet periods. Learn the bedside checks as well and how to carry these out, this is a job you can be doing for your mentor at the beginning of shifts whilst they carry out other tasks.
Brush up on your SBAR and A-E handovers
These are used every time you hand over on critical care (in my experience) and I soon learnt the quickest way to handover whilst still including all the information needed for the nurses taking over the care of your patient. It is a quick and concise way to hand over and means all hand overs include the relevant information.
Take a notebook, this is a must for any placement but especially for this one!
There is so much to learn on this placement, I filled two pocket notebooks in my 6 weeks in critical care! Make notes on everything, ask questions, use quiet time to research common medications using the ward BNF, read medical notes and make a note of any terminology you don’t understand so you can research it later on.
Learn the common medications used there and how they work
This really helped me to understand why patients were on medications and how the different doses worked. Ask your mentor for the common medications used and spend some time researching why they are used and how they help the patient. You can read the common medications I came across in critical care here.
If it is a short placement, use it to develop your medication knowledge and handover skills
If you have critical care for a spoke placement, you may not have time to fully develop your knowledge of the ward but you can use it to develop your handover skills and how to care for a critical patient. Enjoy every shift, take every opportunity and don’t be afraid to ask questions!