A Few Rules For Surviving an ICU Orientation (Dignity Intact Optional)

Rule #1: You're wrong. Everyone else is right.

Corollary: If you're not wrong, don't worry: you don't know enough yet to be right. About anything.

Even today's date.

(True life story! If someone says it's the 6th but it's really the 5th, don't argue with them. Just say, in the most deferential voice possible, "Really? I thought it was the fifth, but I could totally be wrong. Okay, it's the 6th." Even if you just looked at the friggin' calendar, and you know it's really the 5th--trust me, don't set yourself up for failure-to-communicate-with-your-superiors, here. It's the 6th if your coworker says it's the 6th, goddamn it. Trust me. Console yourself with the fact that it's probably the 6th somewhere across the international dateline, if you're having a hard time accepting your new reality of Always Being Wrong.)

In short, just make it easy on yourself and admit you're wrong even before any one else has submitted their opinion about the situation. Saves time and energy, and that's half the battle in an ICU setting.

Benefit: the quicker you admit you're wrong (even if you are in fact, wholly correct) the less apt your superiors and co-workers will be to beat you around the head with your supposed superiority complex. Less beating about the head saves precious neurons, and you're going to need them, even if it seems like you don't, because you're always wrong anyway.

Rule #2: You know nothing, capeche? NOTHING.

Corollary: We lied. You know nothing except for Rule #1: You're wrong.

Beyond that, you know nothing. Even if you think you might know something about something, you don't.

Repeat after me: YOU KNOW NOTHING.

You see, as far as I've worked it out, whereas it might seem counterintuitive to profess your lack of knowledge in a setting where people live or die by their health care providers' skills and professional acumen, it never fails: your coworkers will instantly distrust you if you seem to know more about something than they do.

As far as I can tell, your coworkers--the ones who are sheparding you through your ICU infancy, any way--are not primarily concerned with your IQ, your ability to use big impressive words, or the fact that you memorized the entire contents of your hemodynamic monitoring textbook and can recite them verbatim.

No, they're far more interested in how much of a clueless, panicked pain in the neck you're going to be when the shit starts hitting the fan. And they are not impressed with anything that might suggest in addition to clueless and panicked, you're gonna act like a know-it-all schmuck.

In other words, they might be able to protect you from your own stupidity, but you make their job a lot harder if they think you're an arrogant asshole, and they don't like when you make their already crappy job even crappier.

So, pretending you know nothing assures them you really are just a stupid backwater hick, and they figure they won't beat you about the head as often in order to keep you docile, since they want to protect the few God granted neurons you actually have in that thick skull of yours.

Rule #3: Beg for forgiveness and mercy. Frequently. Remind people of your stupidity early and often, and if all else fails.

I'm convinced generations of ICU nurses have made it through orientation based largely on their ability to submit docilely to humiliation on a daily basis.

You'll be allowed to display more of my own unique personality and attitude later on, when you're off orientation. Right now, however, it's just in your best interest to demonstrate your willingness to frequently profess your own boundless servility.

It's like magic. The minute you say something to the effect of, "Really? My nursing judgment totally sucks ass? I never really thought about it that way, but you know, now that I've thought about it, I totally agree with you! Thank you!" --it seems like everyone seems to relent a bit, and think you're not such a fuck-up after all.

Rule #4: Try not to drink too much or self-inflect head trauma (eg, repeatedly beating head against the wall) to dull the pain after a shift.

Because tomorrow someone in charge of you might decide you do two have synapses to rub together (or they're short two nurses) and let you off orientation--and you're gonna need all the brain matter you can get, even if you have to scoop it back up off the floor from your last work-related clubbing.