I think I'm too slow for Critical Care... - page 2

by GucciRN22

6,094 Views | 16 Comments

i was a nurse for about a year and a half before i came to the icu. i felt fine out there (of course after the initial wanting to throw up every night i had to go to work;)) and i wanted something more challenging. i've been in... Read More


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    You've got some good points there. The metoprolol had no parameters. The patient had recieved 50mg PO AM and order changed to 100mg BID. I have no idea what would have happened. Other situations (open heart...) have parameters to hold for systolic below 100. Meds are not held as often in ICU, I've noticed. I did call the dr. the other night for systolic in the 80s and 90s and he did hold the Coreg and Cardizem. Go figure.

    The charge RN in question does this to most new people. It's like "hazing".

    I too, am trying to put it all together. The thing I don't like (and I'm not sure if others do this) is when I go home and think I dropped the ball on something. I stress about it until I go back and find it was nothing. Working nights is a little tough because you sometimes have to drop the ball on certain things and choose the things you can take care of with limited personnel.

    Thanks for the support. Deb
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    Stick with it!!! The only way those nurses got to be calm and cool is experience! You will get there!
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    I know exactly how you feel. I am still on orientation in the CVICU and I feel the same way everyday. I have about a month left and then no training wheels! I feel like I get MOST of the pieces of the puzzle at this point, but my problem is putting them all together quick enough. I feel sooooo slow. Charting and performing tasks on time seems to be more than a challenge at this point. Preceptors are great but at times they can make things so much more confusing. They tell you to organize and plan for your day and 2 hours into the shift that all flies out the window. It's do this, do that, have you done this yet, don't do that now, worry about that later, did you finish that thing that I stopped you from doing an hour ago ..... That alone is enough to make your head spin! Any suggestions on how to be more organized or efficient?
    imanubee and athena55 like this.
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    I know how u feel. I am a new grad, just got my license in April 2009, and was hired straight into the ICU. I know how overwhelming it can be at times. The other nurses on the unit that I have talked to say that it it took them about 5 years for them to feel completely comfortable in the ICU. Their advice to me was just to give it time. I was also questioning whether or not the ICU was the place for me, but I'm going to follow their advice and hang in there for a couple years, and then re-evaluate how I feel at that time. Good luck, don't give up!
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    I have been working in cticu for about 3 years now and still feel like there is soo much to learn! take it day by day. Most nurses that start out in this field that i have talked to are also a nervous wreck. It takes a long time and personal experiences for you to learn so therefore just believe in yourself. I promise you it will get easier with time. Everyone makes mistakes and says stupid things from time to time especially in a high pressure environment like this. Hope you feel better because there are soo many people that can relate to how you feel including me! My best advice is to stay strong and learn as much as you can. If at the end of the day this is not the area of nursing for you there are plenty other specialties that you can choose from and you will look back at how much you have actually learned and be amazed!
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    Quote from guccirn22
    i was a nurse for about a year and a half before i came to the icu. i felt fine out there (of course after the initial wanting to throw up every night i had to go to work) and i wanted something more challenging. i've been in the unit for a little over a year, about 9 months off orientation, and i'm finding myself wondering if it was the wrong choice.

    i love it, but i'm having a really hard time with the whole big picture and having to think about meds, patho, etc so fast at times. i tend to freeze even if i know what to do. i always second guess myself even when i know i'm right simply because i'm so self-conscious about everything i do. well, not everything, but the stuff that's out of the ordinary.

    i mean, i've only seen like 2 codes and only had one of them as a patient so i still have minimal experience with that. just because i work there now doesn't mean that i know what to do if something happens ( i mean, besides push the code light and get an airway, while, of course, yelling for help:d). i see all these nurses be so calm and cool about things when they happen and more than anything else i want to be like that.

    i just wonder if it's taking me too long to adjust....my coworkers don't seem to have a high opinion of me, but when i do a skill (a swan, or something) and then i don't see it again for another 3 months, what am i supposed to do? i ask for help when i need it, but i still come out feeling lame.

    also, if you couldn't tell, i'm in a whiny mood! lol
    first off, donít be so hard on yourself. you said it yourself you've only been there a little over a year, and haven't had that many opportunities at procedures on your own patients. one thing i might suggest, if any of the other nurses have been there for a long time and appear to be in the sharing mood, if they happen to have a procedure that you haven't done, ask them if they would let you do it, maybe under their supervision, it might demonstrate to them you are willing to learn and ask for help when you need it. it may also improve their opinion of you, but to tell you the truth, i've never been one to concern myself with other peopleís opinions. i always just did my job as best i could and let it go at that. as far as codes go, maybe the next one that comes up, you could volunteer to be the recorder, also after the code, you could check the code cart or box to see what meds need restocking, just to familiarize yourself better with how the cart or box is setup, knowing exactly where everything is makes you far more efficient during the code in getting things out to those pushing the meds. remember, expediency counts under these circumstances. there are a number of things you could be doing to improve your situation, you just need to motivate yourself. the most important thing is, that you still love what you are doing, if you lose that love, you will need to pack up your locker and move on.
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    Look for learning opportunities and never stop asking the "why" questions. Not sure what your work environment is like with the MD's, but I've found if you ask them to explain the rationale because you don't understand and want to learn, most are willing to explain. If they are reluctant, you can tell them that you need to know so that you can provide better care for THEIR patient. If they still are nasty about it, then they truly are an A-hole and not worth getting worked up over. You'll find out who you can rely on, and who you can't. I've never had a problem getting great explanations as to the decisions they make. Additionally, they will see that you truly have an interest in learning and will be more inclined to gain your insight into problems once you become a more experienced nurse.

    Also, you sound exactly like where I was when I first started. Don't fret... when things that you worry bout now become more familiar and routine, you'll start having those "Ah Ha!" moments as you begin to piece together the bigger picture. Once you start opening those doors, the sky is the limit.

    Always keep in mind, that no matter how comfortable you get, every day you will learn something new that will knock you down a few pegs! That's what's so great about working in the ICU
    Last edit by IHeartDukeCTICU on Jul 28, '12


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