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!
Dec 22, '09
Quote from wasabiRN
I too, can relate. I have wanted to be an ICU RN since graduation but chose Telemetry instead. I finally got the chance to train for ICU after 3 years. The first day in ICU I thought "there is SO much I don't know". I was a pretty confident Tele nurse that could handle any situation or know enough to find help when I couldn't.
Within the first month in ICU, the "sharks" as some of us call them, start reporting to mgmt the shortcomings of the new people. So much for having a year to feel comfortable. I find my self confidence slipping at times. I am also second guessing my care as I am waiting to hear that I made the wrong decision. I actually had one of the Charge RNs take me aside and lash out at me for holding 100mg of Metroprolol on a pt with a BP of 92/53. She said I should have called the doctor in the middle of the night, or talked to the charge RN. She is one of the most unapproachable charge nurses I have ever encountered. Now I call the doctor night or day anytime I want to hold a med.
I am very uncomfortable in this environment. I love the ICU, I love learning and love the challenge. I do not like the working environment I am in. There are many wonderful RNs that make up for the sharks but I still get uncomfortable before shifts and do check the schedule of who I will be working with.
The one thing I will take out of this experience: When I am confident and feel like an experienced ICU RN, I will NOT treat new people and new grads in this manner.
Thanks for letting me vent.
I so feel you. I went from school (BSN program) to CVICU. So I lived in the world of "not knowing what to do" or how to critically think. I have been a RN for 9 months and I still have my stupid moments...lol. I don't gauge how good of a nurse I am by my coworkers responses. I go by what my patients and their families as well as what management tells me (knowing coworkers run to them anyways telling). I don't mind the telling. Makes me better. I hate being told of mistakes so I naturally try not to make them ONCE I KNOW what they are.
Now the Lopressor thing....with that pressure I would hold it if it was IV Lopressor (I don't think IV doses would be that high). If oral I know it has to pass thru the GI tract and it's has a gradual effect. I know we provide meds to maintain vitals too so if the pt BP gradually decreased I know I would then call the docs saying, "I gave this med as ordered and now the pt BP is falling below ordered range. What should I do?"
At my hospital, in our orders, it always state the parameters (Hold if HR <60 or SBP <90). So that results in less calls to the docs. Other things I look at is has this med be held before?? Is is PRN or scheduled? I mean if its scheduled and you hold it did the pt pressures stay about the same or did it gradually rise. After all if the patients BP became hypertensive you can always give it right??
Don't know why the charge would lash out on you especially if the patient's BP stayed WITHIN ORDERED RANGE. You a learning ICU nurse. It's a teaching moment so WTH? I swear I try to learn as much as I can on my own. Of course I learn who I can go to and not to go to. As for the docs, I don't care about "bothering" them. The way I look at it is this: It is their job and duty to respond to our calls/pages. I remember calling a doc 4 hours in a row about my pt's Urine output <30cc. I knew he wasn't going to give lasix and after the 2nd time he wasn't giving no more fluids. I call because I want to inform him and so i can chart, "physician aware of low urine output"
I cover myself because the time you don't call and something happens they first thing they will say is that they didn't know and wasn't told (of whatever) and then your butt is on the line.
Last edit by nursingpower on Dec 22, '09
: Reason: correct spelling errors, clarification of thought.