New in the ICU

Ruby Vee, BSN · Jul 29, 2012

i am very comfortable with the environment and people, as i have been a tech in the unit for 3 months. which make me even more nervous because everyone has an extremely high expectation of me, i just hope i can meet them.

nervous is actually a good thing! good luck!

OnlybyHisgraceRN, ASN, RN · Jul 29, 2012

i'm a preceptor, too, and i have to disagree with one point rnerd81 made: asking for a new preceptor. in my icu, there aren't enough preceptors to go around. they make an effort to make good matches between orientee and preceptor, but not all matches are made in heaven. that being said, you as an orientee are expected to make the best of your situation and to get along with your preceptor. asking for a different preceptor is a black mark. most times you'll be told to work it out. if you do get a new preceptor, they'll be tasked with documenting, documenting, documenting because the presumption is that you aren't working out.

acting confident is a double edged sword. no one wants to work with someone who seems to be afraid of everything, but there's nothing more frightening than an orientee who seems to know everything. the trick is to get it right somewhere in between.

expect that you'll have to study in your off time. i had to study at home when i was a new grad, and every time i switched specialties. you will too. i've had orientees refuse to study -- none of them made it off orientation.

try to absorb everything you can. carry a notebook or something, and write down questions you have or terms to look up.

introduce yourself -- to your preceptor, to the charge nurse, to the cna, to the providers, to the echo tach, to the renal consult. be ready to chat a bit . . . about where you're from or where you went to school or the weather. i'm shy -- i understand the shy orientee and appreciate the social one. what i wish someone had told me when i first started is that a little chatting helps to solidify the team and being part of a team makes work so much more fun.

while i won't say there are no bullies in nursing, i will say that they're not as common as you might think from reading allnurses. if you don't go looking for them, chances are you won't find them. what you will find are people -- people you can learn a lot from and people you can learn what not to do from. some of them are shy and not chatty. some of them are having bad days or bad weeks or, like me, a bad year. a nurse with a dying parent, a leaking roof, an upside down mortgage or cancer might conceivably be scowling about something that has absolutely nothing to do with you (and may have no idea that they are scowling), so try not to take things personally.

most of us preceptors want to do the very best by our orientees. i have orientees that have been with us for several years, and when one of them gets a glowing letter from a family or is asked to orient to charge or is complimented by the opposite shift, i'm proud. when my orientee makes a mistake or gets into trouble, i take that to heart as well. if you have a question, ask it. if we're not communicating as well as you'd like, let's sit down and figure out how we can do better. if you don't like my style, i'll try to modify it. please don't take criticism personally; it's part of your job to make mistakes and it's part of mine to correct them. some of us are more skilled at handing out criticism than others, but most of us mean it to be constructive.

good luck -- i hope your first year is minimally awful and that you learn lots.

great post, ruby. i'm new to cvicu as well, and my nm told all of the interns to come to her quickly if our preceptor is not a good fit. i do agree that if you and your preceptor have a non-productive working relationship then a new preceptor need to be found. my preceptor and i bump heads at times but our working relationship is productive. however, i've seen preceptors and interns have world war iii at work and at that point, the intern isn't learning and the preceptor is no longer teaching, they are both just trying to put up with each other.

op, i say this: pick and choose your battles. not every thing is worth reporting or getting upset over. when you do feel the need to speak up to the senior nurse, be professional and calm. icu nurses have a certain anal personality, you will see it but do not take it personally. after a while you'll see yourself becoming a little anal too.

good luck. i'm 3 months into orientation. i'm right there with you!