Icu Nursing isn't for me help

  1. 0
    Looking for advice! I am a relatively new RN-bsn, almost 2 years in, all day shift critical care. I also worked as a cna in the same department during nursing school. So I feel that I have given critical care enough time to know that it's not for me. I spoke to co-workers and managers previously, all said stick it out because I'm a good nurse and I will see that at the one year mark. They said everyone feels like this at first and if it doesn't get better you can go anywhere with icu experience. Well that doesn't seem to be the case. I am still extremely stressed when I am there and always afraid I'm going to make an error. I don't have fun or enjoy my time at work because I am so stressed. I feel like icu nursing lets me know a little about everything, but I'm not an expert on anything. I have applied to numerous specialty fields (mother/baby, l&d, surgery, and oncology) with the hope that I might like nursing if I could become an expert in one thing. I never even get an interview. All the job postings say they require x amount of years experience in that field. My mom is a clinical manager for a hospice company. Although she has offered me a job there, I'm not sure I would like that type of nursing either and I do not want to put my mom in a bad spot if it doesn't work out. She reviewed/edited my resume and cover letter and feels they are very good. So how do I go about getting out of icu? Are there any other jobs besides nursing I can do with my BSN if I can't get into a specialty field? I am just lost and have no idea what to do. Some times I debate going back to college and starting all over with a new career, but really can't afford to go into that much more student loan debt. Any advice would help.
    Last edit by RN-icu on Mar 14

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  2. 24 Comments...

  3. 0
    What it it you don't like?
  4. 1
    Is there any aspect of ICU nursing that you are interested in? My hospital has several different ICU's with different focuses, a Cardiac ICU, a Neuro ICU, an Open Heart ICU, etc. Is there an area that you are interested in that you could use to start building an expertise? What is your favorite type of patient to care for, you favorite things to do while working. Dialysis nursing can often benefit from critical care experience, from what I understand, or you could go for a certification in wound care if that were something that interested you.

    If the stress is getting to you, a transfer to Med-Surg might help, though you will still be dealing with stress, just a different type of stress. I'm guessing that transferring to another speciality would likely require a residency of sorts to learn about that specialty, so maybe look for hospitals with residency programs and talk to their educator about if they would be willing to take a more experienced nurse and train them.
    LadyFree28 likes this.
  5. 3
    It sounds as if you're in a smaller hospital where one ICU takes everything. In large teaching hospitals, there can be several ICUs, each one a specialty. If you like cardiac, try a CCU or CTICU. If you're into the nervous system, a Neuro ICU would be a fabulous learning experience. There's NICU and PICU. But if it's the fragility of the patients or the urgency in ICU, perhaps you'd be happier elsewhere. Med/Surg would still give you the issue of taking a variety of patients and not becoming an expert in any one specialty, but again, a large teaching hospital will have a Medical Oncology, Surgical Oncology, Renal, Cards -- whatever specialty you can think of floor.

    No matter where you get your next job, you'll be dealing with stress; just different stress. I cannot think of anything more stressful than Home Health, unless it's Newborn Nursery . . . but your milage may vary.

    Make a list of what you like/enjoy about your job and another list of what stresses you out the most. Be specific -- not "I'm afraid of making a mistake", but "I'm afraid of titrating dopamine." Or whatever. Then come back and share the gist of your list and maybe we can be more helpful!
    ICURN3020, LadyFree28, and msygrnbw like this.
  6. 0
    Been right there with you, all of my peers said stick it out, and there is a turning point, what don't you like? of course the stress of the ICU in difficult to manage. How many beds in your facility, in the unit, what are your strengths...?
  7. 0
    Dear Ruby Vee--

    Did you really mean it when you said that you can't think of anything more stressful than home health? Given that every job has its own stressors of course.
  8. 1
    Quote from jennycRN
    Dear Ruby Vee--

    Did you really mean it when you said that you can't think of anything more stressful than home health? Given that every job has its own stressors of course.
    Well, the newborn nursery is a close second but at least there you have back-up!

    My Community Health rotation as a student was absolutely excrutiating. I went into one home where the woman was a hoarder. There was junk piled to the ceiling throughout the entire house, with just one narrow little path through from the front door to the kitchen, one place clear at the table, and then another path to the bedroom. The bathtub was full of used toilet paper and the toilet didn't flush. There were about thirty cats living there and no littler box that I could find. The smell . . . .

    I had another patient who lived in a not-so-nice part of town. It was winter, and dark when I finished my visit. The patient wouldn't let me leave her house until her husband came home to escort me to my car because she was afraid I'd get beaten up, raped or mugged on the way to my car. When her husband came home, he scared the everlivin' bejesus out of me, but he did get me safely to my car.

    And then there was the home health nurse in my area who was murdered while out doing her rounds of her patients. (I think it turned out that the ex-husband did it, but the idea that it might have been a patient kept me in nightmares for weeks!)

    The thought of doing home health has me shivering in my boots!
    llg likes this.
  9. 4
    Hey, I'm right there with you Ruby. To me, the scariest patients are those without any monitoring technology. Give me a monitored patient with ventilator, capnography, swann, peripheral A-line, etc.... and I feel much more at ease. There's NOTHING that can happen without my knowing it first. Not the case with a 'walkie talkie' - who knows what's happening in there???? Worst of all?? Pregnant people - for heaven's sake, there's a patient inside where I can't even touch him/her - And to have to deal with a patient in an area where there isn't even a crash cart or mechanism to call a code??? YIKES!!

    See, it's all a matter of perspective.
    ICURN3020, ICURNBSN, hurleygirli1, and 1 other like this.
  10. 0
    Thanks for all the responses. I work in a 240 bed community hospital on a 22 bed icu/tcu unit. Our patient ratio is 1-4 depending on the acuity. (1:1 is pretty rare for us tho) We do resp failure, renal failure, gi bleeds, overdoses, post-op, and just old/sick with an assortment of illnesses. We have a trauma 1 hospital 5 minutes away so everything interesting goes there. While in school I did my clinical rotation in their neuro-icu and took care of very interesting patients (gun shots, MVA, and strokes). I enjoyed my time there, but I was a student. I wasn't a nurse responsible for doing it on my own. So I am not sure if I would enjoy it now or be even more stressed because there will be so many things I haven't done and haven't had the opportunity to see yet.

    I love when I leave work and know that I connected with a patient/family and they really appreciated all the work I did. Because I do my best and bust my butt to make sure my patients/families are taken care of and getting what they need. I went to nursing school thinking that everyday would be like that and I would really make a difference, but sadly more often then not that isn't the case at all!

    Also in nursing school we were told that nursing is the best profession because you can try a different speciality every 6 months until you find the right fit. That doesn't seem to be the case now either.

    I guess I need to make a list like rubyvee said and figure out what in particular I do not like
    Last edit by RN-icu on Mar 24
  11. 0
    So here is the list so far. I'm sure I could add to it, but it's getting late and this is all I can think of now.

    I dislike:
    Titrating pressors. Actually I like doing it, but I do not feel educated enough. It's not all the time that I have the opportunity to do them so I always have to look them up. I can never remember how to mix them, which ones are mcg/kg/hr vs mcg/hr, or the titration ranges. In codes or when my patient is crashing and I need them quick it stresses me out.

    NT suction: I hate doing it. It's torture and it's gross

    Placing ng/dht: same thing, I hate doing it.

    Cleaning up poop: I did that as an CNA and thought I won't have to do this once I'm the nurse with a college degree. I still do it all the time.

    Feeling overwhelmed. This happens a lot especially when I have a 3-4patient team. A recent team I had, but pretty indicative of how they make assignments all the time. I had 2 separate gi bleed patients, both getting blood and needing cleaned up a lot. and a dementia patient that kept taking the bipap off. Until he really couldn't anymore and we intubated him. I just felt like I needed to be in all 3 rooms constantly, but that's not possible so I spent my day running from one to the other.

    The charting: gosh! if I didn't have to chart so darn much I could actual spend more time in those rooms. (This is everywhere. I know it won't escape it)

    Psych patients: gosh! Half the time I feel like we should just rename ourselves psych-icu. I am not a psych nurse for a reason. Hate it!

    Codes/crashing patients: I don't really enjoy this. It stresses me out. I think most true icu nurses get a small thrill form this. Not me!

    Feeling like im not smart enough: I know I am my own worst critique, but I hate when a patient or a family member asks me a questions and i do not know the answer. I have to say I honestly I do not know, but I will figure it out. I'm sure they don't feel good hearing that from their icu nurse.
    Or doctor for that matter. It's worse when you tell them you don't know something or ask them to explain something. Some really do not like that and make it known.

    I like:
    When I feel appreciated

    When I can sit down with patient/family and educate them

    one extreme or the other. I like on the vent, calm, and sedated. Or I like the walkie talkies. I do not like the in between and that whats I get most of the time.

    Hanging blood products

    DKA patients. That is my favorite diagnosis to take care of. I think because you can actually see your work paying off by watching the bs go down every hour and the ketones slowly clear. I know, very random!
    Last edit by RN-icu on Mar 25

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