I have been on AN since nursing school and now I am in a new grad program in ICU/CCU. I am brand-sinking-new. This is my first nursing job and I find myself in the front lines. ICU/CCU was my ultimate goal. I thought after a couple of years of experience I will do ICU. Well, I was thrusted to the goal. I feel overwhelmed. I have been working since March and even today I question when will it ALL sink in. Don't get me wrong, I know it's only been approximately 3 months and I cut myself slack but no one else does. My hospital is a bit backwards. We are just getting computerized charting. They still use heparin flush protocols, even though EBP shows saline is just the same if not better and cheaper. The orders are all written in and I don't know how to decipher the cryptic Dr writing. I end up missing things. I hate it! Then giving report to the night and I feel utterly incompetent. It doesn't help that this particular night nurse is the "I eat my young" variety. I know I'm griping. I am trying to get the most out of this opportunity but there are days when I think, "Seriously, this is my calling? Playing catch up?"
That's all for now.
Ms. Bitter Mcbitterson.
Jun 7, '13
I definitely can understand where you are coming from. ICU can be a great opportunity for a New Grad if the hospital/staff let it. How long was your orientation? Or are you still precepting? Is there anyone on the unit you can confide in and ask for some guidance? Could you speak with your manager? Hopefully this situation can be resolved so you can thrive.
Being in a unfriendly environment for new grads can be awful though. If you are not happy, or worried about patient care, or whatever - can you go to a step-down unit? Sometimes hospitals offer a period of time where you can decide if the unit is a good fit, I know for the hospital I work at now it is 3 months. If they are willing to let you transfer, and you want to, there is nothing wrong with that. I know ICU is your dream, but it is never too late to go back! Better protect your sanity, the patients, and your license. You need to do what makes you happy.
Best of luck!
Aug 5, '13
MLB4 that was great advice. I too will be starting as a new grad in an ICU soon and am a little curious as to how I may react to such a faat place high accuity environment. This is where I always wanted to work. Only time will tell how I will adapt.
Aug 11, '13
It takes a while to earn the trust of "those who eat their young!" But don't give up, and don't let them fluster you. You worked hard to get your license. As you show your determination to learn and assist your patients on the path to wellness, you will become stronger. You can learn something from every patient you care for. Let your focus be on them, instead of on co-workers. You will find your silver linings. Never give up.
Aug 11, '13
P.S. it takes every bit of a year to feel as though you halfway know what you are doing in ICU. And that is when you realize how much more you have to learn! Personally, I love it. Check everything you do - don't be intimidated by those who seem 'superior'....because everyone makes mistakes. Know your patient through all the information you can find in his chart, and you will find that people trust your reports, and appreciate them. I wish you all the best.
Aug 21, '13
Plus remember that even if you step down to an " easier " unit, you still may come across those who " eat their young" and you will get frustrated again- don't let them eat you! And one day when you will have 10000 years experience ( or you will feel like rather) that you don't want to be the one who do not help young ones... Great lesson although painful , take care!
Sep 18, '13
I thank all of you for your support and advice. I have switched to nights, the shift I was hired for, and I love it now. I have won over the nurses that ate me alive. One if them oriented me to night shift and i was able to gain her confidence. The other, showed me we all make mistakes whenI was helping her with a pt. With this experience I have learned to never judge another nurse or criticize them because no matter how much experience I have, I could make the same mistakes they have. ICU is where I want to be. It takes a bit to get used to the fast pace but the things I have learned are...
Always check on your pt the moment you start shift. Don't wait till after report. (Someone has coded turn of shift)
Always check what is hanging is correct. (Some one came in with someone else's I've fluids and I caught it)
Always check your orders
Document everything. If it isn't charted, it didn't happen.
Read the chart and history. If a pt has been there a while, report handoff turns into a game of telephone and the info changes
No matter what, turn your pt q 2hrs. The last thing you want to do is cause breakdown.
Always try to do your best. It's not to make yourself look good, it's for the benefit of the pt.
There is more but I can't spend all night here. 😉
Thanks again xoxo 💕
Sep 18, '13
Take the nurse that you're reporting to in to see the patient(s) to either introduce them or look things over, or ask questions. Show 'em that groin site, or look over the IABP. Helps ease the minds of both RNs. If the on-coming RN doesn't want to, then their loss!
Oct 14, '15
Wow...what a couple of years make. Lol
UPDATE: I'm still in ICU but I have changed hospitals. I'm in a ICU with higher acuity, which is great for learning but my stress level is higher. Different drips, nerve-blocking agents, CRRT, Swans, etc. all learned since April this year. I've had moments where I think, is this where I'm supposed to be and days that I proclaim..YES, THIS IS FOR ME!!!!!! I've had some wonderful patients that have touched my heart and re-energized my passion for nursing.
Thank you for your support everyone.
Oct 20, '15
Thanks for the encouragement and thanks for coming back to update. I'm in your shoes where you were two years ago, a new nurse just starting out in the ICU. So many new things, things everyone else takes for granted (like, uh, knowing what a swan was! Have I heard of catheterizing the pulm arteries, PAWP, and all that? Yes. Did I know that's what it was called? NEWP.)
Nov 7, '15
Sadly, there will always be those hateful B-nurses you are rude and nasty. The love trying to belittle the younger ones cause they allow them to get away with it - they still try that garbage with experienced nurses but we either ignore it or just toss it right back at them. Many times these old hags are clueless about EBP and has done zero to advance their knowledge over the years - they are just unhappy fools.
Three months in is not enough time to be much more than a beginner. It takes time and effort. Organization is huge!! Some advice I can offer:
1) have a preprinted report sheet that covers head to toe to help with report
2) find a go to person on your unit to help guide and give advice
3) ask your doctors questions - find out what the plan is and listen. Many providers love to teach - take advantage
4) try to anticipate - this comes with critical thinking but overtime it helps put the pieces together.
5) find resource materiel - U die many apps at work to look up meds and uptodate is excellent for researching conditions
6) I remember those written order days....ask the doc before he/she leaves any questions, check with other nurses or unit secretary people learn how to read horrible writing over time. And if all else fails call the provider and tell them you cannot read it!
7) When you give report on shift change ask the oncoming nurse if you missed anything - rather hear from them than have them complain behind your back
8) give it some time and try not to be so hard on yourself. I am sure you do many things right but magnify the things you are a little weak on. celebrate your success and learn from your mistakes. there is no one way to make a great nurse...
Best of luck!!!
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