OK, in general there can be a huge difference even between personality types in ED vs. ICU, especially PICU. Yes, there is a lot of maintanence care, as you state, but there is a lot of potential for deeper leaning about disease pathophysiology and treatments. I learned more in all the ICUs I worked then anywhere in 20's years of nursing--that includes pediatric and pediatric cardiac. But here's the thing. ICU nurses are extremely anal-retentive--very particular over everything--and especially in peds, there is is usually a reason for it--but even in adult critical care units, people can be very picky. I think it is the nature of the beast. ED you generally hit what's most important and move em along. Intensive care is very much combing through and covering everything. You become intimately aware of each patient from one body system to the next. There's a lot of detail orientation involved in critical care--and generally speaking, the younger and/or more critical the patient, the more careful one has to be about the details and maintaining them. In these areas, surgeons and all sorts of specialists and residents and fellows of all sorts are combing over the documentation. It is recorded at the very least in most places, hourly--but depending upon acuity, it could be by the minute. Everything is combed over in great detail--again, the nature of the area. That's why they made a huge deal about your assessment documentation.
I don't necessarily think they will fire you, but you had better believe they will watch over ever stitch of documentation and everything you do. Especially in pediatric icu's, you are in a bubble and are watched all the time. Most places--regardless of type of area--are being video-recorded. Shoot, I even do home-care cases, and many of these parents have videos w/ or w/o audio on and around their babies. It's hard for me to blame them at all for this, given the nature of the world and the fact that it's their children or loved ones. I just figure if I am doing what I a supposed be doing, I could care less if they are recording me. So what I am saying is that all areas anymore have much closer surveillance than years ago, and also in critical care units, it's like just about every RN and person there thinks they are human recorders, watching every move you make. It's something you have to accept in order to work there, and there are times that this close surveillance could save a patient's life or prevent needless errors. If you want to really learn in these areas, accept this culture as your friend. It's kind of like I had to give up a huge amount of autonomy in going from adult critical care to pediatric and neonatal critical care. I wanted to learn it, so I accepted the differences, and I realized that they were almost always in the patients' best interests.
I agree with Ashley in that a documentation mistake is probably the best mistake you can make--although, you have to remember that a ton of people (physicians and others as mentioned above) are combing through your documentation--and in reality, they really depend on it. They should see the patient of course and talk with nurses and relevant others if it is going to affect the plan of treatment, still, your documentation could effect the plan of treatment or cause the current one to be brought into question.
Learn from it, and give it another few months unless you desperately hate it. If you do hate it and don't see that changing, keep working well at the position you are in now and start looking and getting your resume out. I agree that you shouldn't beat yourself up--especially over something like this.
I am just sharing what I have seen about how the critical care culture rolls over the years.The interesting thing for me is, though I can be anal-retentive about certain things, it's more selective or based on priority. That kind of makes me more like an ED personality. OTOH, I really like the sleuthing side of critical care--being the detective and combing through information and matching it with the minute-to-minute presentation and critical values of the patient. That part has always been interesting to me. You have to find what works for you, but then deal with the cultural dynamics that are in place, b/c you are not going to change them--at least not immediately or anything close to immediately.