New in ICU... I'm scared I'll lose my license

  1. I'm incredibly smart, I promise... but one year ago, I didn't know what a PRN was. I got my BSN from an expensive/prestigious one year crash course program. Now my smarts have landed me in an ICU (which I'm totally stoked about). I'm about to get off of orientation and I do not feel ready: (

    I fear losing my license over making a negligent mistake after orientation is over
    I fear the things I don't know that I don't know ( if that makes sense)
    I fear missing the critical signs in a patient because I'm overwhelmed with being task oriented and they end up dying.

    prep wise:
    I've literally been reading textbooks tryna remember all the millions of tidbits of information I should be cognizant of. It feels like it goes into one ear and out the other. (like pouring prbc into a hemorraging dic patient). I'm taking a million classes courtesy of my hospital too. I have pocket guides. I'm dizzy with it all.

    Organization wise:
    1. I've adopted my own brain sheet with times meds and procedures mapped out.
    2. I get there 30mins early so I can look at labs and medications, general condition of the patient I'm assigned to before report.
    3.I also make my bed bath pallates ahead of time so I'm not struggling with it later.

    I still manage to leave late : ( and feel like I'm the worst person on the team

    Any advise? Words of encouragement? tips from the nice old battle nurses? things to read? How do I prioritize?!?!
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    About Nyla Maddox

    Joined: May '12; Posts: 7; Likes: 3


  3. by   CPhT2RNstudent
    How long was your orientation? What type of ICU? What trauma level is your hospital? Everyone feels vulnerable when they are new. You need to gain experience before you will feel more confident. I say you should ask for more orientation time if you really feel you need it. If not, make sure you ask questions if you are in doubt. BS'ing is a good way to lose your license and hurt a patient. Always show confidence in yourself. If you look unconfident the patient and/or family will see this and doubt you. Lastly, maybe you could ask to be buddied up with a more experienced nurse. You would have your own patients, but they would have the assignment of being ready to assist you if you need it. They could be a security blanket to help your confidence. Knowing they are there will help you feel more confident, but you will feel even better when you do not need their help.
  4. by   allysun1
    You are a new nurse! These feeling are the same feelings I had when I first started. Well I don't work in ICU but either way, I can relate. You seem to be going the extra mile to be on top of your game, and that is a good thing. Just keep doing those good things(brain sheet, palletes) and eventually you will develop a routine and you will get out of work sooner. I have been a nurse for 6 months(still a newbie!) and I still stay after work often. Also, I was terrified that I wouldn't catch the signs and symptoms of someone who is in distress or or when something was wrong with them. The thing is that all illnesses(almost all) have S/S, you will be able to pick up that something "ain't right." And for the things we can't SEE, that is why we draw labwork in all. Sometimes you may not know exactly WHAT it is, but that is what MD's are for. Plus, as nurses it is in us to know when someone is sick/acutely ill, it's like it's inbedded within us. Make sure you ask lots of questions at work.

    Hope this helps!
  5. by   ckh23
    It is a normal feeling. There is so much to learn and you are not going to do it all on orientation. Start identifying who the strong nurses are and the the ones that are willing to help and teach. Don't be afraid to ask questions regardless of how "stupid" you may think they are. Some of the more experienced nurses on here will tell you that we are always learning and no one nurse or person knows everything. As a new grad you are not going to be expected to know everything and that you will need help along the way. If you feel that you are that far behind, talk to your manager about possibly extending your orientation period.
  6. by   Mike A. Fungin RN
    Quote from Nyla Maddox
    I fear losing my license over making a negligent mistake after orientation is over
    I fear the things I don't know that I don't know ( if that makes sense)
    I fear missing the critical signs in a patient because I'm overwhelmed with being task oriented and they end up dying.
    First thing's first: your fears are completely normal and even beneficial at this stage. They're going to help keep you sharp while you slowly close the experience gap that you're struggling with.

    I was where you are three years ago (new grad, fresh off of orientation, trauma / neuroscience ICU) and I felt the exact same way.

    My advice, don't overdo it on the classes/reading etc. in addition to work. What you need right now more than anything is to just do the job. If you overwhelm yourself trying to memorize everything, it's only going to detract from your performance. Good nurses don't get that way by memorizing things out of a book, they get that way with experience, and experience takes time. Allow yourself room to make mistakes. Learn from them.

    Plan to take the CCRN exam at the 2 to 2 1/2 year mark. THAT'S when hitting the books will really pay dividends, because you'll have been doing the job long enough to put things in context and help the information stick.

    Until then, go in to work motivated to learn. When you get home, look up ONLY what you had questions about that day, and then ENJOY YOUR TIME OFF. Now is the time to develop good habits w/regards to striking a balance between work and the rest of your life.

    Remember, you're right where you're supposed to be and everyone felt that way (even if some don't remember).

    Good luck!
  7. by   Merlyn
    Relax, Kid. Just take it easy and play it as it comes. Ask questions and listen to the answer. Remember Robert Burns," the best laid plans of mice and men oft to go astray."
  8. by   Nyla Maddox
    Thank you everyone for the responses!

    It's a 12 bed general ICU. (there's no one particular system we cater to). It's a small hospital, definitely not a trauma center.

    My orientation is supposed to be 12 weeks. I'm at week 9.

    I had an older nurse(20+ years) as a preceptor for 8 of those weeks but I didn't realize that she was getting the "easier" patients to care for (the ones that are only there because of the vent). Even then, she wouldn't let me do the total care on the patients.

    When I switched to a newer nurse she got all the drips and trauma, and post op patients...I feel like I wasted my preceptorship.

    I asked admin for an extension but the overall sentiment that I got was that "it was already expensive to keep me as an orientee." It doesn't sound like I'll be getting more time.

    I definitely plan on taking my CCRN and eventually getting my CRNA but for now, I just gotta get past ICU
  9. by   krazylady
    That's a very short ICU orientation. I start on Monday, and our orientation will be 6 to 7 months, and I'm sure I still won't feel ready then...
  10. by   njs5068
    I start in a level 2 trauma center on October 8. I am starting to get the jitters. I always try to excel at whatever I throw myself in to. Some call me an overachiever. I am terrified that I won't be good at this. I graduated 2 years ago, and the core of my experience has been geriatrics. Good luck!