[rammom73]

I have been an LPN for 14 years, working with pediatric vent patients in home health, being a treatment nurse for 100 patients in a LTC facility and a charge nurse on an acute care unit in a LTC facility. I currently am in my 4th semester of an LPN to ADN program at a local community college and thought that I should broaden my nursing skills and spoke to a unit manager of the TICU unit at local hospital explaining I was in school and wanted to take an RN position on her unit. Well long story short she made a position for me and I have there 6 months. After reading all the post I have to agree with most of them. The first 2 months I left work crying many times, I was working 12 hour day shifts and having been a nurse for so long was expected to know everything with only 6 weeks orientation even though I had never been in a critical care setting. I switched to nights because I couldn't continue working 3 twelves a week and have 2 nights class & weekend clinicals. I have to say nights is much better but I still see why nurses chose to leave ICU. There was 21 graduates hired to our unit in July, these now interns still are coupled with an experienced nurse and another intern so can't be counted in our census but have been when we're short.
Our unit has a 3:1 ratio and occasionally a 2:1 ratio with no PCA's, the nurses are it, we do our own transports, transfers and admissions plus patient care. You are expected to keep up with all documentation which is still old fashioned paper style and if you don't read your emails from the unit manager every shift you might miss the one about the ever changing forms used for procedures, admissions, home med reconciliation, etc.
I don't want to throw off the new grads but the obvious lack of on hands patient care shows, I constantly take assignments following some of the couplets and find patients sitting in dried feces and urine, supper trays untouched at bedsides, peripheral IV's infiltrated, documentation not completed and this is under the supervision of our experienced nurses working with them who happen to also be assigned patients due to short staffing. I don't know what the solution is but hiring an influx of new grads isn't the answer. My dad & mother-in-law recently both were on my unit and I have to say the feedback from them wasn't positive.
Right now I am torn between going back to home health until I graduate or staying in TICU to gain more experience; the money at the hospital is less & the benefits stink so why would nurses want to make a career there especially in the ICU's where it is so stressful?

[Hellllllo Nurse]

Originally Posted by RN/BSN/JD/ESQ

I feel very sorry for all of you.

I work at a very large, very well-known academic medical center (with Magnet status). I work in one of the surgical ICU's (there are several). We have 20 beds. The manager is a dream, and often leaves the office to pitch in on the floor when needed. I know every one of our RN staff (there are about 70), and I can honestly say that there is not one unhappy, negative, and/or ****** soul in the bunch. Everyone helps each other; everyone pitches in. We have extremely high acuity. We have new grads, and they are well-preceptored, even though some have made it clear that they are headed to CRNA school.

We have 24-hour in-house coverage by attendings, fellows, and NP's (as well as residents). Many of our attendings and fellows have PhD's in addition to their MD's. The docs treat us respectfully, like partners, and our professional opinions are valued. Any doc that is less than respectful to the nurses is "talked to" by the medical director of the unit. It usually happens once a year, and not again.

We are very well paid, and the benefits are likely among the best in the US. Frankly, I love going to work. I can't believe that my unit is unique; there has to be others who love their jobs. If I ever were as unhappy as some of you, I would be headed for the exit door. I wish all of you the best (and no, we're not hiring at the moment).

I've been a nurse for 14 years. I didn't think a place like you dsecribe really existed. I must say, I'm very envious.

What state are you in?

[wabisabi]

Sometimes it's because we get tired of torturing people to death for a living. (8 years in SICU, MICU, CCU)

[TEXAS_BSN_RN]

Any new grad starting in an ICU is asking for the response she/he gets, because it puts too great of a strain on the system.

No one forces new grads to start in ICU, so don't whine about the response you get from the experienced nurses who have no say in hiring and hiring policies.

Who pays alot of the price for you having the opportunity to start in an ICU? It's the experienced nurses. Experienced nurses get stress ulcers because YOU decided you just had to start in an ICU.

Novice nurses are a drain on unit resources. Novice nurses consume the energy of experienced nurses.

On other days, the situation will be overwhelming enough without the added drain of the needs of the novice nurses.

You being there feels like every nurse having an extra patient. And heaven help us when one of the patients of the novice nurses crashes.

new grads in ICU make the experienced nurses hard jobs even harder

You say you have a hard time because new hands are on the floor when you are?? For new grads or students please do not listen to these type of opinions. Study hard. learn everything you can. If you want to go to ICU for a yr and then go to CRNA, do it. Do not let these judgemental attitudes effect what you do with your life.

[Ruby Vee]

Originally Posted by TEXAS_BSN_RN

You say you have a hard time because new hands are on the floor when you are?? For new grads or students please do not listen to these type of opinions. Study hard. learn everything you can. If you want to go to ICU for a yr and then go to CRNA, do it. Do not let these judgemental attitudes effect what you do with your life.

The above quoted attitudes sound harsh, I'll grant you that. I wouldn't have phrased it that way. But they aren't that far off the mark. A new grad who starts in our ICU gets six months of orientation. After six months, they're officially practicing independently, but they still need lots of help. They have questions to ask, need help with critical thinking and troubleshooting and can't be given the most complicated patients. If you're the experienced nurse working next to them, you're the one helping them and sometimes it does feel as if you ave 1.5 assignments -- your own and supervising the new grad. It generally takes about 1 to 1.5 years after orientation before the new grad is a fully functioning, independent member of the team.

Your advice encouraging new grads to start out in the ICU and then leave after a year means that the experienced nurses are ALWAYS training. The new grads we train don't stay long enough to give anything back to the unit, and then we more have new grads to train. So we constantly work "short" because the new grads we train aren't working to full potential. They need a lot of support, help trouble shooting, protocols pointed out, etc. Is it any wonder the experienced ICU nurse are burning out?

[janfrn]

Very well said, Ruby.

[RN1989]

I left the ICU due to the horrible attitude of the critical care educator. She made demeaning comments about non-ICU nurses to the new grads in her ICU orientation course. When I called her on it, she told me that the course was hers to teach any way that she pleased and that she believed that floor nurses killed people and that ICU's were necessary to keep people alive that the floor nurses tried to kill. I realized that with educators and managers like her promoting the bad attitudes, it would never get better. I was tired of the snippy attitudes and have not looked back since.

[happyloser]

On the contrary, I have been dying to get into an ICU, and i finally have accomplished my goal, as a PCT though. My manager is a lovely person who informed me that if I prove myself as a Tech she would not have a problem hiring me as an RN in the ICU.

I know as an ICU nurse there is much to be done and requires a lot of critical thinking, but that's what keeps me going. I have been working in a stroke/geriatric unit for about 4 years and I have exhausted all my learning. I feel that in the ICU I will gain a whole different knowledge and perception of ICU nursing.

However, like a pervious poster stated most people leave ICU to gain their CRNA and make it obviously clear. I have no need to be a CRNA, I detest OR, there is no patient care. If anything I would love to be a Crtical Care Advanced Practitioner.

[bethem]

In response the the person who said all new grads needed to do to get a job in ICU was show up to the interview, well: I applied for a position as an RN 2 in an ICU program. There were 10 spots and 50 applicants. It was quite competitive, and we had to do a lot more than show up. It is NOT the case that ICU will accept any passing warm body - at least at my ICU. There has to be a brain involved too.

I love ICU, I plan to be there for the long haul and the only thing that I can see turning me off is the continuing rotation of shifts - I don't mind nights, I don't mind days, but I hate switching back and forth between the two.

I agree that the smart ones go to advanced practice, which is why I am almost finished my MSN. (There are no CRNAs in Australia. I mean I want to function in an adv prac role in ICU, I still love ICU. Just can't handle bedside for the rest of my career.)