[DDRN4me]

although I have never worked in an ICU; i can certainly call myself anal when i am in a pt room...thats how i organize myself...with such critical patients they just need to have "all thier ducks in a row" to be able to function.

[gradcare]

Two things.

1) When the excrement hits the rotary device, you need an uncluttered environment, leads, wires, old drips/ med bottles all over the place are dangerous. Also if your lines are a mess then you may just accidently give that morphine bolus into the "pressor" line............ Don't want to even think about that!!

2)Sometimes the only way a relative knows how their relativel is being looked after well is the way theyapear (most civilians don't understand what good / poor nursing is.

Hence the anal retention.

Oh and another one surfaces that are not cleaned regularly are a sitter for colonisation, usually by a multi resistant organsism, hence the almost obsesive room cleaning.

[Gompers]

Originally Posted by nursern20

Hmm, well i mostly mean like the nurses have to have it their way or the highway, they are extreeeemly cocky about the fact they work in an icu, they think they know more than you do. As far as ocd is concerned, i'll give u an example. If the previous shift leaves some supplies, equipment, or whatever, on the counter in the pts room, or forgets to discard finished iv bags that are hanging on the pole, the nurse freaks. They go on a cleaning spree of the entire room. I like for things to be neat and tidy too, but not to the point where its obsessive compulsive. These are just my observances on my unit, maybe its just me. im just frazzled at this point, whatever.

What you're describing is typical ICU nursing behavior. Not the cocky part, or the part where you say they are eating their young in another post - that's more your particular ICU because things vary from unit to unit. Let's face it, sometimes you'll work with nice people, other times not.

But yeah, the cleaning sprees? TOTALLY normal. The reason is that before we can feel comfortable, we need to organize our workspace so we know where everything is in an emergency. If old, used, expired supplies are cluttering up the area, it makes it hard to get organized so we attack that stuff first. Then we make sure we have stock supplies of other things that we might need so that when we're working with the patient later, we don't have to keep running around getting things that should have been nearby in the first place. It's common courtesy to clean up and resupply the area at the end of your shift so the next nurse doesn't have to waste time getting organized. What goes around comes around, you know?

We all cringe when picking up from certain nurses. I'm in the NICU, and there are a few people that we joke about after we pick up from them because you can't even find the BABY sometimes. There will be tons of supplies, blankets, washcloths, etc. in the bed and it's just a mess! Getting things clean, organized, and stocked is essential to providing efficient patient care.

And yes, these patients are very, very sick. We need to be a litle OCD about things like cleanliness and organization. Cleanliness because these patients are often immunocompromised and often have things like ETTs and central lines that are germ magnets. Organization because if a patient goes bad on you, there isn't time to shuffle through all the clutter only to find that you don't have the supplies you need in an emergency.

I do agree that your coworkers and preceptor do sound quite unfriendly, though.

[slou!]

I know you didn't mean to offend anyone, but I just wanted to say that there is definitely a difference from OCD and being clean, or anal. Obsessive Compulsive Disorder is not just being really clean and a germaphobic. Being clean and having things done a certain way is a part of a nurses' job. OCD is not something that you just have "sometimes" or are a little, it is something that takes over your whole life and way of doing things. I suffer from OCD, and have as long as I can remember. Too many people over use the term OCD. It's not just being clean, it's about doing things until they are "just right". It's hard to explain it but you need to redo things until you feel like they are just right, even if you have to do them over and over again. I'm not saying some nurses don't have OCD (I'm sure many actually have it, it's the 4th most common neuropsychiatric illness in the US. I'm also not saying people on this website don't have it, because I'm sure many do!)

Your tone also states that having OCD is a bad thing. It is not at all. When I was first diagnosed with OCD I really resented myself. I can see why, too. People act like it is something people can control and just stop doing, when in reality, you can't. It's a disorder you can not help so please don't act like having OCD is a bad thing. Would you say the same thing about nurses suffering depression? I can't imagine someone saying "All ICU nurses suffer depression and it really bothers me! They are all so mean!" I'm not saying it's okay for nurses to have OCD when it puts their patients at harm and it is interfering with their work, either. I'm just saying I don't like how there is a negative tone associated with this disorder.

Once again I know you probably didn't mean to offend anyone by posting this, and I am really sorry you are going through a tough time in ICU. I am not a nurse yet so I don't have any advice on handling these nurses, but I just wanted to show you OCD from a different perspective.

[jbp0529]

I definately believe in keeping a room clean and tidy for my shift and the on-coming shift, because you need to know where supplies are if you need them quickly, and because one doesnt want to hunt around for hours looking for the mainenance iv line to push emergent meds. I used to think too when i first started that ICU nurses were overly anal, but before long I developed the same ideals. I absolutely hate it when I come on, get report, and find the counter overflowing with 20 angiocaths, unused iv tubing, unused pumps laying on the floor, swan ganz catheter dangling on the ground or in the crevices of the bed... not to mention that on my unit we have a supply pyxis which requires you to click on the pt's name to get stuff out, so all those unused supplies left around are needlessly billed to the patient; it can be very irritating. Once I found 3 unopened central line kits in an empty room and had no idea who the patient was (bc i had been off several days), so there was no way i could "credit" them back...those cost alot of money!

As far as other anal stuff, of course everyone has a couple shifts where it is really busy or the pt's are very sick, so one doesn't have time to cross every "t"/dot every "i" (i mean it is a 24 hr job), but as a whole when someone is in the ICU as a patient and the nurse only has 1 or 2 patients to care for, dont the pt's deserve a little extra care? And doesn't the nurse have a little more time to do the little stuff if they carry a smaller assignment as opposed to a floor nurse?

[asoldierswife05]

The nurses are not like this in my ICU. They are very friendly and love to teach (with the exception of maybe one or two who can't wait to trip up a newbie just for fun).

I agree that if your idea of OCD is being excessively neat and particular...that's just the way it has to be in the ICU. Day shift is even worse because you have alot more going on!

If you are having a really tough time and there is just a personality difference between you and your preceptor, perhaps request a new preceptor. Not the end of the world.

If you are having a difficult time adjusting to the ICU setting in general, perhaps spend some time on a Med Surg Floor.

Someone told me in another thread once that if you expect to race on the nascar strip then don't be surprised if you run over (or something like that...thanks Timothy). Basically, you chose a very intense area to work in coming right out of school and others expect you to be on top of your game. You have to have very thick skin...and you have to want to constantly be learning. You took on a very big responsibility.

[asoldierswife05]

I also wanted to add that sometimes the instructors/preceptors who are the hardest on us are the ones that we want to thank later when we are confident and able to stand on our own two feet.

[EmerNurse]

I remember being told by my med-surg manager once that I was "too intensive" because I expected I&O to be charted from the previous shift, central lines to be flushed, heck even assessments to be complete! I took being "too intense" as a compliment, thank you very much!

Even on med-surg, a solid sense of organization and having things "just so" helps make your shift run better. YOU feel more in control and have more confidence that you're not missing important things for your patient or their care.

You find, after a while, that nurses get very possessive of their patients/bedspaces/areas. While I've learned not to dive into the room behind anyone who goes into it, I can promise you my eye is right there on 'em LOL.

If anything, I've gotten even more intense with my ER patients. There's less time to get things done and care for what may be a very unstable patient coming through the door. Having my specific routines and ways of doing things helps me to give the best care I can while the "basics" have become second nature.

Every nurse has their own way, but I've always been happy following another "too intense" nurse. Color me TOO INTENSE!

[NurseyPoo]

I am sorry you feel this way. I am very perceptive to my patients and their environment at all times. I do not have time for chit-chat. The nurses that I work with are all generally the same. We tend to be sticklers for detail...and I mean all details in relation to our patients. You need to be this way in the ICU. A patient can be fine one minute and WHAM! Having a cluttered room can cause mistakes and injuries. Maybe I belong here...When I wokred MS my rooms were never cluttered and I was exactly the same way as I am now. Being detail oriented and having OCD is not a bad thing in the ICU. Give it time and develop your own way of working and you will see that you too will be this way. Unfortunately you will also run into people who are not very warm and fuzzy at work. It is just the way it is...but then again you will have this no matter where you go. People are just being people...You need to find a way to deal with them. If you are concentrating on your patients then this detail should not really affect you. If you have questions you need to figure out who is approachable and who is not.

[carolCCRN]

I went to ICU straight out of nursing school and have been there ever since. I was so lucky to have a few coworkers who liked to teach and didn't mind answering my questions, because ICU is so intense- no pun intended- and you have to be ready for anything (hence the OCD). Some nurses see new RNs as a liabitity, so instead of helping them grow, they abuse them (ignore, neglect, verbally mistreat) which sounds like what's happening to you. I'm so sorry for your bad experience, but be encouraged that Nursing offers a huge variety of possibilities for your career. You need to figure out how to best use your talents---and it may not be in the unit you're in.