Getting all worked up in ICU

pie123 · Dec 15, 2007

I didn't say that you should return to Tele. I asked if it was too late to go back, basically. The reason for that is if you were comfortable on Tele and you are not comfortable in ICU, and don't see much hope of getting comfortable with that level of stress, perhaps you could go back. We see over and over on these boards nurses stressed to the max. It is often the nature of the beast (profession), but if it seems unbearable there is no need to put ourselves through such emotional agony, if there is an alternative.
Take care of yourself, and best of luck.

Thank you for clarifying. Sorry. I think I was in "a mood" when I posted this. Thank you for your help.

BBFRN, BSN, PhD · Dec 15, 2007

Pie,

No one is comfortable in critical care when they first start out. I was a nurse for 10 yrs when I went to the ICU, and I think there would've been something wrong with me if I hadn't been uncomfortable. Just know when to step back and ask for help. The good thing about critical care is that you have all available technology at your fingertips to help you care for your patients. I would strongly suggest ACLS certification if you don't already have it. It will be extremely helpful to you.

And I can't help but wonder why in the heck they transferred a DNR pt who was 'circling the drain' to the unit? Normally, you shouldn't have gotten that pt.

RNperdiem, RN · Dec 15, 2007

That is a lot of codes.

Were you assigned very sick patients right out of orientation?

I have worked per diem in ICU for the past 6 years and have never had a patient code and die on me, and I work in a busy Level 1 trauma hospital. I may have withdrawn support, I have helped others with their codes, but never coded my own patients. I attribute this to luck, and the kind of patients assigned to float and per diem nurses.

Hopefully this spell of bad luck will be over soon.

I assume that you have well developed assesment skills that would let you spot signs of trouble early on?

pie123 · Dec 16, 2007

Pie,
No one is comfortable in critical care when they first start out. I was a nurse for 10 yrs when I went to the ICU, and I think there would've been something wrong with me if I hadn't been uncomfortable. Just know when to step back and ask for help. The good thing about critical care is that you have all available technology at your fingertips to help you care for your patients. I would strongly suggest ACLS certification if you don't already have it. It will be extremely helpful to you.
And I can't help but wonder why in the heck they transferred a DNR pt who was 'circling the drain' to the unit? Normally, you shouldn't have gotten that pt.

When I got in, my assignment was such that I had one patient, and was first up for an admission. This patient was on Med Surg. At that time, he wasn't DNR. Once he got to ICU, that's when he was made DNR, by the family. I guess when he was on Med Surg, categorization wasn't discussed with the family. Thanks for responding.

pinksugar · Dec 16, 2007

It is really unusual to have that many codes in that short of time, even in the ICU.

I agree. We have codes fairly often in our ICU, but a code is not something I expect everyday, or even every week.

To the OP - keep your chin up. Starting in the ICU is stressful. I am 3 months off of orientation. After I got off orientation I thought I would never feel comfortable, but everyday I do feel a little tiny bit more confident. I still have a lot to learn but it is coming, and it will for you. Hang in there. FTR, I also think that they owe you a heck of a lot more orientation!

alilnurs2b · Dec 16, 2007

You will be fine, the more you work there, the more experienced you will be. Consider it a blessing to know you have given the best care you can for a person and you work your hardest to save these people's lives. If you have to go into the bathroom and cry do this, never get so used to ICU where your feelings become null and void. Take it from me I see it a lot working in the ICU as a nurse tech. Besides even when you feel like your best isn't enough people look up to you like the aides, techs, the families, and even though they may not be able to tell you the patients

rn-jane · Dec 17, 2007

It takes a while to feel comfortable, and I think 3.5 weeks is much too short to be on your own. We give everyone 12 weeks regardless of the amount of experience they have, so i think they short changed you on that. Give it some time, Icu is rough and it may take a year or more til you are in that comfort zone. Take a deep breath everyday and realize this is a learning experience for you and absorb everything you can, even from patients that are not yours.

MediHawk · Dec 17, 2007

I've been a nurse since November 2005 on a Telemetry unit. 3.5 weeks ago I went to ICU. My first week on my own, I had a code. When I came to work 3 days later, I had a respiratory code right at shift change and the patient was intubated. The next night I came in, I got a patient from Med Surg, who was made a DNR about an hour after getting to me. He passed away 3 hours later. Ugh! After these experiences, I have been a nervous wreck! I dread going in, and I am soo stressed. Outwardly, you would never know it, but inside, I'm cringing. On tele, I never had a code, and the patient's weren't very critical. I'm terrified to keep going. Any advice would be appreciated!

The experience that you'll get from those codes will certainly help you advance. This is one of the most exciting aspects behind ICU, even though it can be quite exhausting. Also, I've always enjoyed the amount of work that you can put into one patient; these folks are critically ill and need every bit of help from a great nurse. This is obviously what it makes it so different from the telemetry units that typically spread their nurses out over 7 or more patients. It's quite a change since it involves a different style of nursing care.

I hope all works out for you...