ICU - Should I stay or go? - page 3

Hi all, This is my first post but I have read posts for over 2 years. I am having some issues in my new job and need your advice. I graduated in Dec 2004 and began working on a Med/Surg Trauma... Read More

  1. by   Town & Country
    This is what I meant..................
    Don't go quietly. Establish yourself as a critical thinking, caring, safe RN who's willing to argue their case without emotion. I mean, whenever something ridiculous presents itself and you are certain about your facts - represent yourself, demonstrate that your not a push over. Challenge their *judgements* of you. Who are they to judge your passion. Good grief. Bunch of little primadonas... and they're a dime a dozen so might as well practice the art of deflating their hilarious notions with evidenced based practice and theory in a unit you may leave cause you'll be faced with this again and again. Become your own advocate without seeming arrogant. Keep to objective non-emotional responses. Don't allow them to bait and hook you. It's all fun and games for the tenured staff. So NEVER let them see you sweat
    Just said it a different way but this is what I meant......
  2. by   suzanne4
    Removing suction from a chest tube is actually done all of the time, for example, if the patient needs to go to CT scan or for an MRI, or even some x-ray that cannot be done at the bedside. The chest tube is still to water-seal, it is not left open the the air. So, in those terms, there is nothing that is life threatening about that. Chest tubes are always put to water seal before they are actually removed to begin with. We still do not have all of the facts to make a judgement call on this. And they do get disconnected when a bed is moved, or for any other thing. It happens.

    The issue is why it was not being checked every hour. Documentation in the chart in an ICU, states that you are checking it each hour. That is standard procedure in any facility.
  3. by   flashpoint
    A lot of what goes on in a hospital (nursing home, assisted living, etc) is pretty hard to believe. I can honestly see someone turning off the suction to a chest tube to see if someone notices, but I find it shocking that someone would do so. How dare anyone jeopardize a patient's recovery (and life!) simply to see if someone else is on the ball!

    When I was a new nurse, I worked in an LTC that did things to "test" the CNAs to see if they were actually doing their job...the nurses were directed to leave notes under residents with a date and time to see if the CNAs were toileting residents...if the note wasn't brought to the nurse within two hours of it being placed, the nurse was to assume that the resident had not been toileted. Nurses would also mark their initials on soaker pads in beds and go in a couple of hours later to see if they had been changed. I found a lot of this to be a bit excessive...personally, I tried to pay close enough attention to the residents to know what was going on with them without the "tests." But...these "tests" NEVER put a resident in jeopardy.

    Personally, I would get myself out of the environment...sometimes no matter how much you want it and no matter how good you are, you just don't fit in with the personalities on the floor. Learn from it, lick your wounds and go on...you know what kind of a nurse you are and what you care capable of.
  4. by   Bipley
    Quote from RN34TX
    I'm not getting what going to a Med/Surg floor has to do with anything here.
    It is all about politics and social issues on that floor, nothing to do with skills or patient care issues.
    Not socializing properly enough as a reason for being punitive or keeping someone on orientation longer is a sign of a toxic, clique-ish ICU that is more concerned with potlucks and hen-clucking than actual nursing ability and performance.
    Hear hear!
  5. by   rnmom3153
    Quote from Bipley
    Hear hear!
    :yeahthat: :yeahthat:

    Wow, what a bizarre place!
  6. by   nicholrwalker
    Quote from RN34TX
    I'm not getting what going to a Med/Surg floor has to do with anything here.
    It is all about politics and social issues on that floor, nothing to do with skills or patient care issues.
    Not socializing properly enough as a reason for being punitive or keeping someone on orientation longer is a sign of a toxic, clique-ish ICU that is more concerned with potlucks and hen-clucking than actual nursing ability and performance.


    Once upon a time.....nurses (at least where I worked) needed a strong med-surg background before going into ICU. I think the thought was to promote strong well rounded nursing knowledge as well as skills. My personal thought is new nurses would be better served obtaining a med surg background first. I am an acute dialysis nurse and I cant tell you how many times I have worked in ICU dialysing a pt. being cared for by a nurse who has only worked ICU and wasnt familiar with "med surg stuff". I dont hold it against the nurse..but AI rather be more knowledgable about other things beside just critical care...just to be more well rounded. I also run into this with dialysis nurses(all they have ever done was dialysis) not being familiar with "med surg stuff" either. I think it limits you as a nurse...but that is just my two cents, please dont think I am trying to offend or put anyone down. Good Luck
  7. by   RN34TX
    Quote from nicholrwalker
    Once upon a time.....nurses (at least where I worked) needed a strong med-surg background before going into ICU. I think the thought was to promote strong well rounded nursing knowledge as well as skills. My personal thought is new nurses would be better served obtaining a med surg background first. I am an acute dialysis nurse and I cant tell you how many times I have worked in ICU dialysing a pt. being cared for by a nurse who has only worked ICU and wasnt familiar with "med surg stuff". I dont hold it against the nurse..but AI rather be more knowledgable about other things beside just critical care...just to be more well rounded. I also run into this with dialysis nurses(all they have ever done was dialysis) not being familiar with "med surg stuff" either. I think it limits you as a nurse...but that is just my two cents, please dont think I am trying to offend or put anyone down. Good Luck
    I respect your opinion, and it still remains a popular one, however, I think that the old rule about working Med/Surg first as a new grad is outdated.

    A new grad should have the very basic concepts of med/surg down upon graduation and, should they choose to work in Med/Surg, expand and grow on the med/surg knowledge base from there.
    IMHO, prior med/surg experience is extremely helpful when entering ICU, however, not necessary.
  8. by   nicholrwalker
    Quote from RN34TX
    I respect your opinion, and it still remains a popular one, however, I think that the old rule about working Med/Surg first as a new grad is outdated.

    A new grad should have the very basic concepts of med/surg down upon graduation and, should they choose to work in Med/Surg, expand and grow on the med/surg knowledge base from there.
    IMHO, prior med/surg experience is extremely helpful when entering ICU, however, not necessary.
    I have been unfortunate enough to run into a few new grads(not all) who do not have a solid med surg background..it is one thing to learn med surg concepts in school..but to actually see and practice those skills and concepts...PRICELESS. But again that is just my opinion...... And you are right know it is not necessary to have a med surg background but I think for the nurses sake it is better. I like to know what I know or dont know..and I think prior experience can give you this confidence.
    Last edit by nicholrwalker on Dec 18, '05
  9. by   DidiRN
    Not sure I'd use the word outdated...if the nursing shortage was to end tomorrow, I personally believe it would be required again. I've only seen the recent trend of hiring new grads in ICU and other speciality units because they couldn't find anyone else. I doubt hospitals would be willing to spend the $$ training new grads extensively, when they could get someone with experience up and running much cheaper. And we all know how much hospitals are wanting to save a buck
    And back the the OP...you've already got some great advice here. Unfortunately in nursing and I'm sure in other fields too, there are toxic work environments such as these. Been there and done that myself. I think it would be good to notify anyone higher up, but I certainly wouldn't stay at a facility like that if you can help it.
    I was just talking with someone last night who had THIRTEEN preceptors in a large CCU. Ridiculous. She is no longer working there either.



    Quote from RN34TX
    I respect your opinion, and it still remains a popular one, however, I think that the old rule about working Med/Surg first as a new grad is outdated.

    A new grad should have the very basic concepts of med/surg down upon graduation and, should they choose to work in Med/Surg, expand and grow on the med/surg knowledge base from there.
    IMHO, prior med/surg experience is extremely helpful when entering ICU, however, not necessary.
  10. by   caroladybelle
    Sometimes it pays to go somewhere that nurtures you more, and allows you to develop more self confidence for a while. That way, manipulative wretches like this preceptor will not feel that they can behave that way and get away with such as this. They feed off of good and well meaning coworkers, frequently. And they are found in every career field, we just like to think that nursing is above that..and are saddened to find that perception wrong.

    Working in role that may be less stressful will allow you to become stronger than them, when/if you return to the ICU. It is much harder to breakdown someone with good solid experience, and that knows it.

    While you may choose to just go to another floor for time, eventually it would be good to go to another facility. Sometimes it is good to prove yourself a bit and then go on to be fabulous at another facility.

    I was eaten as a student nurse - chewed up and spit out by a couple of nurses on the floor that I wanted to work on. I ended up on an ID ward, full of BKAs from diabetic sores, decubes and liver failures, just the dregs of the hospital. I worked my butt off, for 18 monthes and then transferred to another facility. When I returned a few years later, the nurses that were evil to me were considered the bad nurses and I was the sought after one (and they also didn't even remember what they did to me).

    About 4 years ago, I was being treated badly by my nurse manager. No matter how much my coworkers respected me, how my patients, MDs raved about me, she called me in for the most trivial things. I finally quit because I could not even get up for work without feeling sick and nauseated at the thought of going in. I was going to quit nursing but took a traveler position to give me time to figure out my next move.

    Virtually every manager that I have worked for since has wanted to hire me, made me really good offers and invited back. I have references from 3 hospitals listed in the nation's top 15. I have worked with published MDs that are tops in the field. And when I got ill in Manhattan, one of the attendings at Cornell immediately saw me as a patient.

    The problem sometimes is the Workplace.

    Give yourself the time and a chance to gain the confidence that you need so that in another year or two, or three, you can set the world on fire.

    And remember that G-d has a plan for us. It might not be what we would like it to be. Sometimes bad things happen to guide our footsteps onto the right path and in the direction that we need to go.

    My thoughts and prayers are with you.

    Carolina
    Last edit by caroladybelle on Dec 19, '05
  11. by   RN34TX
    Quote from DidiRN
    Not sure I'd use the word outdated...if the nursing shortage was to end tomorrow, I personally believe it would be required again. I've only seen the recent trend of hiring new grads in ICU and other speciality units because they couldn't find anyone else. I doubt hospitals would be willing to spend the $$ training new grads extensively, when they could get someone with experience up and running much cheaper. And we all know how much hospitals are wanting to save a buck
    I agree.
    However, if the nursing shortage were to end, it would simply put managers in a better position to be pickier about their candidates in all areas, not just ICU.
    We'd be going back to new grads basically getting the jobs where people experience burn out faster and are the least desirable nursing jobs.
    The new grads would once again be looking at jobs like LTC and even some med/surg positions would be at a premium.
  12. by   Gennaver
    Caroladybelle,
    This is a wonderfully inspiring post. I for one and so glad to read it, congratulations and thank you for your advice to the OP, (which I will take also. )
    Gen

    Quote from caroladybelle
    Sometimes it pays to go somewhere that nurtures you more, and allows you to develop more self confidence for a while. That way, manipulative wretches like this preceptor will not feel that they can behave that way and get away with such as this. They feed off of good and well meaning coworkers, frequently. And they are found in every career field, we just like to think that nursing is above that..and are saddened to find that perception wrong.

    Working in role that may be less stressful will allow you to become stronger than them, when/if you return to the ICU. It is much hardly to breakdown someone with good solid experience, and that knows it.

    While you may choose to just go to another floor for time, eventually it would be good to go to another facility. Soemtimes it is good to prove yourself a bit and then go on to be fabulous at another facility.

    I was eaten as a student nurse - chewed up and spit out by a couple of nurses on the floor that I wanted to work on. I ended up on an ID ward, full BKAs from diabetic sores, decubes and liver failures, just the dregs of the hospital. I worked my butt off, for 18 monthes and then transferred to another facility. When I returned a few years later, the nurses that were evil to me were considered bad nurses and I was the sought after one (and they also didn't even remember what they did to me).

    About 4 years ago, I was being treated badly by my nurse manager. No matter how much my coworkers respected me, how my patients, MDs ravedabout me, she called me in for the most trivial things. I finally quit because I could not even get up for work without feeling sick and nauseated at the thought of going in. I was going to quit nursing but took a traveler position to give me time to figure out my next move.

    Virtually every manager that I have worked for since has wanted to hire me, made me really good offers and invited back. I have references from 3 hospitals listed in the nation's top 15. I have worked with published MDs that are tops in the field. And when I got ill in Manhattan, one of the attendings at Cornell immediately saw me as a patient.

    The problem sometimes is the Workplace.

    Give yourself the time and a chance to gain the confidence that you need so that in another year or two, or three, you can set the world on fire.

    And remember that G-d has a plan for us. It might not be what we would like it to be. Sometimes bad things happen to guide our footsteps onto the right path and in the direction that we need to go.

    My thoughts and prayers are with you.

    Carolina
  13. by   fancythatRN
    ]As a new grad who started in an ICU float pool internship and was treated as a "less than", I can empathize with your story. I witnessed many things there that went against everything that we were taught in school - number one being COMPASSION for the patient and families of the patients. I was ridiculed continuously for being too nice, and basically caring too much. It was okay for a nurse of more than 20 years to have her patient paralyzed with no sedative, and don't dare ask her why! Because I didn't fit in the "click", I no longer work in the float pool. Although I didn't realize it at the time, it was the best thing that has happened to me since graduation! I now work in medical stepdown/PCU with a WONDERFUL group of nurses who work together as a team, treat everyone with respect, and don't look down their noses at me in the event I have a question or four to ask during my shift. I am a new nurse. Since my experience of being treated like the "deer in the headlights nurse", I have set myself a new goal: I am looking forward to the day that I can become a preceptor. I can't wait to help guide new nurses without hesitation and without judgement. I realize it will take some time for me to get to this point, but it will come, I have not doubt. As far as staying or going - if it's truly something you enjoy doing and can tolerate the treatment there, I would highly recommend that you stay. Don't be bullied around! However, if you're not happy there, I would look at your options. Only from experience do I know that there really are better places to work - atmospheres to work in. I hope your husband can get back into school soon - what a team you would make! Good luck!! :Holly1:

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