Sad. Not Doing Good on Orientation

Nurses General Nursing

Published

Specializes in LTC, med/surg, hospice.

Just wanted to vent/post.

I recently started in a new area which is critical care at a large hospital. My background is general medical (the floor) and LTC. I feel that I've been working really hard but apparently my preceptors do not see it. I do recognize I have weak areas but I am constantly working to improve. The learning curve is huge in ICU and I realize that I actually forgot a lot of things I used to know very well because I just didn't need to know it for the floor.

So I'm on a 2 week get better or have a "talk" which is likely being fired due to not being a fit for ICU.

Up Vote Up Vote ×
Specializes in Certified Med/Surg tele, and other stuff.

Ouch! Did they not put you on a preceptorship?

Up Vote Up Vote ×
Specializes in CCRN, House Sup, CCT, Unit Director, ICU.

Did you want to work in ICU? ICU is not for everyone.

Which particular areas do you find you're struggling with?

Up Vote Up Vote ×
Specializes in ED, ICU, PSYCH, PP, CEN.

Not sure how much I can help except to say I'm sorry. ICU is very involved and those units can be very "new person" unfriendly. Do you feel you have gotten a good orientation? Can you go back to the med/surg unit or transfer to a different unit in the facility you are in.

It is not unusual for new nurses to have a hard time in the ER and/or ICU. 18 months as a nurse would not be enough time for me to have built up the experience to do ICU.

I started as a new grad in an ER, and couldn't handle it. Some of it was unkind nurses who didn't want new grads in the ER, and some of it was me.

I was "released" and found work in a med/surg unit very quickly. My confidence was shot and I couldn't believe the "floor" liked me, but they did and I learned a lot. After 1.5 years on the med/surg I decided to try ER again and have now been there for 6 years.

When I applied for the med/surg job I just told them I couldn't make it in the ER and they were perfectly okay with that because most new grads can't.

Patricia Benner has a book called "From Novice to Expert" and talks about how long it takes to become an expert in each nursing area. 5 years. So the fact that you r not doing well in the ICU after a few weeks is no indictment of your intelligence. You may just need to do some more general nursing till you have a better grip on everything.

Good luck and God Bless

Up Vote Up Vote ×
Specializes in LTC, med/surg, hospice.

I am still working with my preceptor.

Yes I do want to work in the ICU but it may not be my niche.

According to my eval...time management and multi tasking are my issues. They also said I need to be more aggressive when communicating with the MDs. I never had this problem before but I came from a much smaller hospital. This is a teaching hospital and very busy.

ICU may not be a fit for me but I would like it to be that I made the choice instead of it being made for me. I definitely excelled as a floor nurse.

Up Vote Up Vote ×
Specializes in LTC, med/surg, hospice.

Thanks for the comments.

@gonzo. I worked on the floor for almost 3 years. The 18months was my LPN time at the nursing homes.

Up Vote Up Vote ×
Specializes in Medical Surgical & Nursing Manaagement.

Sorry you're not having a good experience. Please let me ask a few questions.

First, how much experience do you have? Did you want ICU? How long are you there?

With that being said, and I know this will not go over with many people...............be careful what you wish for. There is absolutely nothing wrong with working on a Med/Surg unit. You will gain a ton of varied experience.

Up Vote Up Vote ×
Specializes in Critical Care.

I would question the quality of the orientation you are getting. Time management on the floor and in the ICU are very different. Is your preceptor helping you with that issue? Do you find your organizational tool needs to be different (the sheet you work off of)? What insight can your preceptor give you as to how you can improve?

ICU is a very scary, high-paced environment. It may not be your niche..but please DON'T think it means that you've failed. Maybe progressive care would be a better fit, you get a bit of the ICU but at a different pace with a different ratio. I've told many that I've precepted over the years...that is one thing that makes nursing so great.So many areas to explore and try....if you've been precepted adequately then maybe it is time to consider something else. I'd encourage you to be proactive in initiating the discussion with your management/education team to figure out what's best for you. Don't wait for them to come to you to "have the talk", go to them. Work together to come up with a plan to set you up for success. Good luck to you.

Up Vote Up Vote ×

What EMR are you using?

Up Vote Up Vote ×
Specializes in CCRN, House Sup, CCT, Unit Director, ICU.

How long is your orientation? How long have you been on orientation?

Up Vote Up Vote ×
Specializes in PACU, OR.

Off topic, but something I find very strange; the US has pretty strict criteria regards acceptance of nurses into PACU. They need ICU or some form of critical care experience before they are accepted, yet new nurses are taken into ICU without any formal post-basic ICU training. Isn't that like throwing a toddler into a swimming pool and telling him, "there you go, sweetie, sink or swim" ?

Up Vote Up Vote ×
Specializes in CCRN, House Sup, CCT, Unit Director, ICU.

I was a new grad in the ICU. Our unit hired many. And some sank, others swam. I swam.

Up Vote Up Vote ×
+ Add a Comment