How to grow backbone in ICU?

Specialties MICU

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BelgianRN

190 Posts

Specializes in GICU, PICU, CSICU, SICU.

Without any kind of disrespect towards the OP but it is a one-sided story. I would like to start by saying that under no circumstance anyone should send you away from a patient without providing a reason. But not the entire context of the situation is known.

I'm intensely involved in the training of newer nurses in our ICU and the thing I find most difficult is managing them in an acute situation (code, crash etc.) where they are in charge. (And managing them the first day when you have to explain to them how a three way tap (not sure if this is the correct medicoenglish term) works.)

I don't agree with the way you were sent out. But I can think of situations where it is more beneficial to the patient to ask a nurse to take his or her hands off. A good relationship is key here. The times I told one of my "charges" (for lack of a better word) I wanted them to stop working bedside or stop doing that particular thing they would respect my choice and follow my direction. They know I tend to have good reasons behind my choices and actions. But I would make it a priority to talk to them as soon as possible and explain my reasons.

Again without any disrespect intended towards the OP, but are you absolutely sure you were doing the right things at the right time? I've met nurses that want to help but they end up being in the way. In an effort to make things go smoother they actually form obstacles at the bedside. And some of those nurses have way more experience than I do.

What I try to teach the nurses I'm responsible for is to talk about what you want to do. It provides insight. When one of the newer nurses that work with me want to do an admission and "run" the bedside show they usually tell me which areas they are unsure about or if they want to run it all by themselves. And I can tell you when they run the show I have to reign myself in and not comment on things because you spot a million things you would have done differently (not saying better here). But it is their call and unless they are make grave mistakes I'll let them call the shots and stick to the "boring" administration or follow their lead bedside.

So the only advice I would like to give when working with a more experienced colleague that you know isn't known for letting loose control, talk about it before it becomes a problem. Usually you have at least a few minutes before the patient arrives or have some time at the beginning of your shift if you have to run RRT's outside the ICu. I can see no harm in just explaining you want to be the one that manages the patients. Tell them you might do things a bit different than they would, but that you would like them to provide feedback to you afterwards about how you did things. This way you don't take all control away from her because she is still the one "supervising". And in the meantime you get to do your thing with your patient. It also increase the treshold for her to comment because she is made aware that things might go a bit different this time.

Without knowing your situation of course she could just as well be a bully that picks on you. In which case it is good you are starting over.

Anyway my five cents.

Greetz Marco

P.S. Apologies for any English mistakes as it isn't my first language.

Sanchez RRT

2 Posts

Sounds like you started off in the ICU as a "newbie" and some of the nurses are still treating you that way. I wouldn't tell someone to go outside and chart. Unfortunately there are some aggressive nurses, who think they know it all. That's not necessarily true. You don't have to be an ******* to be a good ICU nurse. I'd never tell the primary nurse to go outside and chart. That's rude. Hang in there. Maybe a different unit will do you good and no one will still think of you as the newbie. And remember, even if you're lacking in confidence, YOU know more about that patient than anyone else,more than the doctor and more than the know it all nurses who pushed you out of the room. Don't forget that.
OOPS!!

AllAngelsRN

75 Posts

Specializes in ICU.

So finally I am here in my new position & settled doing fresh open hearts. I feel great and more confident in my skills and patient care than ever.

Thanks to everyone who replied. I know that there is nothing that can erase the experience but writing what I have experienced and having you write me back words of wisdom was very therapeutic.

After going to the new hospital and seeing how different nursing is, I know that I was working with bitter people who haven't really learned how to help others to grow. I remember the director of that unit was very close to me and she used to tell me that it is the "worst unit" that she has ever worked for. She knew her staff were just a bunch of angry beavers. I know that she didn't like that but had little control over changing that culture.

It's good to see different and it was a good experience to learn from. I have no regrets :)

ukstudent

805 Posts

Specializes in SICU.

I am so glad that you took the time to update your post. So often i wonder what happens to the pople posting.

I remeber that I was worried that you would end up in yet another toxic enviroment and I am so glad that worry did not materialize. Everyone should have what you have now found, a caring and supportive enviroment. As you get more expereince and start precepting, remeber those toxic nurses and strive never to become like that.

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