Hello to all. I am a new grad in the ICU. I have been on my own for two weeks after SIX weeks of orientation. Needless to say, I am not only swamped by the miracles I am expected to perform with two heavy patients, I am disheartened. I can't believe how overworked and miserable the conditions are in my non- unionized hospital. On a good day management is "kooky"...on a bad day, certifiably insane.
I have been reading these posts for two years now...I have always found strength in reading about similar circunstances I have gone through. It has helped enormously to relate my experiences to others.
I really need some help now. From the firts day I hit the floor and met the first of my five preceptors (it was scheduled that way), I became suspicious of the quality of care. In and out..are they septic...what's the Mag..didn't you check the MAG!!!assess the patient, determine what's needed...find the young md right out of school who like me, has no clue how to run the archaic DOS system in order to print me out an order (as a new grad, I wait until the order is in my hands- I have to cover my bootie)
In the beginning, I chalked up all my frustrations on being new and overwhelmed.
But now the fog is clearing (somewhat) and I am looking up and seeing the nurses around me miserable. Fabulous, wonderfully smart witty nurses with plenty of years under their belt being overworked and stressed. BECAUSE...get this...there is NOT enough time in a shift. Surprise? No? I didn't think so...But why is it we need to suffer the effects of a nursing shortage when we are the nurses the hospitals so desperately need. The distribution of roles and responsibilities are all on the nurse.
Florence Nightingale would be appalled if she stepped onto the floor I work on. It's nuts. I need to leave for the safety of patientsa and the sake of my license. The resources I need as a new grad are NOT reliable when I am on the floor (NO time to look up a protocol..too busy looking for a thermometer, finding a glucometer, or reordering the missing med...nurses say"not now...I am too busy) I am not proud of the work I do. When I feel there is a serious problem eg bp goin down to the 70's I say in my man voice " I need some help here" firm and direct and no bs. Nurses do come help, overworked nurses who I know I am pulling them away from their precious moments of doing their workload. I get the vibe. "Sink or swim" is a direct quatoe from management. I got better orientation in a video store. And its the ICU. My goodness...if the world only knew the reality...not simply "nursing shortage" but nursing abuse. I don't want to take this crap. It stuff like this that turns nursing from a proffesion to a joke. Any suggestions on how I can help my unit from continuing on in this disorganized chaotic manner?
Oct 13, '06
MZK, Do you have a unit council or a shared accountability team? Maybe if you can bring up specific instances where there are unsafe practices (which i am sure they are fully aware of anyway) you can help start some new protocols. Brainstorm and discuss options for change. These need to be brought up to your nurse manager in a way that he/she understands the safety issue and what the cost would be if some changes are not made.
If you get too much resistance or no support then I would say, yes it is time to find a place where you feel safe practicing. You may be needed where you are, but if you are in a spot where you could lose your license it is not worth it.
The 1st things I did after i started ICU were to be a part of the solution. I joined unit council and quality so I could see more of what was being missed and what we could do to fix things. I talk with my peers before these meetings for input on changes and I have to say we have made some differences. We do still have a long wasy to go, but i can say there is some difference from my first day til now.
Good luck and let me know how it works out.
Oct 13, '06
MKZ-I agree a unit council is a great place to start. Your frustration is exactly why new grads don't belong in a busy ICU, not that you aren't a potentially great nurse, it's just you need more hands on experience. While you are finding a doc, waiting for printed orders and scurrying for supplies and assistance-the PATIENT is getting in trouble. I am sure your co-workers love you and want to help you become a great nurse and leader, but you said it all--too busy!!
Maybe a less busy ICU or a step down unit would have been a better starting point for you. Please don't get me wrong, I am not knocking your abilities or denying that your unit seems to need some organization.
Please do join some sort of council or group to help change things on that unit. But if you truly feel unsafe leave there, find a lower acuity unit or floor and get some more time under your belt, then please go back to a busy ICU-we need dedicated and caring nurses like you to keep us all sane and to assure the best outcomes for our sickest patients.
Oct 13, '06
I have to say that orientation is key to peak performance on any unit. The fact that you have had only six weeks is apalling to me. You should have at least 16 weeks, regardless of your experience level.
Management is another issue..."sink or swim"?? Obviously your managers are oblivious to the fact that you're dealing with human lives there...pathetic.
I do agree with christy above...if you try something and it doesn't work - find somewhere else to work. Your sanity and your license are worth far more than they're paying you, I guarantee it.
Oct 13, '06
Thanks for the suipport. I really had the wool pulled over my eyes when I had gone in for my interview. I was told orientation would last for three months, that I would work the night shift and quality of patient care was their utmost priority. (I have been put on the day shift)
I was told many things that did not come to fruition. However, the idea of a unit council is something I will look into tomorrow when I return to work.
I always knew in nursing school
there would be a major transition between the school world, the n-clex world and the real world. I was ready to soak up the changes. And unfortunately, I ended up on a floor that hired fourteen new grads and not one of us received a proper orientation to the facility. I asked the unit mananger during a meeting when we were going to be shown the fire escape plan or what to do in case of a natural disaster. It was during the anniversary of Katrina. She told me there is a walk through every six months and we had just missed the last one. Great.
Oct 14, '06
Good luck and let us know how it is working out.
Nov 16, '06
I hate to say this, but I think you should resign immediately. Your manager has absolutely no business turning you loose after 6 weeks of orientation.
I myself have been on orientation in the ICU for over 6 weeks, and I'm a med-surg and ER nurse with 2 years of experience.
Unless there is something you're not telling us, unless you're getting more training, you can easily get in over your head in the ICU. As a new grad, the dangers are multiplied. It only takes one mistake to maim or kill a patient. I don't doubt your intelligence, but you do not have the experience to be on your own in the ICU.
Get one year of experience in med-surg, then go back to the ICU. Or at least find an ICU with a good training program for new grads.
I would resign immediately, without two weeks notice. Sounds harsh and unprofessional, but it is not. You owe it to yourself and your patients to practice safely. Someone could be badly hurt or even killed.
You can easily get another job. You cannot get another license.
Nov 23, '06
MKZ -- On the facts you presented, I'd start looking for a new position STAT.
Very doubtful the situation described will improve in the near term. You're taking on way too much at this stage / status of your career.
Nov 23, '06
Six weeks orientation is not nearly enough for a new grad. You are putting your patients at risk and may not even know it. I would have a sit down with your nurse manager and tell her this is not doable or safe for either the patients or you. If you can not at least have a preceptor (you take care of one patient and she takes care of one patient, then you need to look elsewhere.
Nov 23, '06
Wow! I can't believe you only got 6wks of orientation. I will be graduating in Dec. and starting orientation in the middle of Jan. The hospital that I will be going to work for has 14wks of orientation. The orientation program consists of the ECCO program from the AACN which we will meet once a week. We will get ACLS training, 3 days a week on the floor with a preceptor. The first 10 wks will be on days and the last 4 wks will be on nights. After that we will be required to work nights shifts for at least 9 months, but up to a year. I have a friend in the ICU and he said that all the nurses on both shifts are really helpful. Also the critical care clinical instructor for the hospital will be working with us on skills in the hospitals skills lab aside from what we learn on the floor. I would really confront the management and if they can't meet what they promised you I would resign and find another hospital to work for. Remember its your license and you patients safety at risk. Good Luck!
Last edit by ibnathan on Nov 23, '06
Nov 23, '06
I have to agree with everyone here. For ICU, the hospitals in my area give 13 weeks orientation, minimum.
Nov 23, '06
"I really had the wool pulled over my eyes when I had gone in for my interview. I was told orientation would last for three months, that I would work the night shift and quality of patient care was their utmost priority. (I have been put on the day shift)
I was told many things that did not come to fruition. "
I'm still in school for my RN, but I've got decades of business experience, and if I've learned one thing, it's to get promises in writing. Or at least send a letter stating your understanding of what was said to the person who did the wool-pulling. :spin: At least then you have something concrete to point to when the promises don't come true.
If they don't hire you because you insist on assurance of adequate training, then you don't want to work for them anyway.
Nov 27, '06
Hello, its MKZ again. It has chilled me to read the insight you all have provided. There is too much truth to ignore. And it bothers me I made the mistake of thinking this is okay...this is what I want to do.
I always wanted to be a good worker. I wrote a resignation letter and carried it around for a few shifts. That was about three weeks ago. I got sick (surprise!) and called in sick, I had a full week off. I show back up and somehow the floor is lighter, the patients I got were usually well enough be transferred out to another floor or they were not on the brink of death (the senior nurses got those.) The new orientees would usually report off:and me not being the only one super freaked out and insecure, would usually give good report organized structured information...admiiting diagnosis, past med hx, neuro, CV, resp, gi and gu. Then labs relacements, trends. The stress made us acutely aware of our situation and we all just wanted to do good for the patient.
I took a good look around, the place was cluttered, stained in some areas. I found a blood smear on a monitor, on the floor, on the nurses tables. BLah blah blah, as I write this the realization of how much this sucks comes reigning down upon me And I am sick of complaining. I love nursing. And have. I believe in every person being a healer, I chose this career because it feels good to help this way. And its a good job. I just spent the last four years getting ready to do this.
Once again, it scared me to read some of the replies. Why did it scare me? Because it's the cold hard truth. Thank You.
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