Being a paramedic for the last ten years and cardiac being my most favorite subject, it appeared to be a NO BRAINER to go into a cardiothoracic ICU. Nine weeks into an 11 week orientation, things are not so peachy in "WHOville" I have had 7 preceptors, the last being the best and I've been with her the last 3 weeks. I realize that getting the worst cases day in and day out is educational, but could they just allow me to come up for AIR once. If I have to hear "its a good learning experience" one more time I'm gonna scream. They constantly throw me in on cases which have equipment that I haven't been inserviced on ie(CVVHD, BALLON PUMP, ect...) The other nurses tell me I'm doing a great job, and I get great reviews from my preceptors. They all say don't be so tough on yourself, it takes a good 6 months to get "somewhat comfortable". Thats the toughest part, because when I was a paramedic it never felt wrong. Whether it was my first time intubating or defibing someone I always felt on top of the world. Here it just always feels like I take 1 step forward, then 2 steps backwards never seeming to get on top of the "world" These cases come up like train wrecks from the O.R. and you still have one, sometimes two other patients to tend to while your fresh heart is crashing. I'm just not sure this is what I worked my butt of for in school. Any help, words of incouragement or criticism would be greatly appreciated as orientation is coming to an end shortly
Jun 2, '02
I just wrote you a long letter of encouragement, only to have pushed the "reset form" button by mistake so here goes.
I have worked in Psych, OR and oral surgeries for most of my 15 years as a nurse. The last two years have been spent in the ICU. I did take a 12 week ICU course and had a preceptor for 6 weeks. Even so, there were times I left in tears because of frustration. The key thing you have to remember is that this is nothing you will pick up in a few months- it takes years. Emergency work that you've been familiar with and ICU nursing is a bit like apples and oranges; both fruit but very different. You're actually lucky that you know how to respond to crises such a v-fib, v-tach etc. My two years have taught me some of the basics, but until you're actually involved hands on with the paddles and pushing the drugs, you really don't know what it's like. YOu've been there. The rest will come in time, believe me. There is a steep learning curve, but I doubt yours will be the big brick wall that I feel I hit going 100 mph! Hang in there, enjoy what you're learning, and learn to communicate with your co-workers. It's good to let others know your weaknesses and what you feel you need. They'll be there for you.
All the best!
Jun 21, '02
I was a new grad going into a fairly busy ICU almost 2 years ago. I got 8 wks of orientation and like you, had probably 10 different preceptors.
Like you, I have always gotten good reviews from everyone. Until recently, I was getting all of the insane cases "for the experience". It's hard to gain good experience when you are overwhelmed and your resource people are mostly traveling nurses who are great at nursing, but don't know the hospital well. Needless to say, it has been an upward battle!!! There have been days when I go home and have no clue if I did everything that I should have. Because I was getting the good reviews, my manager kept piling on the work. I finally said no to a couple of big steps and have taken a break from new things for a couple of months (although I think I learn something new everyday!!!). Now that I have had a break, I feel like I can tackle some more things. It takes time and amazingly, you do come out of the fog and realize that you are doing ok. The only word of advice... if you feel that you are putting your patient in jeopardy, step up and say something!!!! Good luck!!
Aug 25, '02
Let me say that I work in different ICU's and I think CTICU is one of the most difficult. The patients are the sickest of the sick, the technology to keep them alive is amazing but I certainly wouldn't want to be on ECMO (just my personal feelings) These poor patients are so ill with so many things going on they should be l:l not l:3 ratio. I think this outrageous ratio contributes to the fast burnout. Be honest with yourself, if you don't like CTICU try another ICU, after a year or so when you have more experience then try CTICU again. You will be suprised how much experience you will gain in just a year. By the way I think the reason that you have so many preceptors is that no one person is excellent in every situation, some nurses just know more about cardiac, others neuro, etc... hang in there.
May 5, '03
Gordo, cheer up, every nurse goes thru this some time when they are acclaimating to the job. Give yourself a year! Jeez, you can't know it all. I have been at this stuff for 14 years & I am still blow away on occasion & do ask advise from someone almost daily, just because I like for my TEAM to know what is going on & learn from what is happening with my pts, ( I have 5 new grads on my shift I am responsible for training & evaluating). Hang in there, Tiger, it's a jungle out there!:chuckle
May 5, '03
Have you talked to any of your preceptors about being overwhelmed? Tell them what you've said to us here. You make a lot of sense, it's difficult to learn something new when you feel so stressed. Just talk to them. I am sure you're doing fine, 16 years ago I was a new grad in a medical CCU, I'd hide when they called codes cause I was so scared. I got through it thanks to a wonderful nurse. I'm sure that you work with someone like that, just talk to them. Keep up the good work, Wendy
Feb 27, '04
tHIS IS OBVIOUSLY VERY LATE YOUR PROBABLY A WELL SEASONED CVICU NURSE NOW. BUT IF YOU REALLY WANT IT...YOU WILL GET IT.....THATS MY PHILOSOPHY IN LIFE. CVICU IS AND EXTREMELY DYNAMIC NURSING SPECIALTY AND REQUIRE EXCELLENT CRITICAL THINKING AS WELL AS SEASONED ICU NURSING SKILLS AND INTUITION. HANG IN THERE