new orientee in the icu

  1. Having just completed my 5th day in the icu i must admit that i am mentally and physically exhausted from taking care of one pt. I have been a RN for 2 years and have had med\surg experience all during that time. I have never felt more incompetent until now. My pt today was a total train wreck. halfway through report the surgeons decide to entubate. then we sink a ewald tube. this guy fills up approx 6 suction canisters one after another. a central line goes into the femoral then a art line into the wrist. meds flying the whole time. my preceptor teaches me to write everything down by not telling me to keep track of everything while it is happening. I cant get out of the room because I am completely wrapped up. I should have just stopped and gotten something to write on i was just so overwhelmed i didnt think of it. than 5 hours later im trying to catch up. of course this is after 2 units of bloot 4 units of ffp and 6pk of platelets. crap!!!!!!Any suggestions on how to keep up? my old med surg floor is lookin better all the time. and I am the float nurse. my five days of orientation are done. Help i am scared to go back. and no, the unit is not offering further orientation. I feel that it is all do able but i guess i dont like the feeling of not knowing exactly what to do at all times and when to do it. Thank you all for letting me rant. I do feel better now. WHEW
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  2. 10 Comments

  3. by   Morguein
    Even as an experienced med-surg nurse, you should have more than 5 days of orientation! You should have at least 6 weeks. That's what we do here at my hospital. ICU is a totally different world compared to the med-surg. I would demand more training. You deserve it.
  4. by   marissa81579
    The more posts I read here, the more I wonder about the quality of so many hospitals out there. Frankly, there is no way a med surg nurse can be ready to work on her own in the ICU after 5 days. The learning curve between an ICU and a med surg takes a lot more to learn than 5 days of training. From the sounds of it, you had a fairly typical ICU patient in your hands today and you could not handle it yet. You should demand more training or do not stay - you're license will be on the line.
  5. by   pricklypear
    Geeze. That's crazy - 5 days???? And you really want to work there? I worked in tele for almost 3 years before I went to ICU, and got 6 weeks. And this was at a small hospital with a really supportive staff, and a good mix of barely ICU criteria patients up to highly critical ones so I could stair-step up as I felt comfortable. I'm pretty sure all our new hires, whether new grad or experienced, get a full 6 weeks. And that can be extended if they need it.
  6. by   CardioTrans
    Are you going to be a full time employee in that ICU?? We have a staffing pool, and if a pool nurse is hired, then they only get maybe 2 wks orientation, because of the exp requirements to get into the pool. I have been a nurse for 11 yrs and recently went back to CCU and I had almost 6 wks of orientation.

    I have however, worked in a flexi position and only got 3 days orientation to ICU. Needless to say, I dont do alot of flexi at that hospital. While I was doing those 3 days, I found out that the most experienced nurse on night shift has right at 1 yr, and all the rest of the nurses were brand new grads. I dont have a problem with new grads in ICU, but someone has got to be experienced in case all hades breaks loose.

    5 days is not enough time to orientate in ICU even with 2 yrs med surg. Ask for more time!!
  7. by   RNSUEIA
    I dont plan to work there full time. I work prn for this hospital and requested to cross train. I do plan to tell my supervisor that I dont feel as though I have had enough orientation to try to do any shifts on my own at this time. I worked WAY to hard for my lisence to risk losing it just to pick up an extra shift.
    I did enjoy learning how to set up an art line and watching proceedures. I just feel as though I need more hands on so that I dont get so flustered when things really get going.
    I just really felt over whelmed and incompetent that day and needed some feedback from other nurses who might understand.
    Thank you all
  8. by   Phishininau
    There is no way that a five day orientation is sufficient for anyone that hasnt worked CC before. That is ridiculous! You should tell them to make sure not to schedule you there again, unless you get a proper orientation.
  9. by   AlexCCRN
    5 day orientation - unless your a seasoned ICU nurse - it's crazy and just plain bad. As for keeping up... consider a pocket sized recorder. I use my Palm PDA with digital recording to keep voice notes if I'm not able to chart. It's just the best! Once you get used to a digital device, you can be so facile with it... accuracy goes through the roof.
  10. by   oldiebutgoodie
    Quote from AlexCCRN
    5 day orientation - unless your a seasoned ICU nurse - it's crazy and just plain bad. As for keeping up... consider a pocket sized recorder. I use my Palm PDA with digital recording to keep voice notes if I'm not able to chart. It's just the best! Once you get used to a digital device, you can be so facile with it... accuracy goes through the roof.
    Hey, that's a great idea!! Thanks for that.

    Oldiebutgoodie
  11. by   RNSUEIA
    that's a great idea. My handwriting is awful when I have plenty of time to write. I cant imagine that anyone could read it when i am in a hurry. and no stopping what your doing if your using a recorder. Thank you for that tip!
  12. by   kersti
    Quote from AlexCCRN
    5 day orientation - unless your a seasoned ICU nurse - it's crazy and just plain bad. As for keeping up... consider a pocket sized recorder. I use my Palm PDA with digital recording to keep voice notes if I'm not able to chart. It's just the best! Once you get used to a digital device, you can be so facile with it... accuracy goes through the roof.
    That's a great idea, thanks!

    Even though I am a seasoned ICU nurse- I wouldn't be happy with just 5 days of orientation, especially if I were going to be working there permanently. :stone

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