Should I leave the ICU?

llg, PhD, RN · Jun 11, 2004

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First off: what kind of nurse would you be if you didn't feel bad about having made an error?
This is actually an important point for you in your ICU practice. The point is, and this is what I told my friend: you can't become a veteran without having gotten a few wounds in battle. Nor can you omit certain things - like making your postop patient completely naked, briefly, and looking at absolutely everything going into, out of, or that's connected to her.
Some lessons you learn the hard way. Here's the secret: EVERYONE, without exception, does that. The hardass nurses just did them a long time ago...and if they're mean, they'll just make you feel like crap. There's a lot of that in nursing.
My stepfather was in the Pacific War, and he used to say that there were two kinds of soldiers - the ones who'd been in combat, and the ones who hadn't. But there's no way to get from newbie to veteran without going through tough experiences: you have to actually traverse that distance, and it changes you: it makes you cautious, careful, wary. And much stronger. That's exactly the way you want to be in the unit.
Here's the other thing: get right back on that horse. If you allow yourself to stay thrown, you'll never learn to ride right.

I loved this post -- particularly the line about acquiring some scars. In fact, I'll probably use that line with someone myself, someday.

Thanks,

llg

new2nursing · Jun 15, 2004

Speaking from experience... I've been there and done that. I was a victim of an ICU nurse who ate their young(me). I didn't know what hit me, until one day I was at work and the next minute I was being called in to be told by the superviser that my work has not been up to standards made up by this one nurse. I later found out that this nurse had it in for me from the beginning, but played up to me being nice all the time. But going behind my back and complaining about me,but all the time complimenting me about my work and such. I was in so much shock and denial, I broke down crying and ended up eventually quitting because of this incident. I brought in the union to clear my name and of course I didn't do anything wrong so it was shown that it was this nurse making false accusations, but I didn't feel the same working with her and I couldn't see any other choice but to leave. But being a ICU nurse, you can get a job anywhere.... your in demand.... and don't forget it.

I got a job doing Dialysis, took the training and now I don't work Sundays and no more nites....!!!! :) :balloons:

I have been in dialysis for 6 months now, but I don't have the passion for my job like I had before. So I am looking on. By the way my name was cleared, and I got an appology from the hospital and she is no longer working in ICU nor able to be a preceptor. She was my preceptor from hell :angryfire .

Tina CTICU RN · Jun 17, 2004

Do not feel you are incompetent. I had the same situation occur when I went to work at an ICU near my house. I had previously worked for a very large reputable hospital recovering open hearts. I left the local hospital at the end of my orientation because I was treated like I was incompetent and like nursing was not for me. Co-workers can make or break you. If you like the ICU, then I would go to another hospital if you can. Otherwise, just know you are not incompetent and certainly are not the first person to "miss" something in your assessment.

Tina

I am currently working in an ICU. I have had enough!!
I left work this morning practically in tears .
I cannot believe the way they have been treating me.
Last week, I made my first boo boo. I have been in nursing for two years and 1 year in the ICU. Anyways, I get a fresh post-op who had a very long back surgery. Her dressing went from about T3-lumbar region, her dressing covered her whole back. As soon as she came to me, on a PCA pump, she was complaining of pain so I encouraged her to use the PCA. When I turned her to look at the dressing, she screamed out in pain but I was able to take a good look at the dressing noting that it was dry and intact. I never rolled her to the other side since I was able to look at that one side and see the whole dressing.
Anyways, I never got in report or did I ever see a hemovac. I did what I was suppose to do but somehow missed it. Apparantly what happened is that the dressing was so long that the tube for the drain went up the dressing towards her nape and sat behind her shoulder area, she had long hair, where I could not see it. BOy, did the day nurse find it, though.
This is my first error and the charge nurses are treating me like I am incompetent not beleiving me when I tell them that I turned the pt to inspect the dressing. Last night when I worked, the charge nurse was on my back like a wolf. Not even believing me when I told her that I zeroed the bed for the new pt coming in. Questioning me because she didnt see a pillow on the bed. UNREAL!! She even went up to a co worker (thank god a friend) to question my work ethic and told her to keep an eye on me. They are making me feel incompetent which I know I am not. I have always been very careful but this was an unfortunate thing that was overlooked which they are blowing way out of proportion.
I have always liked Home Health and I think that this situation has helped me make my mind up that ICU nursing is not for me.
I have an interview tommorrow with an agency.
I just hope the hospital I work for wont bad mouth me!:angryfire
This situation is stressing me out so much that I cannot even sleep at night or eat.
Advice??
Diana

cmathews40 · Jul 21, 2004

Very well put Mark. Hang in there Diana, learn from your mistakes it will make you that much stronger. The people giving you a hard time will find someone new to pick on soon enough. It is sad that nurses tend to eat their young.[

QUOTE=MarkHammerschmidt]Hi Diana - as a certified old, grey, battle-ax ICU nurse, let me throw in my two cents. A while back a coworker of mine made a med error: she miscalculated the drip rate of an infusion. The patient became immediately symptomatic, and the nurse realized what she had done and fixed it right away, but it was quite scary, and of course the story whipped around the unit like they always do. I talked it over with her a few days later - she told me she was ready to quit. She's an excellent nurse - here's how I tried to talk her out of leaving:

First off: what kind of nurse would you be if you didn't feel bad about having made an error?

This is actually an important point for you in your ICU practice. The point is, and this is what I told my friend: you can't become a veteran without having gotten a few wounds in battle. Nor can you omit certain things - like making your postop patient completely naked, briefly, and looking at absolutely everything going into, out of, or that's connected to her.

Some lessons you learn the hard way. Here's the secret: EVERYONE, without exception, does that. The hardass nurses just did them a long time ago...and if they're mean, they'll just make you feel like crap. There's a lot of that in nursing.

My stepfather was in the Pacific War, and he used to say that there were two kinds of soldiers - the ones who'd been in combat, and the ones who hadn't. But there's no way to get from newbie to veteran without going through tough experiences: you have to actually traverse that distance, and it changes you: it makes you cautious, careful, wary. And much stronger. That's exactly the way you want to be in the unit.

Here's the other thing: get right back on that horse. If you allow yourself to stay thrown, you'll never learn to ride right.

RNforLongTime · Jul 31, 2004

Great post from Mark!

Diana, did you get report from the OR before your post-op pt came to the unit? If you did, that person SHOULD HAVE told you that the pt had a drain that ran all the way up her back and was behind her shoulder. Whenever we get a post-op from the OR, the SRNA ir CRNA calls to give report and they usually tell us that the pt has some sort of drain. We get CABG's, Trauma's and any other surgical pt that needs ICU monitoring post-op.

That said, you made a mistake that you will learn from. For those nurses to make you feel like an idiot, well that's just uncalled for. No wonder there's a nursing shortage when we treat eachother this way! My advice to you is to get back on that horse and learn to "ride right" as Mark so eloquently stated. Goood luck!

Kelly :)

nurselily3 · Jan 12, 2005

Uup, I'll bet that day nurse has never made ANY mistakes (well, none she's willing to share anyway). We all do it. Did the patient survive your shift?? As a newbie, that's all that matters. That's also why day and night, old and new, we should support eachother and help each other out. Working in the unit is stressful enough without someone whining about something you missed. That's also why there are 24 hours in a day and two shifts covering. It would be impossible to get EVERYTHING done on a patient in 12 hours sometimes. When in doubt, ask for some help. A second set of eyes that are new to the situation sometimes come in handy. But don't let one whiner ruin something that you like to do in a place you like to do it.

erezebet · Jan 24, 2005

I have done some stupid things and I have been in ICU for 3 years now. Once I switched my IV's over to a triple pump and accidently ran my propofol at 100 an hour and my ML at 20 mcg/kg/min. It was like that til my art line showed a pressure drop and I caught the mistake but it could have been worse if I left the room for five minutes right after I switched them. Some of the other nurses noticed my error and gave me funny looks. I felt incompetent but I tried harder and now when I switch to a triple pump, I double check everything----twice!

What you did/missed was an honest error that could happen to anyone. Every time you "miss" something it only reinforces your weaknesses and makes those critical thinking areas stronger. Stay with ICU and when you are a seasoned RN, be kind to the newbe's!

Ruby Vee, BSN · Jan 24, 2005

we all make mistakes. the best of us admit them, learn from them, and do our best not to repeat them. even the most intimidating icu nurse has made mistakes. maybe worse mistakes then yours. i've certainly made some doozies!

you've had some good advice from the posters above. unfortunately, there's no way to become an experienced nurse without experience. we all have to do it the same way!

JAXSON · Feb 2, 2005

[]Please hang in there. Remember everyone was new once and everyone makes mistakes. The only people who dont make mistakes are those who are not working. No one came out of the womb being super icu nurse. Just hang in and do your best . :)

mattsmom81 · Feb 2, 2005

We all learn from our mistakes and in ICU failure to do a head to toe asessment is a biggie. You will remember this booboo won't you. We all remember ours too...hang in there and learn if you are drawn to ICU, and take your constructive criticism in a positive way whenever you can. I would be tempted to go directly to the gossippers and be very upfront, explaining you are new, you KNOW you have a lot to learn and welcome their CONSTRUCTIVE input at any time.

That said, recognize a full drain can cause buildup of fluid and dehiscing of the postop wound (with a line to the spinal cord area...not a good thing)...so I can't agree with other posters who suggest its is 'simply nothing to worry about.' Q4h head to toe asessments (or more frequently) include lines and drains and care of same, and you did not meet the ICU standard of care if you didn't inspect the postop area well.. Live and learn; we all do....and good luck to you.

This is an old post...wonder if the OP stayed with ICU?

ladydi94956 · Apr 10, 2010

I was looking at all my old posts..I had no idea that I had such a great response here. Thank You everyone for some great advice. And No. I left ICU and went to home care shortly after that incident. I have no regrets because I really did feel that it wasnt for me. Home care was a nightmare with all of the paperwork so ended up in a short stay unit in the hospital that I became in charge of. This unit just closed so am going to med-surg float pool..Yikes!! Will be on orientation for awhile until I get the hang of it!

sistuh · Apr 30, 2010

Unfortunately this is the old story of nurses eating their young. The new title is latteral violence. When communication becomes a problem between coworkers and supervisors the potential for worse mistakes can happen. It's also hard to live down a label. You've acknowledge your mistake and learned a good lesson. We all have and there the problem lies with medical errors, we err because we are human.

I would hesitate to give you advice about this situation as I don't know you but had an experience with another nurse where we "almost became Walmart greeters". The way we helped ourselves through this was to have a meeting with an employee assistant counselor so we could see the real issue and not the emotional issue and coping mechanisms. Your facility should have a program for employee assistance who can help you with communication with peers and supervisors.

Believe me you will get over this. Don't make a hasty decision you may later regret. :nurse: