HELP New Neuro-ICU nurse

  1. 0
    Hello to all. I am a new RN and new to ICU. I have done Peds as an LPN for almost 5 years. I feel like I am inept and stupid! I don't feel like I know a thing. Today was my second day with taking two patients. I cannot get a grasp on the routine and everything that has to be done. I have always been told that I am efficient and good at what I do. My preceptor told me yesterday that I "only have one speed and I need to step it up." I was so mad. Today i tried to step it up and she ended up doing the majority of the charting on one of my patients. Where am I going wrong? Am I going wrong? I hate feeling inept and running around with a rectal-cranial inversion. Any information and constructive criticism would be greatly appreciated.
    Thank you,
    Matt

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  2. 13 Comments...

  3. 0
    Hi Matt

    I have been working in a 29 bed multidisciplinary ICU (in South Africa) for the last 7 years. And from experience, it really does take time to find your feet and get used to a routine - yours, theirs or anyone else's will do in the beginning!!! I still sometimes think that taking 2 patients can a much greater challenge than one because it takes some serious juggling to get them both sorted out! Hang in there!! Good luck! Liz
  4. 0
    Matt you hang in there!!! This is only your second day taking 2 pt's and your preceptor probably wasn't born an ICU nurse either. Those that like to make you think they were are only trying to cover their own poor self esteem issues. Rmember the first rule of nursing is "ABOVE ALL ELSE DO NO HARM" SO IF THAT MEANS IT TAKES YOU SOME TIME AND QUESTIONS THEN SO BE IT.....oooh these kind of nurses that eat their young make me so mad......you'll do fine, just think in logical terms and remember 1. safety, 2.ABC's Good luck to you
  5. 0
    Matt, I don't have the years of nursing experience that you do but I can tell you that my neuro ICU orientation didn't include care of two patients till week #3. Maybe you can ask your clinician and preceptor to back you down to one for the immediate time being. I know when I feel overwhelmed, I learn zero, nada, nuttin. Isn't learning the objective? I think we suffer more than we have to because we don't speak up to the right people.
  6. 0
    Good posts everyone and I concur - too much way. way, way too soon. Complain - do it early and do it high so that it gets heard.
  7. 0
    Hang in there...I'm a new grad in ICU as well, but with one year behind me (whew!). I can so relate to your frustrations. I actually had very supportive preceptors, BUT sometimes I think they would forget what it was like to be a new nurse (not on purpose, they weren't trying to discourage me, it just happened.) Most of them have been nurses for 20-30 years.

    I do have a baseline problem of not being very good at time management...I tend to get bogged down in the details. Finally after a good talk with my manager (bless her!) after feeling like I was still drowning and wondering if I had chosen the wrong profession, she was able to pair me with a nurse who was very good at time management AND could give me helpful constructive criticism including identifying specific ways I could do things differently instead of just telling me I needed to "kick it up a notch" constantly with no additional information.

    I think it's safe to say it takes a while to get the routine down smoothly, and even then all it takes is for one of your two patients to crump, or require closer supervision and the whole shift routine seems to fall to pieces and you are there at the end of it hoping you didn't miss anything really important.

    Nope, I don't think you're going wrong and give it some time. Depending on your preceptor try to communicate that you need more specific feedback than just "step it up". If you feel like you are still hitting your head against a brick wall, talk to your manager about your frustrations and if possible have a list ready of what you still feel uncomfortable about and maybe he/she can put you with a preceptor that will help you learn what you need to do to be successful and grow as an ICU nurse. It's not a put down on any particular nurse, but some nurses are just better at teaching than others, I think it's a personality thing.

    I look forward to when I've been a nurse for several years and can confidently handle any assignment I'm given without inwardly quaking in my shoes when things get crazy and no one is immediately available to help me. Good luck, and don't give up...it's so worth it. It really does get easier the more experience you get. I love being in critical care and can't imagine starting anywhere else.

    RNlove2fly
  8. 0
    Hi Matt,

    Hey kiddo, don't be so hard on yourself! And, your preceptor shouldn't be either! The role transition between an LPN and an RN is a huge hurdle to clear---and, you've done that! Pat yourself on the back! Now going from one to two patients is another. Your preceptor is telling you to pick up the pace, but, is he/she offerring you any timesaving tips or organizational strategies? That IS part of a preceptor's job....to prepare you to be a good icu nurse in a real icu. Ask he/she for more specifics....if you are taking 30 minutes for mouth care on a vented patient...then they need to say that.
    Take a minute and reflect on what parts of patient care are easy for you and what you struggle with....usually, you are a bit slower in the areas you struggle with.
    Start with that. You are open to questions and constructive criticism and that is the first step towards getting help and doing better. Come back and keep us in touch......and don't give up!!!! That is the only way you will fail.
    Even the most experienced nurses have days/weekends/months of complex patients, wacky schedules and whatever else makes neuro the land of the nuts which really challenge them to be organized.
    Take care!
    CCPam
  9. 0
    I am in the same boat, I'm fresh out of school and just started working in a neuro- ICU. Yesterday was my 6th day caring for one pt; it's been tough. My preceptor is a young nurse who has been in the system for one year and she makes me feel very stupid sometimes. She hardly criticises me in my face, but when she does, it's not constructive. She tells me I fall behind (I don't know what she specifically means and never tells me areas I need to improve), she also said I am overly confident,in other words, arrogant, which I think is a very wrong perception. I am as humble as I can be always willing to learn.
    Being trained in a electronic system of charting, transitoning to a paper charting system hasn't been smooth. I've been able to fill out most of the section on large flowsheet alone, however, when I leave a blank spaces because of a unique situation and ask her for help, she queries me, saying "You've been herelong enough and I expect you to know all these". She hardly spends 20 continues minutes with me, she leaves her two patients (plus mine, so 3) with me to talk to other nurses or see a friend on another unit, leaving me petrified.And when she comes back and something hasn't been done she queries me. Fortunately or unfortunately, I usually hear what she says to other nurses about me, because some of 'em are double agents. I feel very frustrated sometimes. Frustration , they say is a sign of weakness, I don't want to be that way, I'm humble, willing and ready to learn, I wanna be the competent nurse.

    She talks to me like a kid and makes me feel so unwanted sometimes. I'm a male nurse originally from Africa, I lived and schooled in the states for most part of my post-secondary education, however, I still have an accent. You should see the grimace of digust on her face when I am talking to her . This won't stop me from asking questions and making sure the right decision are made.

    She has already made some reports to my clinician and I have had a meeting with her. My clinician said I should learn to work with her ( I don't know what my preceptor told her though). Yesterday, before I left for home, she said "be ready to take two patients when you come in next week"

    I dont know why things are going so rough. I am just another human being willing to care for another person. Why all these hurdles? With the help of God, I know I'll grow in this profession and become a competent nurse.

    God Bless Nurses.
  10. 0
    Quote from owura143
    I am in the same boat, I'm fresh out of school and just started working in a neuro- ICU. Yesterday was my 6th day caring for one pt; it's been tough. My preceptor is a young nurse who has been in the system for one year and she makes me feel very stupid sometimes. She hardly criticises me in my face, but when she does, it's not constructive. She tells me I fall behind (I don't know what she specifically means and never tells me areas I need to improve), she also said I am overly confident,in other words, arrogant, which I think is a very wrong perception. I am as humble as I can be always willing to learn.
    Being trained in a electronic system of charting, transitoning to a paper charting system hasn't been smooth. I've been able to fill out most of the section on large flowsheet alone, however, when I leave a blank spaces because of a unique situation and ask her for help, she queries me, saying "You've been herelong enough and I expect you to know all these". She hardly spends 20 continues minutes with me, she leaves her two patients (plus mine, so 3) with me to talk to other nurses or see a friend on another unit, leaving me petrified.And when she comes back and something hasn't been done she queries me. Fortunately or unfortunately, I usually hear what she says to other nurses about me, because some of 'em are double agents. I feel very frustrated sometimes. Frustration , they say is a sign of weakness, I don't want to be that way, I'm humble, willing and ready to learn, I wanna be the competent nurse.

    She talks to me like a kid and makes me feel so unwanted sometimes. I'm a male nurse originally from Africa, I lived and schooled in the states for most part of my post-secondary education, however, I still have an accent. You should see the grimace of digust on her face when I am talking to her . This won't stop me from asking questions and making sure the right decision are made.

    She has already made some reports to my clinician and I have had a meeting with her. My clinician said I should learn to work with her ( I don't know what my preceptor told her though). Yesterday, before I left for home, she said "be ready to take two patients when you come in next week"

    I dont know why things are going so rough. I am just another human being willing to care for another person. Why all these hurdles? With the help of God, I know I'll grow in this profession and become a competent nurse.

    God Bless Nurses.
    Make no mistake - she is bullying you. Pure and simple. And she is being less than professional in her conduct - document, document, document and make it known to her and SOON that you will NOT take anymore of this behaviour. Especially document that she left you within your first few days of orientation with 3 ventilatated patients!!

    Just to give you some perspective - our patient ratio here is 1:1 going up to 1:2 ONLY for meal breaks!! We would NEVER have 1:3 VENTILATED NEURO patients!!

    But to be fair we also do not have resp. therapists etc.
  11. 0
    The beauty of this career is that if you dont like where you're at, you gave it a shot, and you move on to something else that might fit better.

    I knew getting out of college that I was going to be an ICU nurse. There was no way in this lifetime I would work on a med-surg unit or something of the sort. Not even to get my feet wet into nursing.

    The bottom line is, if ICU is not for you, its just not. It doesnt mean anything more than that. I have a friend who went from Med-Surg to ICU and misses the floor. He said he missed talking to patients. Me on the other hand MY favorite patients are crashing and cant speak to even save their life, intubated on diprovan and versed, and throw in a little bit of sepsis.

    Good luck at finding what works out for you. The process will put a ton of experience under your belt and you will be a very marketable nurse!

    -C


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