Will I survive this?

Specialties Neuro

Published

Specializes in Critical Care.

I am 56 years old, and just graduated from nursing school 5 months ago. I started a job in a neuro intensive care unit, and have been working under a preceptor for 2 1/2 months.

I am freaking out.

I love the complexity of the unit and neuro in particular, however it became very clear within the first few weeks that I wasn't "cutting it". I am tryng to grasp the technology, computerized charting, meds, titrations, multiple IV's, EVD's, vents, CVP's, feeding tubes NG and GJ, diagnosis, reporting off, communication with MD/NP, not to mention how the unit works, in such simple matters as how do you page, etiquette, etc.

My preceptor became very frustrated with me, either because of what I didn't know, or how long it was taking me to learn it. I have just not been able to learn complicated multi-step processes by just doing it once, or being instructed once. Most of the meds are new to me. I am obsessed with safety, so I will take the time to double check or look something up, but this bottom line takes time. I get behind in charting, and everything snowballs. Before you know it, I have forgotten to place an order, or chart a dressing inspection, and I lose my confidence. My preceptor started only looking for what I was doing wrong...and she started getting mean, abrupt, rolling her eyes, quizzing me in front of patients and families, until I finally broke down and started crying and had to take my 10 minute break to compose myself.

I spoke with my supervisor, and my preceptor was changed. While things are better, I am feeling snubbed, ignored, and like I am the "failure" of the unit by others. I want to hang in there...I have SO much to offer to this unit someday with my life experience, but I have to learn everything, pick up speed, and am willing to put in the time to do so. I arrive 30 minutes early for each shift to research my patient before I even clock in, and spend hours at home researching what I don't know.

It blows me away how a new grad, or maybe even a new to the unit nurse, can be virtually rendered ineffective by being ignored, turned away from, whispering to others in your presence then looking at you, or even doing something as simple as putting their head down and smiling and shaking their head when I ask a question....like, "why in the hell do you not know THAT?"

Do you think I will survive this? I love the patients I work with and their families, I am a great communicator and can handle just about anything that comes my way when it comes to verbal communication or education. I just feel like I have failed in the eyes of my co-workers, and don't know if I should even bother to hang in there. Has anyone else had this experience? I don't want to bail, but I'm about to. I can't believe how much I didn't learn in nursing school. I am overloaded with new information. I can't absorb it that fast!

Please....any advice? I can't believe this is happening to me. I am an intelligent, hard working, dedicated person who wants to be a successful nurse. Why do I feel like it is my collegues who are trying to push me out of it?

Help!:cry::sniff:

Hello.

I feel your pain. I am now 45 and 1 year ago I was hired on for a new unit that was to open. In the meantime I did orientation in the ICU and was given pts that I should expect to see in the new step-down unit (hemodynamiclly unstable, art lines gtts etc...) I had a similar experince with preceptors and etc as you do. After the new unit opened I stuck it ourt for a month, some days good others felt as if my head was above water. After much stress, I decided to chg units and now in a step-down neuro unit and love it. It was a long journey which entailed therapy, SSRI, but in the end, I am happy. I do get a bit hard on myself that "I counldn't cut it" but it is ok, nursing doesn't have to be like that. So my advice is to start looking into another unit and accept that it may not be the right "fit" for you.

Well, as an 'old' nurse, too, I think it is harder and takes longer to learn new things, especially tactile skills. And being stressed out doesn't help any. I see 2 options: go work on a neuro step-down unit until you get more used to being a nurse, or, just stick it out. It's amazing what being off orientation does to your performance. Bearing the responsibility for your patients clears the mind and focuses the attention wonderfully. If you get to be good enough, people will stop being nasty and will forget about this time. It either is too much for you at this point in your being a nurse, or it is just going to take you a little longer. Believe me, you arn't the first person this has happened to. I've seen hundreds of even young new nurses take a while to adjust to critical care.

I would ask, though, to get the same patients for a couple of days in a row. So you don't have to reinvent the wheel every darn day.

Specializes in Neuro Critical Care.

I would look into moving to a neuro step-down or medical floor. I think it is very hard for new grads of any age to jump right into critical care. If you can develop a routine, time management skills and confidence on a regular/step-down floor then moving to critical care will be much easier. If you really want to stick with critical care then maybe move to one that isn't so specialized. Neuro is tough to learn and you are not stupid or less of a nurse if you need to take a step back. I worked medical floors, including a neuro floor for 3 years before moving to critical care and that experience was invaluable. Give yourself a break and consider what is best for you.

Specializes in Trauma, ER, ICU~CCRN,CNRN.

Unfortunately that is sometimes the way some ICU's are. Depending on the size of your unit, most have a handful of staff that have been there for years and years and become quite close and clique. This in no way excuses how they are making you feel...we do STILL eat our young...and I wish it wasn't true.

I've been an ICU nurse for around 15 years and just moved out of state to work in another facility in the Neuro ICU. I have been treated like the plague as well! This ICU is filled with young nurses who are either intimidated by my experience, or just plain ol' don't like me! I'm made to feel that their way of nursing is the only way to nurse and refuse to allow my input on anything! :p I have also been added to the "blacklist"...I get terrible assignments, virtually no help when I need it and frankly I won't be here very long!

What I'm trying to say is that there will always be some units that will be worse than others. This just may not be the one you need to start your ICU career in! Find one that will encourage your growth as an ICU nurse and give you time to nurture your skills. (they are out there, believe me!) It will take you a good solid year before you will feel comfortable at all!

Good luck to you and don't fret about it, it's reallly not supposed to be like that!

Specializes in neuro, ICU/CCU, tropical medicine.

déjà vu! you don't happen to be working in seattle, do you?

man, i got burned severely when i went from a neuro floor to a neuro icu in a toxic work environment. it was the lowest point in my career. i have since gone on to prove that all of the rotten things the nurse manager said about me were absolute bs (i was a "substandard nurse," i was going to kill a patient some day, that she would be afraid to be a patient on the floor i came from - she even asked me if i thought she was full of sh** - probably to use it against me. yes, you were fos, and you knew it too!).

i'm inclined to tell you to get out before the final dump (my preceptor left a hand unrestrained on my intubated patient who had a history of self-extubation - i caught it). find a healthy work environment.

yeah, nurses eat their young.

Specializes in Critical Care.

The responses to my thread have been helpful and insightful. With a couple more weeks of experience on this unit, here's a summary of how things are going. Thanks to all of you for your advice...!

1. Things are about the same, however my perception/reaction to it has changed. I am less bothered by the reality that I am not necessarily a welcomed addition. If my co-workers need to solidify self-worth by bashing those around them, then so be it. My focus is on my patient.

2. I work as hard as the next person. I may not have the years of experience as an RN, but I continue to move forward. I will always be a student, and proud of it. If the day comes that I think I "know it all", I need to take a dose of humility.

3. It has been very difficult for me to accept that I can't expect to have a procedure/process/concept "down cold" after doing it one time. Remember learning how to ride a bike? Did someone just explain it to you in a rushed flurry of activity full of interruptions, point out where the bike is, and expect you to jump on, ride it with speed and grace while navigating turns and potholes with a smile on your face? I think not. Worse yet, how would you have felt if you stumbled and had to ask again how those hand brakes worked....and your "teacher" said, "what? you should KNOW this by now!!"

4. I won't give up. It's tough, but I can't run around looking for a better situation. I can only modify my reaction to it, and I am moving forward on this. My patients are my priority. I don't work for my co-workers, I work for the hospital I was hired by and my nurse manager. I will not leave until one of those two ask me to.

5. I will continue to smile, offer to help, greet fellow nurses, and generally be the positive, supportive person that I am. I will welcome new staff, and strive to be the example by never, ever engaging in that destructive "bash the newbie" mentality.

6. Each shift, I try to take a moment to say something positive and reinforcing to a co-worker. Each time I have done this, it has elicited a smile or a general response of pride from the recipient. Hmmmm. Even nurses who "know everything" and hate "worthless new grads" like to be recognized for what they do well! Isn't that interesting. Try it. You'll like it.

7. This job rocks. It's hard as hell, my feet hurt, and it's terrifying. But if it's YOUR mom who is assigned to me, you would want ME as her nurse. My energy and focus is on HER and not what my co-workers happen to think of me that day.

Thanks to everyone...your support has kept me going. Keep writing!

Specializes in hospice.

Imgettingthere,

You ARE a terrific nurse, and you are in very good company. No one comes out of school and hits the ground running. No one. Not your preceptor, your charge nurse, or even your supervisor. This is universal. Your patients and their families are very fortunate to have you. Keep up the good work.

Specializes in Critical Care.
Imgettingthere,

You ARE a terrific nurse, and you are in very good company. No one comes out of school and hits the ground running. No one. Not your preceptor, your charge nurse, or even your supervisor. This is universal. Your patients and their families are very fortunate to have you. Keep up the good work.

Thank you so much for your words of encouragement. I'll tell you I am so on the edge of giving up that I need to keep hearing this to hang on.

Specializes in Critical Care.

Well, I gave it my best.

Met with my DON and requested a transfer to another unit. I have learned part of being an excellent nurse is to take care of yourself, and continuing to subject myself to this environment of lack of encouragement and confidence was going to eventually take it's toll on patient care. I stopped before it did.

Some parting thoughts that I wish my "colleagues" would have heard from me. (thanks for letting me get this off of my chest)...

-If you tell someone often enough that they won't succeed, they won't. Even if they have all of the motivation and enthusiasm in the world. If you want to contribute to the nursing shortage, just beat up a new grad.

-New grads cannot do anything about their lack of experience. There is no school that teaches experience. Accept this as fact, and don't spend so much time telling a new grad that they need something they can't get without time.

-Just because YOU went "through the trenches", this doesn't mean you are not a "real nurse" unless you have done so, too.

-Just because I am old enough to be your mother, I'm not a "has been". No one...NO ONE...gets through nursing school and NCLEX being a wimp. Could YOU have put yourself through nursing school as a single mom and passed your boards if you had to do it today? (Or 20 years from now?)

I feel better. Thanks. Everyone here has been a great support. I appreciate that.

Specializes in Neuro ICU.

What a fabulous attitude! I would want you on my team any day. Best wishes to you in your career as an RN. You will be great!

Specializes in Critical Care, PACU.

I'm currently a nursing student and honestly your story gave me alot to think about. I've worked on a unit that was way harsh on their newbies before and it's awful the way "old" nurses treat their "new" nurses. You're completely right, you can't learn experience in nursing school. If nobody is going to give you the chance to see and learn, then how would you have "known this by now."

I'm sorry that happened to you and I hope you gained confidence and will benefit from those experiences. You made the right decision, best of luck with your new unit. :up:

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