Overwhelmed!

randybayrn · Mar 11, 2007

I am also a new grad that has started in the NICU. My RN residency is 6 months and starts with about a month of classes before we get to the unit. It then mixes unit time with class time until near the end of the six months when you are pretty much just doing unit time. We precept on the shift we were hired to with a two week exception where we are scheduled to work the opposite shift to see how things are on that shift. I am basically writing because I had my first week on the unit last week. My program has an excellent reputation, but I still came home and felt completely overwhelmed. My first day was great. I love my preceptor too, but the second shift was completely overwhelming. We had so many admits. Such a high census and super acuity level. I feel a little better today as I wrote down all of the diagnoses of my baby and looked them all up on the Internet today. Wow, I had no idea my baby was so sick.

Anyway, I hope this helps a little to know that you are not alone. I too feel completely overwhelmed!!

wincha · Mar 11, 2007

Personally, I think a new grad shouldn't be working in a unit and if so should get an extensive specialized training. Your babies are at risk because you are a new grad and are not getting extensive training. You are also putting your liscense on the line. But who am I to say, I have over 20 years of experience. I have had the hospital "try" to put me in areas I was not trained for and I refused.

**canoehead, BSN, RN** · Mar 11, 2007

I would expect tears post shift once in a while for a new grad but every night is going to affect you ability to think, and make things worse. It sounds like your preceptor is busy putting out fires all over the unit, and you are coming in dead last in her priorities. Bad orientation. Get a nurse all to yourself or get a hospital/unit that can commit to teaching.

Gompers, BSN, RN · Mar 11, 2007

Personally, I think a new grad shouldn't be working in a unit and if so should get an extensive specialized training. Your babies are at risk because you are a new grad and are not getting extensive training. You are also putting your liscense on the line. But who am I to say, I have over 20 years of experience. I have had the hospital "try" to put me in areas I was not trained for and I refused.

Exactly, more training is needed. It's actually very very common for new grads to start in the NICU. The thing is, the only thing that can train you for the NICU is being in the NICU. You don't learn this kind of nursing in school or in any other part of the hospital. That's one of the reasons new grads do fine - they have just as much of a knowledge deficit as a nurse coming from, say, med-surg. Plus with a new grad, you have a clean canvas, a fresh slate - no bad habits to break, no adult-nursing mentality to change.

However, a typical NICU orientation (for both new grads and experienced nurses with no NICU history) is MUCH different than what the original poster is reporting. Most units have a classroom-type orientation for at least a few weeks, followed by one-on-one training on the unit for several months. And when I say one-on-one, I mean one-on-one! New NICU nurses are typically precepted for three or four months before they're on their own.

I don't blame the original poster for being overwhelmed - she very well should be. This is not a normal NICU orientation and I hope to get an update soon as to what the nurse manager had to say. Unless things are going to change soon, this unit sounds like a bad idea.

lencialoo · Mar 11, 2007

travel920...

I'm so very sorry for your hard time in the NICU. I am also new in the NICU and almost 1/2 through my training (40 weeks). Our training is 1 day of class and 2 days in the unit. We have 20 weeks in level II/ 20 weeks in level III, which consists of 5 weeks/days with preceptor, 5 weeks/nights with preceptor then 5 weeks of "buddy time" with both days and nights where you are paired with the preceptor but have your own assignment. Our unit is very busy and at times we have had so many babies that precepting is harder but it seems like we are able to still get alot of learning done, it is far from an ideal situation but I can accept that. I have had a few rough spots on nights where I was paired with a very rude nurse for my preceptor and I asked my Ed. coordinator to change me, the 2nd preceptor was better but not by much. Many of the preceptors on nights are very new or they are the "old hens" that love to see the new grads struggle (sad but true). As others have suggested speak with your NM or Ed Coordinator and make is clear that you are struggling and new more help to be a "safe" NICU nurse...this is your right and responsibility to your little patients. I am in a group of 8 nurse all with diff levels of experience and learning speeds/styles. Dont let this get you down, keep your chin up and look at all you have learned and be proud of your strength.

A very nice nurse on days asked me once when I was having a hard day if I ever felt like not coming to work...I said sometimes I did, she said "Dont worry I had days like that too" She advised me to journal and then look back on it later...that is good advise. Also find someone who you can call or speak with as a friend who understands and who you know will encourage you, you do need support. Make sure to get your sleep and also most important leave the problems at work and enjoy your family time and take some R&R for yourself...even 30 min to walk, read a magazine or take a hot bath will help.

One thing I always do before going to work is pray. I know I need all the help I can get, so I ask for it each day. I made a little card that I lamenated and put behind my badge and I read it in my car before going it....it's a special prayer my boyfriends' father used to say to face each day......all this helps me. See attached file if you think it would help.

God bless you and Good Luck to you....your lil patients will be better off with you as their nurse because it is obvious you have a good and kind heart.

lencialoo

Lord_help_me.doc

travel920 · Mar 12, 2007

Well, I had a long discussion with my preceptor. I picked a time when things weren't as hectic, so we could talk. I think, originally, that she thought that I could make a seamless transition from taking care of a well baby, to a lower acuity sick one. I couldn't, because I don't understand a lot of things.

I am getting a new preceptor when I go to nights, and I have already met her. She promises me that things will be so much better. She has already suggested that I get one of the books that everyone here has recommended. She told me that it was what she did when she first started. She said that she felt that she was learning skill and action, but didn't understand the rationale behind the action. That is where I am at.

I liked her, she was very calm, and genuinely seemed interested that I get the best start that I can. If closer to the end of my orientation, I feel that I need more time, I will talk to my NM.

One thing that I do like about the unit is that everybody checks everybody elses meds. I have found the Neofax, and it has become my bible.

Thanks everybody. You really helped me out more than I could ever say. I took to heart everything that was written. It really made me feel better to know that I shouldn't expect to know everything when I first graduate.

I will treat this like I did school. I will just work harder than everyone else.

travel920 · Mar 12, 2007

The experience and CARING all of you who replied put into your posts means a great deal to my wife. She has repeatedly stated that the replies she has received to her initial post have ALL helped her both emotionally and professionally.

By an understanding of the training she SHOULD receive to allow her to meet the standard of care for her patients, she has been able to negotiate for that level of training with certain knowledge she wasn't asking for more than her due or more than what is required for the job. In the business of Nursing, it seems that knowledge is power.

I just wanted to add my two cents worth to this thread and a thank you. Our family has put everything on the line to help my wife and mother reach her life goal of not just becoming a Registered Nurse, but also being a Nurse and all that means. We are all very, very proud of her.

And yes, she works harder at her profession than I thought a human being was capable of working. Yet she still is the heart and soul of this family and always will be. We love her. And we respect her.

Larry the Husband

prmenrs, RN · Mar 12, 2007

I'm glad things are looking better right now, but if it doesn't happen on nights like it should, DEFINITELY get out of that facility and find one that will orient you properly.

Larry the husband---please make sure and take care of her. If that unit doesn't come through, help her out of there! No more crying on the way home!

I still can't believe they don't have any didactic!

danissa, LPN, LVN · Mar 12, 2007

[quote=travel920;2107700I We are all very, very proud of her.

And yes, she works harder at her profession than I thought a human being was capable of working. Yet she still is the heart and soul of this family and always will be. We love her. And we respect her.

Larry the Husband

Babe, with your Larry, (btw, this man is solid gold!!), and your family wrapped tight in your heart, being the wings that make you fly----you WILL get there! And when you reach where you want to be, look at them again and be soo proud that they love and respect you for being YOU!!! Melts your heart!!! :bow: :icon_hug: