I've been working on a Neuro/ tele step down unit for almost nine months now and I cannot take it anymore. When I was first hired, I informed the director of my goals and how I wanted ICU and she was completely on board, said I would be evaluated in six months. Unfortunately, that director left and now we have a new one, who could careless about my goals.
When I was on orientation, I met a CRNA who said I could shadow her, I went to the OR director, she agreed and said that I only need an okay from my director and that it would have to be on my days off, which I was completely fine with. I reached out to my director multiple times and ways (email, notes on her desk, voicemail) and no response, then I finally saw her. I work nights so it was difficult to run into her but I did and told her I have been contacting her in regards of the shadowing. She said she knows and that she thinks I need more experience first. I said to her, I need more experience to shadow? And she said yes, I need more time.
I used to constantly remind my manager of how I want to be in ICU... I don't mention it at all anymore. I feel so trapped, I can't help but cry as I'm typing this. Working on this floor has been difficult.
Every time I'm called in the office, I know its because I did something wrong, I never get a good job. All of the ICU nurses that come to my floor keep telling that I'm the best hire and would be a great ICU nurse, the charge nurses on my floor tell me that too. My manager said to me that her and the director were considering me for ICU but that was months ago and clearly a lie because they just hired a bunch of new ICU nurses.
My manager has called me into her office, accusing me of having a potential drug problem because pharmacy said that I've been pulling and returning too many narcotics, but nothing was missing and the count is still accurate...
Last month, my manager and director had a scapegoat meeting with me, trying to blame me for a patient's death. The patient should've been in ICU, not on the floor and I followed the facility's protocol and informed the charge, nursing supervisor, and doctor. No one did anything, so what was I supposed to do? But they wanted me to do a presentation on what happened at a staff meeting. I sent an email stating that I would not because it is unprofessional.
Last week, my manager told me to either present or get written up.
I spoke with union representatives and fellow coworkers regarding the matter. Everyone is stunned and doesn't really know what to do because they've never heard of such things happening but it is, to me.
Ever since I started working here, I've been having anxiety, panic attacks and chest pain. My doctor put me on Xanax because it was getting so bad... I also started seeing a therapist. I'm so paranoid going to work, thinking something is going to happen and I'm going to get in trouble.
Sorry for the lengthy background.
TL;DR... I applied to PACU, CVOR, MICU and CVICU at my facility. I've been working on a neuro/ tele step down unit for nine months. I'm on a two year contract. In order for my applications to go through, I have to complete a transfer form, which requires my manager's approval.
There is already so much tension, I don't want to rock the boat further but I also can't take it anymore. I'm the youngest nurse in my hospital and it feels like management treats me this way because I am young, my charge nurse and colleagues agreed.
What should I do?
Thank you all in advance.
Wow....Ruby gives a lot of good advice to people. Just by reading your responses, I see why you might be having issues at work.
Last edit by dianah on Nov 6
: Reason: continuity
Hear me out and please read my whole post. While it doesn't look like your manager has any intention of letting you transfer to ICU at this time, the fact that you are being called into the office may also show that you are not ready for ICU yet. If you need xanax now on a step-down unit, that may also be a sign that you are not ready for ICU. It is even more stressful there because you are all that is between your patients and heaven sometimes!
The presentation about the patient death is pretty routine. I don't think it is meant to blame you more as a debriefing to analyze what happened and how to prevent it in the future. Most hospitals have emergency response teams that you are able to call to intervene when a patient is taking a turn for the worse. In an ideal situation they would have done so and transferred the patient to ICU. Unfortunately that is not always the case either because the Dr doesn't want to transfer the patient to ICU because they will have to come in and see the patient, but more commonly because they either don't have open beds or enough ICU nurses to take the patient.
As for the narcotics, this too is something to be aware of. I know it doesn't make sense to accuse you of drug use. Be aware most places can drug test you for "suspicion" and some hospitals have a drug free rule where you may not work if you take narcotics or other controlled substances like xanax. If that is the case it would be in the policy. It is unfair, but a fact of life that because some nurses divert narcotics we are watched like a hawk. The pharmacists or their computers per se analyze each nurse against others for pulling narcotics and controlled substances. If that history seems high in comparison to the average they may start an investigation to determine if that nurse might be diverting drugs. It's sad to have to worry about being targeted because you give the pain meds when people need them, but it is the life of a nurse these days. Don't pull a narcotic until a patient asks for one, always do a witnessed waste, always do a pain reassessment. Red flags that will trigger an investigation include pulling a larger than average number of narcotics, not witnessing wastes, not doing pain reassessments, and giving out another nurses pain meds. In fact, it was the ADU that caught a favorite nurse who'd been thru cancer and was diverting pain meds. We were all shocked!
I think you made a mistake letting everyone know your goal is ICU. Also I think you are in too much of hurry. You need to slow down, learn all you can and prove yourself. Think seriously about if ICU will really make you happy. It comes across as you have an almost irrational belief that you can't be happy until you are in ICU.
I imagine you feel pangs of jealously that new grad friends were chosen for ICU but you weren't. This is totally understandable, but I really think they are not doing the new grads any favor by starting them off in ICU! Where I work people are given the chance to switch to step down if they either don't like ICU or can't cut it at the time. Some who failed in ICU eventually tried again elsewhere after more experience and were successful at another hospital. Some decided it wasn't really for them. From what you've said I'm not sure ICU is for you, at least not at this time.
Definitely, go to the presentation about the patient death and don't take it personally. It is common practice and not an indictment against you. Speak up that your concern for the need for ICU was blocked and defend yourself. If you charted every action you took you should be in the clear as far as that goes.
I agree that 6 patients and no CNA is poor staffing and understand your frustration on your unit. I hope that is the exception and not routine. Since you have a union can you file an unsafe staffing form when they leave you like that?
Good luck and best wishes in your nursing journey!
Last edit by brandy1017 on Nov 6