New PICU nurse

[madimomma]

Hey....just graduated in December and began working in the PICU in early February. It's the end of my 3rd week and apparently I only have about 7 weeks or so of orientation to go. Does that seem like a short amount of time to orient to the PICU? Anyway, I feel lost....not completely, but there are so many procedures I haven't heard of, policies, paperwork....etc, I'm still trying to get the hang of EVERYTHING all at ONCE and it seems rather overwelming. It seems at the moment that I am having particular trouble PIE charting. My clinical instructors were never hard on me and I think that may have been to my disadvantage now. My preceptor is hard on me...which I need, but something I'm not used to and I don't feel adequate. How will I ever be ready?! Any advice would be appreciated.

[pcicurn7]

Wow, that sounds like really short orientation, especially for a new grad. If you aren't ready, make sure to make it known. You don't want to jeopardize your license or a patient's well being...

I've heard a couple of friends of mine get jobs at med-surg, and get 7 weeks of orientation. I thought THAT was way short. For the PICU, you should be getting more than that.

good luck!

[freedom4]

I recently have been hired to PICU. I will start in May. I will get 14 weeks, and I am getting 2 extra weeks devoted towards Oncology. The hospital I will be working at is an St. Jude affiliate.

[jamonit]

hi! i started in february as well. we get 14 weeks in total. i guess the best way to do it is use your resources. look things up, check dosages in the iv med book, ask questions of your fellow employees (not just your preceptor), and take good notes to study when you get home.

also, i know in my program that if by the time of orientation that you don't feel ready, you can ask for a little more time. meet with your charge or manager and make sure to discuss your feelings...that you are understanding a lot, but that you have certain concerns. do it now before you are put out on your own.

also, talk to the other new grads. see how confident they are feeling, and see if they have any good advice for you. that can be invaluable. because really, if you are overwhelmed, so are they...and they can tell you what they've been doing, learning, reading, charting...to get through it.+

after preceptorship, when you aren't comfortable with assignments, make sure the charge knows that you will probably require a little back-up, like if you are getting a fresh post-op scheduled or if your kid is crumping. usually everyone likes to help the nurse with the sickest of the sick kids.

call pharmacy with questions, bring a calculator for titrations, write down the specifics about PIE charting that you are having difficulty with. study up on the strange pathophys/policies and procedures. yes it is your license, but there are things you can do to feel more confident up until the end of orientation.

oh, and another thing....have your preceptor write a critical criticism list...things she senses you are having problems with. ask her to go through them with you when you guys get time. keep a log of these things to work on, and ask her to update you when she sees that there's something else about your charting or whatever that needs to be reviewed. ask her to be honest with you and tell her what it feels like you are missing. your preceptor wants you to do well, it reflects poorly upon her if you feel like you aren't ready.

anyway, these are the things i'm working on as well, and these are the ways i'm addressing my concerns. we're going to be alright, we just have to stay calm, confident, humble, and ask when we need help.

let me know how it goes!

[RNNPICU, BSN, RN]

I started as a new grAd in the PICU and I had 6 months of orientation. I have now been "on my own" for a little over a week now. My orientation had three months of classes along with the precpetorship. The last three months were just the three shifts with the preceptor. My las two weeks of oreintation I had the sickest patients, ECHMO, CVVH, I couldn't believe it. Now that I am off, I get a mixed bag. My shift last night though was crazy. I started off the shift with one patient. Then at 7:50pm, they realized that this nurse wasn't here, so I had to pick up a sick 1:1 patient for three hours along with my other patient. It was crazy. Then the nurse came in and I was left with my original pt. Around midnight the charge RN told me I was up for an admission, I was the only one who did not have a 1:1 assignment. So the admission comes up, no problem.. then at 4am, my original pt was being sent to the other side of the PICU, because we needed the bed space for the AM, so I sign off to the other RN, who no longer had a pt, she sent hers to the floor. Oh such is life in the PICU. I ncan't believe that I did not go crazy, especially just being a week off orientation.