PICU fear

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    Hi! I will be graduating from a BSN program in May and have accepted a position in the PICU at Hershey Medical Center. Am I crazy for doing this? For you PICU nurses, do you think it is okay to be a new grad in the PICU? Orientation is 5 months, and I feel like I'll learn the skills but I am sooo nervous. Any suggestions? Should I have done a couple years of med-surg first? Thanks for any help!!
    rnin0513 likes this.
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    OK, I oriented PICU after 6 years of pediatric nursing in the same hospital. It was so frightening and stressful I couldn't function after 3 months and I had to resign. I had nightmares of sedated, vented children. I couldn't remember the compatibilities of a drug from the time I looked it up til I walked over to the bedside. The second day I was there an infant had a 10 bt run of v-tach when I laid my stethoscope on his chest. After I resigned it was about 2 weeks before I could get my gear together and get out the door for a gym class. It was just too much organization for my little pea brain to handle.

    I've gone on to some very challenging positions, lots of coordination, priority setting and life and death issues, but PICU was too much for me. So my vote is no, as a new grad you want to give yourself the best chance you can at success with your first job. You won't even know how much you don't know until you've been working for a year on a regular floor, and you'll thank God every day you didn't kill anyone.

    That said, I admit some people are just born PICU nurses, or ER nurses, or whatever. You might be the one, or the orientation might be awesome. How many new grads have gotten through the program before you? If they do this all the time, why not take your shot? Be aware though. If you don't make it on your first shot out know that many older and wiser nurses have tried PICU and failed. That doesn't mean you suck as a nurse, or that you won't shine in another unit. It's just not what you were meant to do.

    Good luck no matter what.
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    okayyyy so I'm a little nervous now...
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    I graduated last May and started in the PICU in June. I was scared to death!!! I finished orientation in September and I have survived and actually enjoyed it! I will say everyday I probably have a little scare where my heart will jump but I just have to take a minute to breath and think. I love the PICU because I love the variety and type of patients. I also have comfort in the fact that the minute something is wrong with my patient there are ten people in the room to assist. I also work at a huge teaching hospital so I have learned a lot from my co-workers. I ask a million questions on a daily basis and I am slowly starting to feel a little more comfortable. I will say that my orientation group is divided, half of the people love it and half look miserable on a daily basis. I think you will know pretty quickly if you will love the PICU. I do believe you should give yourself some time to adjust it.You have opportunity to learn a wealth of information. Good Luck! If you have any questions let me know.
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    Thank You! I'm goign to give it my best. I think I can succeed. I also asked one of my clinical instructors if she thought I was capable of starting in the PICU and she said definately. She said I had the critical thinking needed and that I was a good decision maker. That also made me feel more comfortable.
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    It won't be easy going into PICU as a new grad. The exacting nature of the job will be a challenge. Having a 5 month orientation will be helpful; ask if there's an on-going mentoring arrangement after orientation so that you will always have someone to provide you support. Find out what arrangements are in place for staff development; it's important that you be given opportunities to grow and learn before you're thrown into the deep end without your waterwings. Look for opportunities to learn new things, ask to watch procedures you've never performed, ask to listen to the gallop murmur the myocarditis patient has, look for chances to practice new skills. Make a deal with your preceptor that you will be doing those kinds of things and that you're not there to necessarily do all the "work". If you have a good preceptor, those kinds of things will just happen, but sometimes you have to be assertive and insist.

    Our PICU has seen a large number of new grads in the last couple of years. Our unit has one of the highest acuity levels in the country because of the programs we support (cardiovascular surgery, extracorporeal life support, heart/liver/lung/renal transplants, trauma, neurosurgery and the usual PICU complaints) and the expertise of the physicians we support. It's always difficult to find appropriate assignments in our unit for new grads who are still learning the ropes of being a nurse. And there are days when the new staff greatly outnumber the "old" staff, so the resource aspect isn't always fulfilled. I often find myself, particularly on nights, the only experienced nurse in my section of the unit, surrounded by junior staff members. Because of the kind of person I am, I think everyone deserves a chance to excel, but I sometimes resent being made responsible for essentially supervising the care being provided by others. You may come up against this kind of scenario; I hope the senior nurses involved don't make you feel unworthy or incompetent. You might find that you are one of those born-to-it PICU nurses, or you may find that you really hate it. As Canoehead said, it isn't for everyone, and it's not a failure if you realize it and move on. I would sooner have 32 root canals than work LTC... but I know I'm a darned good PICU nurse. So give it a try. What's the worst that can happen?
    nola1202 likes this.
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    I guess you're right...what is the worst that can happen. I've worked LTC since I'm 16 and I love my residents but I know this is not for me for the rest of my life. I worked on a med-surg floor last summer and I was always jealous of those who worked in the PICU. When I did my Peds rotation, I begged my instructor to let me go to the PICU every week we were there. I really hope I'm going to enjoy my time there. I am intrigued by learning new things, I just hope that I'm able to grasp everything. I hope the senior nurses have enough patience to teach us and I hope that I can learn everything I need to know to have a good base of knowledge to begin.
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    HERSHEY! I did my nursing clinicals there! *grinning from ear to ear* I love that hospital.

    I went straight to PICU as a new grad. I had a 6 month orientation, the first 6 weeks of which were on other floors in the children's hospital, getting to know "regular" sick kids before jumping into PICU. It was the perfect length of orientation, and I've never looked back. They put me on the same weekend as my preceptors so on those times when there's not as much staff around, I at least have my "PICU mamas." (Being the youngest RN by over a year, I'm widely referred to as the "PICU baby.") That being said, I'm also a born PICU nurse. I truly do believe that. I think you're either a PICU nurse or you aren't. And I think you'll find out pretty quickly either way. I started at the same time as another new grad; she quit after 3 weeks.

    I love PICU. To echo an above poster, I love the varietyand the constant changes in my patient population. It's why I wake up in the mornings.

    Best of luck to you! Where did you go to school?
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    I am currently in school at East Stroudsburg University and will graduate in May. What school did you go to? I am hoping I'm a born PICU nurse. I think I am really going to enjoy it. I did my externship there on the fourth floor, which is a med/surg neuro/trauma floor. You may have done clinicals there? Thanks for your advice. Where do you work now?
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    I went to school at Messiah College ... little Christian school in the middle of a cow field, near Harrisburg. I work in Jersey, where I live. Big teaching hospital, which I won't name so I can't get myself into too much trouble with the HIPAA police. =) I did clinicals at Hershey in regular peds, a couple med0surg floors, and a 90-hour preceptorship in NICU. Seriously thought I was a NICU nurse, so I'm glad I accepted my PICU job before the NICU job offers came through!


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