A year and a half into ICU nursing and still not feeling like I'm getting it

salexandra · Feb 19, 2019

4 hours ago, Ruby Vee said:
Thank you for your take.
It absolutely blows my mind that you chose to get on my post, and those are the words you chose. You could easily have chosen to be kind, but chose to be snarky instead. It rather invalidates your take, because if kindness is so much more important than honesty, you could have chosen to model kindness, but you did not.
The struggling new nurses that were once taken under my wing are now nurse practitioners, CRNAs, nurse leaders and lifelong friends. I don't think I've done so poorly as a preceptor and mentor.

Advice that you had given was incredibly valid, in fact parts of it made me feel better. But I don’t think I am being crazy or overly emotional by being hurt by the way it was expressed. I feel my original post already made it very obvious how low I felt. Like I said to Tricia, I found it hard to be inspired when I was being knocked down at the same time. Once again, I’ve heard constructive criticism: “You need to manage your time better, here’s what you’re doing wrong and this is what I do” vs. “I just cannot understand how you’re STILL not getting it? Of course you aren’t getting it!!”

However I did react out of hurt, I am sorry. And the seasoned nurses of the world are a gift.

salexandra · Feb 19, 2019

6 hours ago, Aliens05 said:
Salexandra, on a side topic, how the heck did you ever find a job that offered no weekends???? This is what I lay awake at night praying for haha....
On the main topic I am sorry that I cannot give you any advice as I myself am a brand new nurse, never worked in a hospital yet. Good luck to you and keep your head up even when times get hard.

Haha I got very lucky!! This hospital has so many weekend workers they don’t need us!

salexandra · Feb 19, 2019

5 hours ago, TriciaJ said:
These were the standouts for me, too. Also the belief that coworkers should be making more of an effort. Heck, maybe even they should. But whether they do or not is another thing.
This is the umpteenth thread where a new grad expressed having problems, got some advice (blunt and otherwise) and then blew up with anger and sarcasm. At least this one hasn't accused anyone of being jealous of her youth and good looks. So far.
I notice the usual crowd doesn't even bother to weigh in anymore. We've all been told too many times that we're all bitter and no one wants us for their nurse. Okay. Carry on. You do you.

I would never say that and 100% do not feel that way about the looks. Nothing to do with the job. I believe in solidarity of women and of nurses which is why hateful nurses bother me so much. I don’t see anything rude about my reaction to being told to suck it up, when quite clearly that is what I have literally been doing for 6 months now and will continue to do. Treating new nurses with little compassion and patience is indeed what is wrong with nursing culture. The very fact that you all do not think current employees should go out of their way to be kind and encouraging to new employees is so sad to hear.

If you continue to get negative responses, maybe change the way you respond?

AceOfHearts<3 · Feb 19, 2019

You came here asking for advice and didn’t like what Ruby had to say. Ruby gave you some tough love- you’re in your third job in less than two years!!! You can’t afford to quit again. You’re an adult now and have adult responsibilities, so yes you do need to suck it up for a bit. And trust me, I know what it is like to have a job you absolutely hate. I sucked it up for 1.5 years and I’m better for it.

I’m friendly to the new hires in my ICU. I don’t say I’m friends with them yet as that takes time. I’ve been at my current job for 2 years and I’m not friends with that many of my coworkers outside of work. As another coworker says- I’m there to work and not make friends. I have plenty of friends outside of the job.

If you need help making friends join a meet-up group- that is literally what they are for (making friends).

Have you reached out to the clinical educator at your job? They might have some resources that will help you.

Ruby Vee, BSN · Feb 19, 2019

6 minutes ago, salexandra said:
I would never say that and 100% do not feel that way about the looks. Nothing to do with the job. I believe in solidarity of women and of nurses which is why hateful nurses bother me so much. I don’t see anything rude about my reaction to being told to suck it up, when quite clearly that is what I have literally been doing for 6 months now and will continue to do. Treating new nurses with little compassion and patience is indeed what is wrong with nursing culture. The very fact that you all do not think current employees should go out of their way to be kind and encouraging to new employees is so sad to hear.
If you continue to get negative responses, maybe change the way you respond? 

You didn't say your colleagues were hateful; you said they were mostly nice but didn't go out of their way to make friends with you. That's different from being hateful. Being kind and welcoming to new employees is different from becoming best friends with a new employee without getting to know them first.

Your colleagues already have friends in the area; they aren't desperate to make friends the way that you seem to be. I understand that as well -- I've been there. I've also been the established employee with whom a new employee desperately wants to connect . . . and sometimes that's problematic. For one thing, we're told we shouldn't be going out with new employees we might have to evaluate. It makes sense. Try joining a church, or meeting people who may become friends at the gym, the community pool, a special interest group.

As preceptors, part of our job is to help the new employee acclimate to our community. We don't have to be your new best friend -- we just need to be able to tell you that "people your age seem to like the Iron Rooster," or "I don't personally have a dentist I can recommend, but I know Trudy lives not far from you, and her kids have had a lot of dental work. Let's go ask her."

But the best advice I -- or anyone -- can give you is learn to accept and benefit from negative feedback, even when it's given in a way you don't like. (Because feedback is almost never given in a way that you like.). That, and the piece of advice that you've noted yourself: If you don't like the responses you're getting, look at your own behavior.

mtnNurse., BSN · Feb 19, 2019

6 hours ago, TriciaJ said:
This is the umpteenth thread where a new grad expressed having problems, got some advice (blunt and otherwise) and then blew up with anger and sarcasm. At least this one hasn't accused anyone of being jealous of her youth and good looks. So far.

Oh my gosh, has someone really accused older, experienced nurses of being jealous of the young'ns good looks?! Absurd if so! ?

6 hours ago, TriciaJ said:
I notice the usual crowd doesn't even bother to weigh in anymore. We've all been told too many times that we're all bitter and no one wants us for their nurse. Okay. Carry on. You do you.

I feel for this new nurse who is sensitive and wants what she said those "millennials" want regarding feedback, and my heart goes out also to the older, experienced nurses. I honestly can't imagine how anyone could work as a nurse in this country for decades and not become bitter, and if one of you has managed to do so then you are a hero (well, you're probably a hero even if you have some bitterness too)! I would want you for my nurse!!! If I were a patient (knock on wood), I would take an older, bitter, highly experienced nurse any day over a young, inexperienced one who doesn't understand how to prioritize appropriately yet and might fluff my pillows or instantly bring me coffee but won't instantly recognize it if I get sepsis. I think one of the biggest problems in hospitals is not having enough older experienced nurses who are given enough time to properly train new nurses. In many places of work, it's the blind leading the blind because conditions are so bad that experienced nurses flee.

I really think nursing schools would do a great benefit to students to devote an entire class on training new nurses to develop the "tough skin" needed to survive in real-world nursing jobs. It takes tough skin to handle abusive patients and also to advocate for patients. It takes tough skin to handle stressed co-workers. It takes tough skin to handle understaffed hospitals and to know where your limitations are. And it takes tough skin to stand up to bosses when they demand you do so much work that you are no longer able to give adequate care to each patient.

Anyhow, god bless all you older, experienced, bitter nurses in the world and know that many people have been grateful for your service and kept alive because of it!!!

guest1048932 · Feb 19, 2019

I see that you're very frustrated with this, and that has come out strongly on your replies. Here's something to consider: Read things over a few times before replying. It's ok to feel offended, or like someone is rude, but emotion does not come out over the internet. I personally did not find Ruby's reply to you at all rude. Read it again a few more times. Try and read it over as calmly as possible the last time. Those words were not meant to be offensive. Remember, these nurses are truly trying to help you out and give you some good sound advice. In fact, they have given you good sound advice.

In terms of your job: You do not have a lot of experience in ICU. I'm not saying this to be mean. You have had three jobs in 15 months, not 15 months of one job. I've heard it takes a minimum of two years in one position (no switching!) to learn the ropes. It takes 5 years of working the same position on the same unit to get truly comfortable with things. Like another poster has said, you have 6 months of experience in three different units. While that does add up to about 15 months overall, you need to stick to something longer than a few months to gain any sort of confidence. You need a minimum of two years. Don't keep switching. You may be a jack of all trades at the end, but a master of none.

Lastly, it sucks being a new nurse. It sucks trying to make friends on the unit. As a general rule, many nurses don't make friends at work because they just want to come in, work, and go home. They don't want to have lots of friends at work because they don't want to talk about work at home (or home at work). I learned this the hard way when I complained at my workplace (two months in!) that "No one wants to go out for dinner on our days off, and they don't want to do anything outside of work!" One of the nurses took me aside and said: don't take it personally. We see so much of each other at work that we don't want to see each other when we're not here. It's not you. We've also found that by distancing ourselves, we don't get sucked into rumours and all sorts of other things. Separate work from home life. You'll be a better nurse for it.

Bearcat-RN · Feb 19, 2019

I am a BRAND new nurse, so I’m not sure how much I have to offer on this post, but I am a millennial so...

You’re right when you talk about teaching styles. I found that many of my classmates, and myself, typically benefited from the professors or clinical instructors who were “less blunt”. However, I feel like your approach is just way off base. First thing I would say is when you post and ask for advice, you are putting yourself out there. There are thousands of nurses on this site with their own backgrounds, experiences and beliefs, and it is important to realize that you are quite literally asking for their opinions. As an unbiased third party, I can maybe see how Ruby’s post got under your skin or aggravated you. However, sometimes what you want to hear and what you need to hear are two different things. It doesn’t take nursing experience to know that. Nursing is a second career for me, and I have had multiple jobs where I have felt similarly to how you do. I also feel like I am someone who is pretty easy to get along with, but I think it’s important to acknowledge that it is not their job or responsibility to make you feel comfortable. Yes, it would be great if they did and would make it a much more pleasurable experience, but they are there to do their job, not necessarily make friends. I’m not going to knock you for having three different jobs in 15 months, but you truly haven’t allowed yourself to get settled in anywhere completely. I would just suggest to give it some time, and allow the friendships and relationships to grow organically. It’ll happen.

I know I am not telling you anything that hasn’t already been said, I just thought maybe hearing it from a new nurse and someone similar to you in terms of age would maybe help a bit. Best of luck.

guest1048932 · Feb 20, 2019

38 minutes ago, Bearcat-RN said:
However, sometimes what you want to hear and what you need to hear are two different things.

Excellent point Bearcat-RN! I've worked with some really unpleasant people, but sometimes you need to step back and look at it from a different view. Just because it hurts to hear doesn't mean that someone is being mean. I was pulled aside as a new RN and told about something I did wrong. The person was blunt, told me what I did wrong, and out of the goodness of her heart, walked me through how to do it properly. I learned from that experience, and this nurse and I work together well.

As for the OP: Kindness is nice, but in the end, I will always take honesty over kindness. Imagine if you messed up something really badly, and a nurse corrected and covered up your mistake for you. Instead of telling you about your mistake, the nurse told you, "You're doing a great job! You're so smart!" You don't learn from your mistake, in fact, you gain a false sense of security and confidence. This is so dangerous, because then you get into a matter of, "Well, I've always done it this way and no one has told me it was wrong."

rn409, BSN, RN · Feb 20, 2019

On 2/18/2019 at 12:34 AM, salexandra said:
I hope this topic helps me, along with other nurses stuck in the middle like myself.
So my background: I graduated nursing school in May 2017. I passed my NCLEX in July '17 and was hired right away onto a SICU at a level I trauma center/teaching hospital. I was miserable the first 4 or so months of my job, as I had very little confidence and had an incredibly patronizing preceptor. I thought I was an idiot and had no business being a nurse, much less an ICU nurse. However, by 6-7 months in, I started to gain some confidence and felt fulfilled through my job. I started on night shift with 6 other new grads, and I found many friendships at this jobs as we always had 8-9 workers at night. However, I was moving to South Carolina to live with my boyfriend I had met in college. I was very sad about leaving this job, but was hopeful for my future. I'd like to think of myself as very easy to get along with and likable.
I accepted a job at a very small hospital- 8 bed general ICU but a day shift position. This job was a nightmare. It was incredibly short staffed, I was floating to the floor (which I had no training on) constantly, and I felt my license was at stake. I also did not feel challenged enough on my nursing and critical thinking skills. This being said, I applied to a larger hospital in the city on a CVICU where I thought I would be a lot happier. It was night shift, but no weekends and I was going to have a higher base pay too. I also thought it would be a way to make new friendships as I hoped their would be other nurses close in age to me there as there weren't at the small hospital.
I started on this unit back in August (maybe 25th?), and right away was very intimidated by it. I quickly realized how completely different a surgical ICU is from a cardiovascular ICU. I had no knowledge about the heart, how to admit an open heart patient, and honestly all of my critical thinking skills were incredibly rusty from being away from the SICU for the past 4 months. My preceptor was very nice, but I began to hear word from other workers that she teaches her new hires basically nothing.
I was fairly content on day shift orienting, but as soon as I flipped to being off orientation onto night shift, my overall feelings completely changed. For one, there are maybe only 4-5 nurses on night shift as we usually only have 5 patients or less. They were never welcoming from the start. I don't mean to speak poorly of them, as they're nice enough, but they just did not go out of their way to befriend me despite my own efforts. As I previously stated, I was used to being surrounded by a bunch of other new grads and a large staff at night at my first job.
Secondly, they all have 2-5 years of CVICU experience, so I struggle a lot to relate to any of them. I constantly fear looking or sounding stupid as my concerns and questions are not ones they can relate to at this point in their nursing careers.
Third, I feel stupid ALL the time on this unit. It has been 6 months, and I feel as though I'm asking questions that the other staff feels I should know the answers to by now. I still struggle with my confidence on this floor greatly- a huge reason being that I learned by relying on paging a resident for every single problem I came across with a patient to now a non-teaching hospital where I have to rely on my own instinct and protocols to make incredibly important decisions.
Lastly, to make matters all the worse during my M-W shifts, I don't see my boyfriend at all. I understand why this may seem like a silly point to make- but I still have no close best friends in the area and he is my entire support system. So, basically, through each work week, we go until Thursday nights without contact except for quick 30 minute phone calls when I'm driving from and he's driving to work in the morning. With little support from my coworkers and little interaction with my best friend, I'm feeling so isolated and depressed at this new job.
Now with my background covered, I suppose my problem and question is has anyone else been past their 1 year mark in their nursing career and still struggled with confidence in their knowledge? I guess I justify it to myself constantly that I feel as though I started over completely in my nursing career when I started on a CVICU. We have to make so many critical decisions I never had to make on my own previously. I also am learning the body in totally different way of thinking, as I said before, knew nothing about the heart. I had felt incredibly confident at my last place of employment, so I just think the unit has something to do with it. I know I wanted to be challenged, but this is just depressing.
I constantly consider applying to a new job or returning to the job I was at before this current one. At least I was miserable with an incredibly supportive staff and saw my boyfriend. However, I am dying to just be somewhere for at least a year and I'd feel like I'm only complicating my critical thinking skills further if I leave after only 6 months at this place. That would be 8 months at one place, 3 months at another, and 6 months here. I should try to stick to something. But then I just think that maybe I am incapable of learning critical thinking and I should just apply for a slower paced job somewhere.
Can anyone out there relate? Please say yes.

Definitely know how you feel, but I think you might want to hang in there. Give yourself some credit, you just started something totally new 6 months ago. It took me a solid 2 years to feel somewhat comfortable in the ICU. It doesn’t even sound like ICU is your problem, it sounds like the people. I would still try to give them a chance, but I know I would t be happy at a job with people I didn’t care for.

Workitinurfava, BSN, RN · Feb 20, 2019

You need to be in a place where you can manage the position before moving up to another position. Please don't rely on others to feel a void in your confidence level. You will have to work on that part yourself. At the same time, you want to be around people that you know you can open up to and people that understand what your needs are. Honestly, if age is on your side ( you are young enough to take your time in advancing) and you can take a step back, do it. You are the one that has to go to this job and work it. You can later get into the area that you really want to be in. The positions aren't going anywhere. You would not be quitting. Quitting is if you just stay put and never try to go where you really want to be. You would just be taking it slower. You can still end up where you want to be at a slower pace.