Advice please? Stressing and struggling new nurse in ICU and not doing well

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Specializes in new nurse.

I have a few weeks till the end of my orientation. I am a freshly graduated nurse who is working on the ICU. I really like my unit and finds the staff really helpful and really to help me learn new things. The past few weeks have been pretty bad especially last week. It was the busiest week for me and the unit in general especially with everything picking back up. I had a few transfers and keep getting new admissions. I made some mistakes or did not catch on to certain things, so my preceptor had to correct me. I learn from them and know better now. My confidence was slowly being built and I thought I was doing okay. I do forget to do certain things, but I am honest about it when my preceptor ask. I knew that I had things to work on, but didn't know it was that bad.

I had my first meeting in regards to my orientation and it went really bad. They were saying that they felt I might not be the best fit for the unit and I really need to prove myself. They said that I seem unsure when I am talking to doctors and seem like I don't know anything about my patients. I have horrible time with rounds and talking to doctors in general. I am a pretty shy person who, which as my username implies, lacks confidence in general with myself due to years of just being talked down to all my life by everyone even my loved ones. When I am questioned, I blank out even when I know my material. I am trying to improve myself as best as I can and trying to review my material. They say I lack critical thinking and don't understand why the other new orienteers are doing better and why I am struggling. (the other orienteers have experience either as a nurse or a PCT on the unit). I have a heavy accent as well as English is not my first language. I was told to learn how to talk especially with my pronunciation with the drugs. 

I am trying really hard now to review and to somehow build more confidence in myself in the next few days that I am off. I am writing different words down, looking up their pronunciation and repeating them to myself. I plan to come even earlier than I have been to look up patients' charts.  However, I would admit the meeting really made me lost the little confidence that was slowly being built. I feel so overwhelmed and don't want to lose my job. I really love nursing and the patients in general, so I want to be able to improve myself as best as I can to show that I really do want to be here and be able to perform at the level they want me to. I could really use some advice on what I can do to improve myself and tips. Thank you. 

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

You only have a few weeks left and you just had your first meeting to review progress? How long is your orientation? Did they provide you with measurable goals or milestones to reach? Is there a chance that you could transfer to another area? 

I grew up listening to accented English, so I have no issues with accents. Please don't ever apologize for being smart enough to speak more than one language. ? Learn how to talk? Really?? That is an awful thing to say to someone! 

 

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I’m so sorry that you are going through this. If your supervisors are saying that you’re not a good fit, did they have suggestions for you? Like maybe transferring to a less acute unit? Nursing is really hard especially going into ICU as your first job. If I were you, I’d probably strongly consider what they are saying and ask for a transfer or look for another position elsewhere. I hope you can be kind to yourself and maybe seek some counseling for your self esteem and anxiety. Hugs ❤️

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Specializes in new nurse.
6 minutes ago, Pixie.RN said:

You only have a few weeks left and you just had your first meeting to review progress? How long is your orientation? Did they provide you with measurable goals or milestones to reach? Is there a chance that you could transfer to another area? 

I grew up listening to accented English, so I have no issues with accents. Please don't ever apologize for being smart enough to speak more than one language. ? Learn how to talk? Really?? That is an awful thing to say to someone! 

 

It is about 12 weeks long? I am in my 9 week starting next week, so I should have 3 more left. I would be going to nights on week 10. Yea, it was my first one to review progress so I was caught off guard. My other friends said they have theirs every 2 weeks or at least a few times. I didn't realize it was a thing. They told me to step it up and suggest for me to review my material again by using a critical care book and just improve my confidence. They did not mention any transfer options and I don't think there's any openings in the hospital. Yea, I was a bit stung when I heard that comment. Thank you for replying to me.

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Specializes in new nurse.
10 minutes ago, jobellestarr said:

I’m so sorry that you are going through this. If your supervisors are saying that you’re not a good fit, did they have suggestions for you? Like maybe transferring to a less acute unit? Nursing is really hard especially going into ICU as your first job. If I were you, I’d probably strongly consider what they are saying and ask for a transfer or look for another position elsewhere. I hope you can be kind to yourself and maybe seek some counseling for your self esteem and anxiety. Hugs ❤️

They didn't mention transferring, more I need to improve my confidences and need to go back to critical care books. The funny thing is finding a job was so hard for me. It took me a few months with the whole situation of cov19 and hiring freezes. This was actually the only job that was offered to me and I took it. I mean, I did like the unit and actually planned to start with med surg, but somehow, I got hired on this unit. I applied to everything too. Thank you for your kind words and for replying.

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

Not sure if this might help, but it popped into my head! 

https://www.toastmasters.org/about/all-about-toastmasters

Probably more of a long-term thing, but it could help you build your confidence. 

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Specializes in Vents, Telemetry, Home Care, Home infusion.

It took me 3 months as new grad to understand my RN night shift supervisor from Thailand; she had a accent  + rapid speech pattern. My aides repeated what she was telling me.  She was a brilliant woman and ran entire hospital night shift.

Two years latter, I took her to my Nursing Cultural day as a guest speaker-- fellow students were upset as couldn't understand her.  So others have dealt with this issue.  Speaking slower and enunciating words might help you. 

Your confidence will grow with PRACTICE and time.  Do you have friends or supportive RN at work you can  practice  giving report/talking with doctors? Prepare SBAR and run it past them for critique; otherwise ask to practice with your precepter.

You should have measurable goals or milestones that you need to meet to complete orientation.  Take the next day off to decompress then think what you CAN DO to work on the concerns.

Check out Notes on ICU Nursing   http://www.icufaqs.org/  

Great site with lists of  topics and FAQ's.    See the section: Starting Out - New in the ICU at top of page.

Don't get discouraged. Over the next 2 weeks decide if you want to continue in ICU or request transfer to less acute setting.   Hope you find the best position for your skills.

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27 minutes ago, lackofconfidence12 said:

They didn't mention transferring, more I need to improve my confidences and need to go back to critical care books. The funny thing is finding a job was so hard for me. It took me a few months with the whole situation of cov19 and hiring freezes. This was actually the only job that was offered to me and I took it. I mean, I did like the unit and actually planned to start with med surg, but somehow, I got hired on this unit. I applied to everything too. Thank you for your kind words and for replying.

I think it’s hard all around right now. Do you have any outside and at work support? There is usually free counseling through your employee assistance program. I strongly urge you to seek counseling as it feels like you are maybe blaming yourself when it sounds like you didn’t get any direction or feedback. That and the statement you made about not having a supportive environment while growing  makes me concerned about your mental health. My thoughts are with you tonight as I have been in similar situations and I had a terrible childhood. Counseling and many years of psychotherapy have changed my life. You can private message me anytime and I will support you. ❤️

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Specializes in new nurse.
10 hours ago, Pixie.RN said:

Not sure if this might help, but it popped into my head! 

https://www.toastmasters.org/about/all-about-toastmasters

Probably more of a long-term thing, but it could help you build your confidence. 

Thank you! I will look into it!

2
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Specializes in new nurse.
9 hours ago, NRSKarenRN said:

It took me 3 months as new grad to understand my RN night shift supervisor from Thailand; she had a accent  + rapid speech pattern. My aides repeated what she was telling me.  She was a brilliant woman and ran entire hospital night shift.

Two years latter, I took her to my Nursing Cultural day as a guest speaker-- fellow students were upset as couldn't understand her.  So others have dealt with this issue.  Speaking slower and enunciating words might help you. 

Your confidence will grow with PRACTICE and time.  Do you have friends or supportive RN at work you can  practice  giving report/talking with doctors? Prepare SBAR and run it past them for critique; otherwise ask to practice with your precepter.

You should have measurable goals or milestones that you need to meet to complete orientation.  Take the next day off to decompress then think what you CAN DO to work on the concerns.

Check out Notes on ICU Nursing   http://www.icufaqs.org/  

Great site with lists of  topics and FAQ's.    See the section: Starting Out - New in the ICU at top of page.

Don't get discouraged. Over the next 2 weeks decide if you want to continue in ICU or request transfer to less acute setting.   Hope you find the best position for your skills.

Talking in general is okay, but I have issues with the medical terms! I will try your advice! I have been looking into speech therapy for accent modification or extra help, but they are expensive!

I do have some nurses friends to help with and I will definitely planning to practice with them. 

Thank you for your kind words! I will definitely work my butt off these two weeks to prove that I can stay in that setting.

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Specializes in new nurse.
9 hours ago, jobellestarr said:

I think it’s hard all around right now. Do you have any outside and at work support? There is usually free counseling through your employee assistance program. I strongly urge you to seek counseling as it feels like you are maybe blaming yourself when it sounds like you didn’t get any direction or feedback. That and the statement you made about not having a supportive environment while growing  makes me concerned about your mental health. My thoughts are with you tonight as I have been in similar situations and I had a terrible childhood. Counseling and many years of psychotherapy have changed my life. You can private message me anytime and I will support you. ❤️

Work support, not really. I don't think they have anything like that. I do have support with some of my friends who are nurses. They're the one who actually told me that they felt like I should have an earlier meeting, instead of almost to the end of orientation. So I am going to work hard and prove them wrong. My childhood definitely made me a nervous wreck that I am today with lack of confidence. Everything was never good enough and being the oldest of 5 siblings did not help at all. I was constantly compared to my other siblings and I actually ended up going to nursing school as a second degree, but it is never good enough for them. I have had therapy before in college and it helped a lot, but they stopped when I graduated. I do plan to get therapy when I can, but expenses now are really tight. I actually moved out a few months ago to get out of that environment and say that I'm a lot happier than before and better in terms of mental health, but of course, things don't change in a day. 

Thank you for your kind words and I really appreciate your support.

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I think every nearly work place has an employee assistance program especially if you are working in a hospital. It would be listed in the HR info. Or you could call HR and ask. 

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