Am I just a nervous new grad or is the ICU not for me?

night_owl_504 · Aug 22, 2008

welcome to nursing... being intimidated is a good thing b/c you very well should be... after all someones life is in your hands. However, with time the anxiety does decrease, but its still always there. Lets face it, its not like if we forget to put ketchup on a customers burger and the only reprecussion is a quick yelling. Nursing is a profession and a very serious one at that. I guess what im trying to say is, your feelings is normal and is a good thing. If you love and feel drawn to the ICU then its for a reason. I say a prayer every time before i walk in the door that I make the best and right decisions for my pt's

Sterren, BSN, RN · Aug 22, 2008

Thanks, I needed some encouragement. I think part of the problem is that friends I graduated with are off orientation and are "real nurses" now and I'm still orienting and feelng clueless. It's a weird feeling. I appreciate you taking the time to reply with your experience, thanks.

athena55, BSN, RN · Aug 22, 2008

Excuse me, but did you not graduate from a nursing program and did you not pass your Boards?

You are a "real nurse". Gosh, give yourself some slack! [smile]

I agree with night owl 504: if you love and feel drawn to ICU nursing that that is your calling.

Hey I have been an ICU nurse for over 25 years and I still feel nervous especially when confronted with a disease process I don't really know or understand. Thats what those large heavy textbooks are for, ha ha.

Please don't be so hard on yourself!

athena

joeyzstj, LPN · Aug 22, 2008

Thanks, I needed some encouragement. I think part of the problem is that friends I graduated with are off orientation and are "real nurses" now and I'm still orienting and feelng clueless. It's a weird feeling. I appreciate you taking the time to reply with your experience, thanks.

Ignore orientation times or what your friends are doing. I orientate several new employess and it isnt always about the skill (or lack thereof) so much as staffing cruches and things of that nature. Sometimes I will have GN's that need 6 more months of orientation :), and my boss will tell me to take them off and send them to night shift becasue we are short. Critical care is a stressful environment even for an experienced nurse, but thats part of the appeal. I have a feeling you wouldnt have went there if you hadnt already known that part. You dont get to just experience Critical Care in all of its glory without going through hell first. You have to read, learn, experince, FAIL and pick yourself back up again to make yourself into the very people that you admire at work. Being a little scared is good for you. It makes you aware and keeps you from killing people. Being so scared that youre going to have an anxiety attack isnt good for anyone. Take the hardest patients that the staff will let you take. Help out with difficult patients on your downtime when other nurses have them. Ask questions from RT, LAB, Radiology, DR's, Other Nurses, Physical Therapy, Metabolic Support. Take note of their mistakes and READ, READ, READ. Books are your friend. You have already done something which Im willing to bet 95% of the people you work with dont do, and thats read and research. Stay sharp by ALWAYS learning. People forget important details of what they are taught. This is why its important to read over and over and over. Check out "The ICU BOOK" here by morino (sp), or HERE on google books. Goole books will let you read part of the book and decide if you want to buy it. Another excellent book is Postoperative care in cardiac surgery. You dont have to work in Cardiac surgery to benefit from this. It has a lot of Drug info and explains physiology in very simple detail. It is very interesting and easy to read. You can get it HERE or possibly read part of it on Google HERE . Learning receptor sites and actions and how each drug effects a specific receptor will help you greatly in my opinion. This is explained pretty well in Bojars book. Good luck.

BTW........In case nobody has told you this, your unit secreatary and the Housekeeper are VERY important people. They can easily make your life great or make it hell depending on how you treat them. Make it a point to treat them well in your unit.

sicushells, RN · Aug 23, 2008

I've been in the ICU for alittle over a year, and I started feeling comfortable about three months ago. It takes awhile, but orientation is supposed to be difficult. You are changing the way you think, the way you prioritize, you're adding new knowledge, learning new practical skills, and on top of all of it trying to figure out how to use those critical thinking skills they talked so much about in nursing school (but don't seem to know how to pass on to us).

If your friends work somewhere else (the floor especially) the degree of intensity is so different that it's not necessary to compare yourself to them. In six months you'll know so much more than them about gtts, vents, codes. YOU'LL be the one they look to when their patients are crashing.

sicushells, RN · Aug 23, 2008

Good luck, btw. And... crying is normal. :yeah:

elizadream · Aug 23, 2008

"If your friends work somewhere else (the floor especially) the degree of intensity is so different that it's not necessary to compare yourself to them. In six months you'll know so much more than them about gtts, vents, codes. YOU'LL be the one they look to when their patients are crashing."

Oh, so you don't think that floor nurses caring for 10 patients have any idea about "DEGREE OF INTENSITY"...so what about gtts (u don't have to figure it out any more..smart pumps..:-{ ) codes..all your coworkers help..YOU're not THE HERO.

THE FLOOR NURSE IS USUALLY BY HERSELF with 5 other pts...when one of her pts. codes...they don't have the luxury of tele monitoring.. try a stent at being FLOATED up to a FLOOR and see how YOU will be be the one looking to THEM to help YOU!

Eliza, rn ccrn

Pittfarm · Aug 23, 2008

Sterren,

I am SOOO glad that you posted this thread. I, too, am a new grad in ICU. I am in my 5th week of ICU orientation on the floor. I passed my NCLEX and went through 4 years of college, but feel like I know nothing! Yes, I know that I am exaggerating, but it is so frustrating to be forgetting so much during a shift. I will learn a new skill or procedure and then forget to do something that I've learned weeks ago and done many times already. I have done nothing that wasn't an easy fix, thank goodness, but it scares me everytime I have forgotten something.

I have a wonderful preceptor and she is incredibly supportive and patient with me. My problem at this time seems to be time management. I have figured it out...as long as I don't take any breaks, don't eat lunch and work connected to a foley catheter, I am close to being on time.....Yes, you may laugh, but it is true. I was caught up the other day until I used the restroom and had a 1/2 hour lunch. That set me back hours it seemed! Ha! Ha!

So time managment and clustering my tasks while in the patient's room seems to be where I need to improve. I'm thinking this will all come with time....I hope!!! Remember you are not alone though. I totally feel and understand your pain! We WILL get there!!! Let's both post on this thread 1 month from now and see how we feel compared to this, ok?

Wendy

joeyzstj, LPN · Aug 23, 2008

Sterren,
I have a wonderful preceptor and she is incredibly supportive and patient with me. My problem at this time seems to be time management. I have figured it out...as long as I don't take any breaks, don't eat lunch and work connected to a foley catheter, I am close to being on time.....Yes, you may laugh, but it is true. I was caught up the other day until I used the restroom and had a 1/2 hour lunch. That set me back hours it seemed! Ha! Ha!
Wendy

Wendy.........Every GN's problem is time management . Thats why you normally start out with one patient and then progress to two patients and then on your own with a preceptor peeking around the corner. I work with a lad who will take a piece of paper and break down each of the twelve hours with a box. She has the GN's go through meds, vitals, wound care, line changes, swan readings, EKG strip charting, ect and has them write down when its due. This sounds a little childish, however it actually works quite well in this situation.

joeyzstj, LPN · Aug 23, 2008

"If your friends work somewhere else (the floor especially) the degree of intensity is so different that it's not necessary to compare yourself to them. In six months you'll know so much more than them about gtts, vents, codes. YOU'LL be the one they look to when their patients are crashing.

"

Oh, so you don't think that floor nurses caring for 10 patients have any idea about "DEGREE OF INTENSITY"...so what about gtts (u don't have to figure it out any more..smart pumps..:-{ ) codes..all your coworkers help..YOU're not THE HERO.

THE FLOOR NURSE IS USUALLY BY HERSELF with 5 other pts...when one of her pts. codes...they don't have the luxury of tele monitoring.. try a stent at being FLOATED up to a FLOOR and see how YOU will be be the one looking to THEM to help YOU!

Eliza, rn ccrn

Eliza..........the person that wrote that was attacking YOU personally and didnt say the degree of intensity is HARDER, but that it was "Different", which it is. I take offense to your reply trying to downgrade what we do. Many hospitals dont use "smart pumps" as you call it. We actually DO have to know how to figure drips, and we even know what they are used for. In regard to the codes and monitors, your statement is so completely ridiculous its funny. Having a monitor in a unit isnt a luxury. The typical critical care nurse is responsible for knowing identifying a wide variety of rhythms and treatment for these rhythms (Outside of basic ACLS class), adjusting drug class and doses based on that information, taking that information and putting it together with labs, and other body systems information, ventilator settings and mode information, Pulmonary Artery catheter information and drug changes, Art line and Swan waveforms, Balloon pumps, external and internal pacmakers knowing how to be a dialysis nurse, and OR scrub for many besdside procedures, identifying complex life threatening situations based on the information we have the "luxury" seeing on the monitors and then trying to manage ALL OF THIS with a smile while the crying sick family is laying over their family yelling at you becasue they need an outlet for their anger. In the meantime you have the surgeons doing the same. In regard to having the "luxury" of things, we dont have the luxury of a med nurse to do all of our meds, a Rapid Response team to call if something goes bad, ect. You and both know as well that a code isnt ran by one of the nurses on the floor. A code team or Rapid response team is called to that room and takes over. What you fail to forget is most of that code team comes from WHERE???...............Thats correct, Critical Care and Respiratory Therapy. I have no ill feelings toward any floor nurse, but this type of attitude really bothers me. We all have stress. You have the stress of multiple patients and we have the stress of complex situations with a few patients. So, please spare me the inferiority complex, becasue I have been in both positions and there is no comparison. Why dont you try it sometime. You might be great at it will all of the skill you already proclaimed to have. Seriously, there are shortages everywhere and a huge turnover rate in Critical Care. I work with nurses everyday who have done both and one even works in both postions as we speak. Take a chance and try it out. I think you will see that you are sorely mistaken in your views.

BTW........I think the fact that your reading through the ICU section of the site shows that you already have some interest in it. Am I mistaken?

Pittfarm · Aug 23, 2008

That is a great idea. I grid of tasks throughout your shift. I think I'll work on making something like that this weekend. I don't think its childish though because until it becomes 2nd nature to me, I just can't remember every single thing. Dual tasking is just not happening for me very efficiently! :)

Thanks for your suggestion!

Wendy