Anyone regret starting in the ER or ICU?

Sabira · Oct 28, 2007

I accepted my first position in ICU and regret this decision. Perhaps I am just not the right canidate for an ICU position. You really don't have the time even with two patients for psychosocial needs. You are there to treat the physical.

I find it to be an overwhelming experience as a new nurse with huge responsibilities. I should mention, however, that my preceptor is extremely high strung, overworked, and lacking patience. Also, my co-workers seem to "eat their young" and are not giving me the support I so badly need.

Patients often come up from the ER with many many drips, several that are titrated. You really have to be on the ball or else you can hurt someone. I think a year of med surg then some tele experience would be a smoother transition to ICU or ER. Then again, perhaps a more supportive environment would yeild a more positive experience.

MelBel · Oct 28, 2007

I didn't start in the ICU, and am VERY glad that I didn't. I had considered it, and in talking with experienced nurses, decided not to.

Reasons I'm glad I didn't?

1) As a new nurse, one or two lines going into each patient is plenty.

2) When a patient goes downhill, and I am overwhelmed and at a loss for what to do...most often I send them to the ICU. In my experience transferring patients there, there is just too much to know for someone new (or maybe just me) to NOT be overwhelmed.

3) I was told by my nurse recruiter that although new grads often do well in the ICU, she feels med/surg is important. For example: I had a patient have a massive MI. This patient was non-verbal and lethargic to begin with, and in order to determine there was something wrong with her, I had to pick up on subtle cues, use my judgement to take her vital signs, and determin something was seriously wrong.

The nurse recruiter told me one of the main differences in ICU vs. Med/Surg is that in the ICU, the patient is hooked up to who knows how many monitors telling the nurse when/if something goes wrong, and she is responsible to fix it. In Med/Surg, things probably go wrong less frequently, but the nurse must use her own resources to know that something is wrong.

I don't love Med/Surg all the time...but I look back at how much I have learned, and do not at all regret not starting in an ICU. I have gained experience that I wouldn't have been able to anywhere else.

Dbb82 · Oct 29, 2007

You cant really go by people's advice on where to work, go where you felt the most comfortable with.

Im getting advice from the people on here not to go to the ER and go to MS first as a new grad, but nurses that I know told me to go straight to the ER just like they did. One particular nurse went MS route before goin to the ER, but she told me that I would be fine going straight to the ER since she knows how much I hate bedside nursing.

meandragonbrett · Oct 29, 2007

I went straight to the unit and never looked back.

PiPhi2004 · Oct 30, 2007

I agree with the other posts, it really depends on if you are a good fit for the area. I am a new grad orienting in the MICU, and I find it really challenging and exciting. However, you may not. You really do depend more on physical needs, so if you like that bonding time with patients, it might not be the best place for you. I'd make a list of things you would like to deal with, and things you dont like to deal with. Also it depends on how well your preceptor is and other hospital politics. But wherever you go, remember you can always change your mind! Do what makes you happy! Good luck!

krisjazzer13 · Oct 31, 2007

I jumped into a general ICU head first after finishing school and don't regret it one bit! I also have an extremely supportive environment that helped me gain confidence in my skills...although I have to admit that I felt very stressed/unsure during orientation if I was really going to be able to manage these types of critical patients (but that feeling soon passed...an experience that many new nurses before me have had!) If you are determined, you can do anything

longjourneydream · Oct 31, 2007

Hi all,

I need an ear so I can vent.

I graduated in May of this year, and started working in June in the ER.

I have 1.5 years experience as an ER tech,17 as an aide. I have 7 years total hospital experience in the same hospital I work at now.

In the beginning I was with my assigned a nice preceptor who built me up, and felt I was doing a wonderful job. Every day I was told, what a great job I was doing. Even when I felt it was not all that great YET.

Before my 12th week I would be up to 4 patients, and starting to feel good about my skills. Then I was let to go on my own on my 12th week.

Season here in FL is from Sept to about April, and very heavy starting November to March.

I have felt the pace now, and now beginning to fall apart.

EX:

I have been told. "Get the admissions up to the floor now, while my patient in room 9 has rapid A-fib, with no IV established.

They pull my admission out of my room to finish while another,is put in there to assess.

In the mean time one charge nurse is telling me get this patient out of here and up to the floor, and my supervisor working with patients is saying NO IV LINE IN 9. Needless to say, I told my supervisor I was not ready to deal with this fast pace yet, and that I needed more training.

My paper work is suffering, my morale is at an all time low, and they are telling me that they are worried about me being too stressed out.

What can I do?

Yes I have told them I need more training, and cannot run with the big dogs yet. They all have these high expectations of me, but you cannot make a full grown dog out of a pup in just 4.5 months, I belive the pup needs a year to become an adult.

The doctors have not had a problem with me yet, and I have worked well with all of them.

I have told my supervisor I am unsafe to practice at full capacity, but they did not want to listen to me!!!

Each nurse has a 4 to 1 ratio. The new plan would be for me to stay on day shift take on 6 patients with a highly seasoned nurse, I take 4 she takes 2 (she would also be the charge nurse). I really don't know if that would be a great idea either, charge has a great responsiblility.

The other option would be to train with a 3p- 3a nurse who would not be the charge nurse, and I know her she is a great nurse, a great mentor.

These are now my options.

I was told that they would not like to see me lose my licence, after just getting it, due to burn out...

I am at a loss right now.

Critical thinking comes with time, I feel it is not instant.

Any advise?????

I jumped into a general ICU head first after finishing school and don't regret it one bit! I also have an extremely supportive environment that helped me gain confidence in my skills...although I have to admit that I felt very stressed/unsure during orientation if I was really going to be able to manage these types of critical patients (but that feeling soon passed...an experience that many new nurses before me have had!) If you are determined, you can do anything

cherokeesummer · Nov 1, 2007

I started in a level four NICU and I thought I was ready because I had done my internship in a level three nicu and I figured it would be close, not the same but close.

It was a different hospital though and not only did I need to learn how to be a new nurse but also a new way of doing things b/c of a new hospital, etc. and the push on new grads to be fast is really hard. I asked (along with several others over the past few weeks) to be transferred to a general care unit (peds).

I think if you can hang with it, go for it! I think I would have been ok if I had been at the same hospital that I went to school at, who knows. I will try higher acuity later on when I've had more time and skills but I don't think that you have to have general care first, I think many people can do great with straight into high acuity.