Baby RN's running ICU?!!

Published

My particular unit has had such a huge turn over even in the last year that it is now mostly staffed with new grads on my shift (night shift). Baby, baby nurses are being thrust out and literally learning thru the trial by fire method. I have nothing against new grads in ICU, as I started out the same, but so many at once?? It scares me to death because it's a high acuity unit (level 1 trauma & teaching center) and it's the blind leading the blind! I've got 5 years ICU under my belt so I'm considered the seasoned one, but the thought of leading a unit full of babies freaks me out. It's a huge safety issue!

Are you guys having the same problems & concerns??

Specializes in CVOR, CVICU/CTICU, CCRN-CMC-CSC.
In our ER we hire new grads, but in "the City" they don't. So we get a new group of 6 or so every year, they get their certifications and their orientation, and 80% quit and go to the City. Then the old hags like me start again. Constant orientation without getting any benefit from it gets old. We produce some amazing and knowledgeable ER nurses, and just as they start to get good, they leave.

My preceptor was just talking about this a few months ago when I mentioned I wanted to stretch my legs at a trauma center after a year in my current CAH. After her lament about training good nurses and watching them walk out the door, I asked her why she put up with the thankless cycle. By the end of the conversation, I had talked her into "sticking it to the system" and finding a more appreciative work environment. I really wonder if her leaving will help change the administration's current attitude toward its very valuable preceptors.

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Specializes in CVOR, CVICU/CTICU, CCRN-CMC-CSC.
I occasionally get the attitude giving report to the older, experienced days nurses that I don't know what I'm talking about or they openly question why I have been given such sick patients with so little experience.

I hear ya! I work in a critical access hospital with ICU, ER, and med-surg capabilities. When I was scheduled as the only RN working the floor one night at not even 1 full year of experience, the look on the day shift nurses' faces when I gave report on a total of 9 patients (2 criticals, 1 ER, 6 med-surg) would have been enough to curl one's toes. Even one of the on-coming CNA's said ("well, that doesn't sound very safe"). Talk about feeling drained!

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Specializes in NICU, PICU, PCVICU and peds oncology.
My preceptor was just talking about this a few months ago when I mentioned I wanted to stretch my legs at a trauma center after a year in my current CAH. After her lament about training good nurses and watching them walk out the door, I asked her why she put up with the thankless cycle. By the end of the conversation, I had talked her into "sticking it to the system" and finding a more appreciative work environment. I really wonder if her leaving will help change the administration's current attitude toward its very valuable preceptors.

It won't. This scenario has been playing out on my unit for at least 5 years. The solution to that was to have the most recent people off orientation precept the next group. Those of us with the years of experience and the knowledge base to be effective preceptors may be "buddied" for a shift toward the end of their orientation but by then it's too late. Two out of the last three people I was buddied for a single shift this calendar year with have left already. One left right as her orientation finished because she came to us with several years' experience but was oriented to the unit by a new grad just off orientation herself. She said it really scared her to think she knew more than the person teaching her the job. The other left after a couple of months because her assignments were all chronic patients; she came from the ED and had tons of high-intensity experience. Then if you add the comments of the CNE to the mix where the new staff were told not to ask senior staff any questions because we don't know WHY we're doing what we do, we're just doing what we've always done, it makes it really hard to get fired up about new staff.

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Specializes in Interventional Radiology.

Unfortunately, it seems this is the trend in healthcare. Hospitals don't want to continue to pay experienced nurses- it's cheaper to train nurses. Not safer- just cheaper- at least that's the way I see it

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I am one of those "baby" nurses that works in a critical environment of a trauma 1 level hospital. I started in the medical ICU right after graduating from nursing school. I don't really feel there is anything wrong with hiring new grads straight into the ICU as long as the hospital has a in depth training program. Also, there needs to be a right mix of experience on the floor.

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Specializes in ICU.

It's cheaper to train new nurses? My hospital's residency program has always said that it costs them an extra 60K to train new grads, on top of the wages paid. Then add the preceptor pay on top of that.

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Hospitals don't care about patient safety. They are too busy pressuring their politicians to enact, "Tort Reform", to make it more difficult, if not impossible, to sue hospitals, for negligence. Let the patient's take the fall, for nurses' inexperience. There are a million ways to make the nurse the fall guy for a patient's unexpected demise. And administration always comes up smelling like a rose.

As more states fall for the lie that is, "Tort Reform", more and more patients will die, or be injured, with no, or few, legal remedies, that will to allow them to get justice.

JMHO and my NY $0.02

Lindarn, RN, BSN, CCRN, (ret)

Somewhere in the PACNW

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I understand your anxiety regarding working with new grads in the ICU however I personally hate the term baby nurses. All of us were once new grads just starting out and having to find our way. I have been a nurse for 16 years now and I still hate that term baby nurse. It is just condescending in my opinion. Like I said I do understand your anxiety about working with all new grads in the ICU. If you have an Unit Educator they should be able to help the new nurses and you feel more comfortable. Also make sure that you speak with management regarding your feelings about the new grads in the ICU all being on night shift. Make sure to do so in an e-mail so that you have proof that you raised the concern.

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There seems to just be a high turnover rate no matter where you end up. Lately, I've seen a very high turn over rate that I have never seen in the past 7 years in our ICUs, and like you, there are a good share of new grads taking up those places. Healthcare isn't really about patient care anymore, but rather patient satisfaction scores, which all ties into reimbursement. Hospitals seem to care less about educating us nurses anymore (we don't even have a nurse educator nor a CNS, and I work at a "teaching" hospital), but rather they would cheaply fill the void as long as the patient surveys come back with good numbers. Anymore, ICU seems like a joke. The skill set has been really dumbed down, and it feels more like an adult baby sitting unit. We are just expensive baby sitters. Would you like a blanket?

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Specializes in Informatics / Trauma / Hospice / Immunology.

There has to always be at least one senior ICU nurse on or you would have no rapid response team, right? There is still a pharmacist, an internist, specialist physicians, protocols, house supervisor, and clinical supervisors I would think. So really the new grads are not running anything. They are just filling in and learning the craft in anticipation for the huge numbers of soon to be retiring older nurses. 55% of RNs are 50 years old or more. 1 million will retire over the next 10-15 years. So do we need baby nurses in every area now? I think the geriatric nurses would say yes. That is if they want decent care for themselves in coming years.

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Specializes in NICU.

Didn't read the read, but wanted to comment that I lol'd at the title, as my title used to be "babyRN" - meaning that I took care of babies, not my lack of experience, lol. Now it's "babyNP" and while I'm probably still considered a "baby" (been a NP for 6 months), I wonder if that's what people will think of me perpetually since I'll probably keep the same name, lol.

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Didn't read the read, but wanted to comment that I lol'd at the title, as my title used to be "babyRN" - meaning that I took care of babies, not my lack of experience, lol. Now it's "babyNP" and while I'm probably still considered a "baby" (been a NP for 6 months), I wonder if that's what people will think of me perpetually since I'll probably keep the same name, lol.

Haha! I've clearly been working with the little bambinos too long because the only reason I even opened this thread is because I thought they were talking about the NICU. Ha! Your post gave me the biggest giggle!

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