Baby RN's running ICU?!!

Do-over, ASN, RN · May 5, 2015

Recently had a family member of a patient comment on how young the night staff looked... His mother reprimanded him for not including me in the "young-looking" group...

At any rate, it was a great opportunity to manage up the many bright, intelligent and hard-working young new nurses I work with - they receive an intense orientation and one that is specifically tailored to critical care.

canned_bread · May 6, 2015

Wow, no! Day shift we occasionally have one or two new grads, and then we have some second years and what not. But the second years, if they are there, are the good ones.

This is a concern I would speak directly to the manager of your unit about, as they do the staffing. Are they having difficulty staffing? Perhaps they need to have an extra senior nurse rotate through the nights?

Zookeeper3 · Jul 16, 2015

I''m finding this as well in my Florida hospital. My unit has... get ready... a 68% of staff with 2 years exp. or less in our ICU. I'm exhausted from precepting, exhausted from my name being called thirty times an hour in every direction, and I left and went to rapid response

The changes in health care... no foley's or central lines in my vented and sedated patient?? Really? Open visitation, families sleeping in recliners when I can't get to either the vent or IV pumps (all allowed), pharmacy that makes me count their pyxis meds, central supply that acts dumb and takes forever... lab that looses labs, then takes two hours to process stats, .....

.... and then I'm going to round hourly, use scripting, fetch coffee and blankets... fill out six extra forms to prove I did my work, while never being allotted the real time to do so.... THEN I can't make the frequent flier DKA'er happy who is NPO, they score me low on patient satisfaction survey... and I NEED remediation??

These are a few reasons why... patients are going to have increased morbidity and mortaility rates, but administration wants to make dang sure they are happy in the process.... Those who know better are leaving.

Ruby Vee, BSN · Jul 17, 2015

I''m finding this as well in my Florida hospital. My unit has... get ready... a 68% of staff with 2 years exp. or less in our ICU. I'm exhausted from precepting, exhausted from my name being called thirty times an hour in every direction, and I left and went to rapid response
The changes in health care... no foley's or central lines in my vented and sedated patient?? Really? Open visitation, families sleeping in recliners when I can't get to either the vent or IV pumps (all allowed), pharmacy that makes me count their pyxis meds, central supply that acts dumb and takes forever... lab that looses labs, then takes two hours to process stats, .....
.... and then I'm going to round hourly, use scripting, fetch coffee and blankets... fill out six extra forms to prove I did my work, while never being allotted the real time to do so.... THEN I can't make the frequent flier DKA'er happy who is NPO, they score me low on patient satisfaction survey... and I NEED remediation??
These are a few reasons why... patients are going to have increased morbidity and mortaility rates, but administration wants to make dang sure they are happy in the process.... Those who know better are leaving.

The pendulum has swung too far . . . hopefully soon it will head the other way.

RN_pophealth · Jul 18, 2016

I agree on the labels. They also diminish the credibility of our profession.

Toremeup2 · Jul 18, 2016

We are suppose to have thick skin. I let it all roll off. Goodness knows that is

minor compared to other things I was called.

Nurse4babies · Jul 18, 2016

I must disagree with you . I was a BSN prepared nurse hired along with a hospital diploma prepared nurse right out of school in the trauma SICU. Our skill sets were very even and I was chosen to be charge nurse right after I passed boards which was two months after taking them back in the day. The old chestnut that BSN graduates are know nothings is false.

Sorry, but the initials after your name do not translate to good clinical experience straight out of school. In fact, I would say that most new grads really don't know just how much they don't know until they've been a nurse for several years.

Nurse4babies · Jul 18, 2016

Give new nurses chances to experience nursing

That's part of the problem. Putting a plethora of inexperienced nurses on a unit at any given time diminishes the experience and often sours them to the units. There is nothing worse than being in a stressful situation and not feeling like you have adequate resources (experienced mentors) that can help you figure things out. Being left to sink or swim on their own is not only dangerous to patient care, but undermines their own self confidence.

On my own unit, we recently had a baby with a low temp. The unit was over staffed with new grads and only 2 experienced nurses (the charge and the delivery nurse who were both very busy. When the baby didn't warm with extra blankets, the nurse put the radiant warmer back on...all per policy and after discussion with the other new grads on the floor. Unfortunately, what got missed was the baby was cold because he was in shock and was developing NEC. Had a more experienced nurse been with her to help with her assessment, it might have been picked up prior to change of shift and the intestine perforating. Unfortunately, this child did not survive the transport to the surgical NICU.

arrie · Jul 18, 2016

Thank you icuRNmaggie, BSN, RN :up:

tmremramr, MSN · Jul 18, 2016

While I agree that not having seasoned nurses is a safety issue, calling new grads babies is only perpetuating the bully nurse stereotype. I work the floor as a less than 5 yr expertise and I am one of the most seasoned nurses on the floor. I'm being asked to take a charge position of which I've already turned down with less experience, because to me a charge nurse should have more than 5 years experience. Now the problem with this is that those who have less experience than me are now my charge nurse. Not its not I can't handle a younger less experienced supervisor, it scares me how this impacts my patients safety when I hit the rapid response button and get 10 fresh faces all asking me what to do when I hit the button in order to have back up.

New grads make the world go round, foster those fresh minds, build them up to be better than you, they are the main highway to retirement.

tmremramr, MSN · Jul 18, 2016

I'm not sure about the original poster but we do have educators however we NEVER see them. During my last training session, I was only supposed to have max of 4 pts so I could teach yet we had 6 with an admit and all she got to do was watch me put out fires as there was not enough time to show her or let her do things. It's not the new grads fault, we are failing them. We need new management, oh and our current management and some of our educators have less experience than I do, and I didn't feel I was qualified for the position. Oiy vay, the patient safety is not top priority like I wish it was.

bizzyndizzy · Jul 19, 2016

I absolutely agree. This is a huge problem where I work as well in the ED. "Blind leading the blind" as someone mentioned. We don't have solid training programs nor is there education in our facility. It is a disservice to both the patients and the nurses and causes a lot of stress for the experienced nurse who happens to be working with a crew of new grads. I would like to see an actual timed preceptorship put in place for new grads so that their foundation can be laid before being thrown in and told "sink or swim." The problem always comes down to money and in these times smaller facilities especially arent willing to include this in their tight budgets.