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Being 'advised' to take a new position


Hi Y'all,

So I seriously need help.

Long story short, I was accepted into a critical care program with a renowned hospital system in the DFW area. But for a month my recruiter was sending interviews, phone screenings, etc to firstname.lastname@ICLOUD.com to firstname.lastname@ICOULD.com.

There is no @ICOULD.com. For a month he just assumed I wasn't interested and never even bothered to call. I had to call his department in order to get a hold of him. By the time I contacted him he told me that all the positions had been filled. He asked me if I would be interested in going to the Central Texas area and I said yes. So I contact the recruiter who essentially tells me all the positions I wanted had been filled. BUT I found a challenging unit that I thought if I did well in would impress the ICU management once the time came. I started on the unit, my orientation was HORRIBLE and I learned close to nothing during that time, and then when I got on my own I tried to go into work and do the best I could with everything I had every day.

That was 5 months ago.

Three days ago, I was called into my director's office where my manager was. They told me that over the past two weeks my rating during pt rounding was low. There was also an incident where (I screwed up on this one) during a pt. assessment a nitro patch came stuck to the inside of my pt's gown but the paste was still on his body. He had suffered a lot of trauma and the paste on his body was right where a wound was. I told the night nurse that he was refusing all medications and that 'he stated he wanted to die' and was put on hospice. Why she put another nitro patch on him is beyond me but I'm the one that had to take the bullet for it.

They told me I didn't have the time management skills to excel on this floor OR in the ICU

Tbh I HATED this job. Each day I had 5-6 stroke/epilepsy/brain injury/total care pt's that were on my own. It was hell. I truly hated it but at the end of the day I got the job done.

It was very different from my last experience. For my preceptorship I did 90 shifts at a Neurosurgical ICU. While I was there with my preceptor I worked up to taking total care of not ONE but TWO of her patients. I learned how to titrate drips from her, I spent 4 shifts with following a respiratory therapist learning all about ventilators and looking at breathing waveforms. I loved it and the staff on the floor said they loved me.

Anyhow in January a new nurse critical care orientation group starts and I am debating applying. But I want to make sure that I'm ready for it.

Please give me your thoughts and your opinions.

HouTx, BSN, MSN, EdD

Specializes in Critical Care, Education. Has 35 years experience.

Are you sure that you still meet eligibility criteria for the "new nurse critical care orientation group"? If it is intended for new grads, you may not qualify. I'm so sorry that you have hit so many bumps in the road with your career launch.

It is troubling that you state that you learned nothing during your orientation and yet your current manager is unhappy with your time management ability. THIS is probably what you should have focused on during orientation. The goal of orientation is learning how to put everything together and manage patient care effectively - NOT how many new things you can learn. But based on your reaction to your manager's comments, it seems like the actual goals and objectives for your orientation may not have been very clear.

Has your manager provided you with specific information about the objective (time management) criteria by which you are being rated?? If not, I recommend that you ask for this. After all, you can't improve what you don't know about. In your next position, get this information (orientation goals and criteria) up front so you'll have a better idea of how to prioritize.

Wishing you the best of luck on finding a new job that is more satisfying.

HouTx, thank you so much for your reply. I greatly appreciate your well thought-out response.

The eligibility criteria for the program is as follows:

Full-time positions for both day and night shifts are available in MICU, PICU and Cardiac


- New graduate from an accredited school of nursing

- RN with A.DN or BSN, seeking new specialty training


Given that I'm a BSN seeking new specialty training I would still fit the criteria of the position.

When I said I learned nothing what I was referring to was learning/practicing to manage time/group tasks/prioritize patient care, not just demonstrate how to insert a foley.

My manager stated that they have a list of 12 different criteria that they take with them on a list to every patient's room whenever they do their rounds and each criteria is a part of our evaluation. If 2 or more are negative, it is considered a negative pt review. The only specifics they offered were things like 'not responding in an appropriate time', 'not feeling as if the nurse was present enough', the pt's 'perspective on time it took for their call light to be answered', people who get their Px med scheduled confused no matter how many times I explain it to them/write it up on the board.

I just can't freaking do everything at once for 5-6 people. If somebody's 3 hours into getting blood and only half of its transfused bcz the previous nurse didn't notice I'm going to be late giving someone their pain meds/ask someone on the unit to help - I thank God when ppl I see ppl show up in the morning that are actually willing to help me are there - because blood is like a freaking gold brick and I'm going to start an IV on them as fast as I possibly can.

If a 28 year old was diagnosed with AIDS whose family didn't know and was put on hospice the very next day after his diagnosis, I'm going to spend some time with them and get a feeling for how they're going instead of re-adjusting somebody's pillow for 10 minutes.

And (no offense to the ladies I've seen some super strong women) but when I'm the only male nurse on the floor and 2 feet taller than the rest of the female staff, who do you think ends up doing compressions?

And that's what it is, that's what is taking up most of my time. 2 out of 3 shifts a week I'm on my feet from 0615 (where I show up 30 min early to look up my pt's) till 1600 where I can finally sit down and eat lunch.

I truly feel like I walked into a situation where I couldn't win. It wasn't what I wanted, it wasn't what I expected, and now I've hit this career...bump where I'm trying to figure out what to do next.

And to be honest I really want to do ICU, I want to go for it, I want to win it. But I've got this situation on my hands. I need to know more information about it, how long it is, how their orientation process is laid out and how long it is, and then I need to decide if I should go for it. If it's not what I expect it to be thencI think for the next 6 months I need to play it safe, get a job that I can do well in and then go for the ICU with some more confidence and experience under my belt.