I am very sad and a little frustrated today because my manager just talked to me and wanted to let me go during orientation in ICU. I was lucky that I got an ICU job as a new nurse. I had clinical in ICU before so I feel I know basic critical care nursing, but I guess I am wrong.
1) It's not about the task, it's about communication
I am very focused on my task (meds), and I have hard time multitasking (listening to family, overhearing from doctors etc). It is even worse when nurses and doctors use abbreviations and medical jargon that I have never heard of!
For example, when I report lactic acid is high to a doctor, he just said, "Do a D-dimer". I have no idea what a D-dimer is and I don't know how to look it up when he expects me to put his verbal order in.
I have a preceptor, but a lot of time I feel people just talk to her instead of me. So I missed out a lot of information.
Talking to doctors on the phone is also frustrating. I am new to the job and also new to the hospital. When I receive a phone call, they just say things quickly, I did not even get who they are. There is one time I was told by my preceptor to call a doctor, let him know that he's the new consulting physician. So I did look up his name and phone and paged him. I told him specifically that the patient's name, room number that is newly assigned to him. He said, "I don't know what you are talking about. That doesn't help." and hang up on me. Later I found out he's always like that. He doesn't really like when attending assigned him to be consulting physician when he feels there is not much he can do about.
2) I feel I need to be perfect, not making any mistakes.
The manager said he let me go because he doesn't want to compromise patient safety. God knows I am always check check check. I am so fearful of making med errors. But I feel a lot of minor mistakes (not med mistakes) are due to my lack of experience. I was never told that or my preceptor showed me briefly before I can try on my own and master my skills.
For example, drawing blood from lines. My preceptor showed me two different ways doing that. I was a little bit mixed up from drawing blood from peripheral line and arterial line. So after flushing the picc line, I did not attach the syringe to the line pot, I attached the vacutem to the pot, but of course it doesn't fit. So I was there thinking, my preceptor was yelling "What are you doing? I taught you this before." After the second time, I remembered and able to master the skill.
But this becomes a reason for my manager to let me go.
It's very frustrating because I feel I know what to do, but very slow. In ICU, people changes orders all the time. I do not have much time sitting on computer, waiting to see there are any new orders. When I am busy with things, and come back to my preceptor, she will say, "ok, there is a new order." I feel bad that I cannot multitask or keep up with the ICU world.
Finally, I start to pay close attention to new active orders, like monitoring facebook newfeeds. I saw there is a new order of "Mg draw". so I grab all the supplies and went to my preceptor and told her what I am going to do. She said, it's an add-on. so just call the lab and let them know. They could use the blood sample the night shift has drew" I feel so dumb that I did not see the "add-on" words.
3) I feel so lonely and depressed.
I am nice person in general, and trying to "obey the order" get things done quickly. But when patients sense my "not outspoken", they take advantage of it. They would be very rude to me, but very nice to my preceptor, even though I am the one doing the care, she is chatting with them. I feel so little.
I feel no one to talk to, because no one would understand this. I even feel a lot of nursing falls into "gray area" that if an experienced nurse made all these minor errors, they would just shrug it off. For example, I failed to insert an IV on a patient. I feel so bad that I lack of the skill. My preceptor tried, but she failed too. But she's able to get over it quickly, like it's nothing to do with her competency. I don't know how to manage the stress and self-doubt.
jifferte, BSN, MSN, RN
105 Posts
IMHO, the ICU is not the place for a new grad. Nurses that work in the ICU generally have a wealth of clinical experience and tightly honed instincts from which to draw upon. Please do not be too hard on yourself, try Med- Surg for a bit and then try again. 😀
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