I'd like to get a consensus from you all about how quickly in to your ICU nursing career you were trained to perform "advanced" ICU nursing tasks, like managing post heart patients, CRRT (CVVH or SLED), or IABP. I've been working in an ICU for the entire 2 years of my RN career, although at my current job for only one year. I am very eager to learn these skills, but am constantly getting the brush off from my boss when I ask about getting this training. I'm starting to feel genuinely ready to take this next step, but am becoming very frustruated with our unit director's apparent unwillingness to train me, and also to tell me why. I don't make any more mistakes at work than anyone else, and have been doing all I can to request hard assignments and otherwise demonstrate my skills. All my coworkers think I'm ready.
I started in CCU. Fresh caths/post MI. Pulling sheaths within 2 weeks. But my unit was 32 bed post intervention so sheathes were a dime a dozen. IABP within 6 monthes. Orienting to carge at 7 monthes. Prisma,CVVHD at 8 monthes. We got cabgs and valves 24-36 hrs out that were failure to thrive, failure to ween or bubble heads or strokes sooner. Stayed there for 2.5 years until management drove off there "seasoned" nurses. Started traveling, back to ER for a year, then started open heart as a traveler. Did it for 2 monthes, then ER for 8 monthes, then back to ICU for 3 monthes, then ER 8 monthes, then CVICU/transplant/VADS for last 1.5 years at a new heart hospital in Ohio. Love fresh hearts more than anything, the VADS have been a big bonus, nice padding for the resume. When I settle down should be able to walk in and say I want a job, and get it.
Secret to my success 1) excellent preceptors 2) aggressive by nature, always looking for the next challenge 3) hit the units when staffing sucked and was flexible and loved the OT.
If they won't give you the challenge someone else would be more than happy to.
By the end of my first year in ICU, I had taken care of dozens of CABGs, and several IABPs (we don't do CRRT here).
By the end of my second year, I was precepting new RNs on those kinds of patients.
Far from holding you back and not teaching you, If I were in charge, I would never allow a nurse to go 2 yrs without learning these patients. It holds the staffing grid back. There are already normally so many new RNs that have to be accounted for when making assignments, I wouldn't want to have to account for the experience level of 'experienced' nurses also.
By the 2 yr mark (if not the 1 yr mark), nurses had better be completely capable of handling anything on the competency grid, for the sanity of those making assignments, if not for those nurses themselves.
sawbones
21 Posts
I started in CCU. Fresh caths/post MI. Pulling sheaths within 2 weeks. But my unit was 32 bed post intervention so sheathes were a dime a dozen. IABP within 6 monthes. Orienting to carge at 7 monthes. Prisma,CVVHD at 8 monthes. We got cabgs and valves 24-36 hrs out that were failure to thrive, failure to ween or bubble heads or strokes sooner. Stayed there for 2.5 years until management drove off there "seasoned" nurses. Started traveling, back to ER for a year, then started open heart as a traveler. Did it for 2 monthes, then ER for 8 monthes, then back to ICU for 3 monthes, then ER 8 monthes, then CVICU/transplant/VADS for last 1.5 years at a new heart hospital in Ohio. Love fresh hearts more than anything, the VADS have been a big bonus, nice padding for the resume. When I settle down should be able to walk in and say I want a job, and get it.
Secret to my success 1) excellent preceptors 2) aggressive by nature, always looking for the next challenge 3) hit the units when staffing sucked and was flexible and loved the OT.
If they won't give you the challenge someone else would be more than happy to.
Just my .02 cents