Concerned for new grad in ICU supervisor role

Nurses General Nursing

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I am concerned for a friend who has accepted a hospital ICU supervisor position. This is a new grad with no nursing experience other than as a CNA for a year (not in the ICU). This is a small hospital, so my friend will be responsible for caring for those in the ICU as well as stabilizing for transport anyone who needs a higher level of care.

As an ICU nurse, I remember the first year of nursing well. I also started in the ICU (of a major metropolitan hospital) and loved it. However, I had great mentoring and a lot of support. I can't imagine transitioning from a new grad to ICU supervisor in a matter of weeks. I care a lot about my friend and want my friend to succeed. I have spoken to my friend about my concerns, but she does not appear to be at all worried. Obviously, there is nothing I can "do" but hope for the best and remain supportive of her, but I must say I am truly shocked that a facility would place a new grad in this position. I was ICU charge for years, and it is not easy. She is very competent FOR her level of experience, but I fear for the safety of her license and her patients.

I'm sorry, but your friend is being set up for failure. There is no way a new grad should be in the ICU straight out of nursing school, let alone in a charge nurse/supervisor position. I'm am not trying to bash your friend, but she just don't know what she don't know.

Where will she get the support from? Who will be there to guide her in the most critical time when a pt is coding and need to be transferred out? Oh yeah, NOBODY. Because she will be the "go to person" that everyone else in the code is going to be coming to for answers.

Is she even ACLS certified? Has she even been in a code before?

You are a great friend to let her know she may be making a mistake. I fear for the pts and her license. I sure pray to God nothing happens where she may be sued because the hospital is gonna throw her under the bus if something happens.

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Specializes in Gerontology, nursing education.
I don't know your friend, but I have faith in her. Continue to encourage her and give her POSITIVE advice. Nobody knows what she capable of handling,not even you, so don't doubt her. Obviously, they saw something in her that made them vow her a good candidate for the position... This is not the first time a hospital has put a new grad in his type of position and I doubt it will be the last!

The more I know about nursing, the more I realize how much I DON'T know. In my eighteen-some years as a registered nurse and throughout every level of education (currently graduate school), I have seen MANY new nurses and quite a few students who thought they already knew everything and would not hesitate to take such a position.

I am sorry but I DON'T have faith in people like this. They're frightening and dangerous when they're in practice. I've seen inexperienced nurses who made horrible mistakes because they "knew everything" and didn't listen to nurses who have a bit more experience and clinical wisdom under their belts. I've also seen inexperienced nurses in positions of power who have been unable to grow and develop as nurses because they were so overwhelmed with learning how to be a nurse AND learning how to be a supervisor.

I would be very suspicious of a hospital that would hire a brand new graduate to be an ICU supervisor. It says to me that either the hospital is poorly staffed and will take any warm body with the initials "RN" or "GN" behind his/her name or that they're looking for someone who will become the hospital's lackey and "supervise" the way the hospital tells him/her to do, without having the clinical knowledge or experience that would help that supervisor do what is right.

When there are problems----and there will be----the OP's friend will likely be thrown under a bus by the very Powers-That-Be who hired her.

BTW, I also agree with Roser13 and notice that you, Closetoyou21, list that you are a pre-nursing student on your profile. You might be able to discuss this with a little more credibility and through a lens of reality after you have gotten through your own program and see what it is like to get through nursing school and get into the workforce.

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Specializes in Emergency.

To the OP, please have your friend read this thread.

As stated above, she doesn't know what she doesn't know. I simply cannot see how this will work out well for her.

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Specializes in Critical Care Nursing AKA ICU.

that is nurse that needs her license taken away...she doesn't even know that she is WAY over her head... also that hospital needs to be reported for given that posistion to such an unqualified person

that's a setup for disaster!!!

My wife was telling me the other day that her friend that just graduated from nursing schoo (5/2010) is working as an agency nurse going to differnent ICUs around town!!!!! what an idiot!!!!

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Your concerns are valid. I take even more issue with the hospital because while your friend is in new grad dreamland where she thinks she is invincible the hospital absolutely knows better. She's cheap labor and she's in way over her head. There are also problems on this floor if they can't get a qualified candidate to fill the spot. She's a supervisor on ICU and has never even worked a nurse before? Good Lord. I feel for the patients and if God forbid something happens to one of them a lawyer will have a field day with your friend and the facility.

I get the feeling that even if you approach this with her again you will be pooh poohed once again. She needs to learn the hard way. Pray no patients die in the process. She's so green she doesn't even realize the danger her license and the patients are in.

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Specializes in Home Care.

As a new nurse I don't want to be "charge" anything. I'll never understand new grads who accept "charge" positions of any kind.

OP, please continue to talk to your friend about this job offer and why she shouldn't accept it. Don't be afraid of upsetting her, you have to firmly and bluntly point out all of the possible negative situations she may find herself in.

I'm also concerned about how she got this position in the first place. This job offer makes no sense at all to me. Its unsafe for the ICU to have a new grad as a charge nurse. Sorry to say, but I can't help but wonder if your friend padded her resume with some untruths.

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Who is this nurse going to be supervising? Will she be the only RN at the hospital? It sounds odd and it sounds odd to have e new nurse as an ICU agency.

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I am a new grad and that sounds VERY skeery- BAD BAD idea!

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Specializes in Peri-op/Sub-Acute ANP.

The basic problem is that (s)he doesn't know what (s)he doesn't know. The learningn curve will be steep I fear. If they cannot be talked out of this, even with all of your good-intentioned advice, then the best thing you can do at this point is be as supportive as you can without getting overly involved in this situation.

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Specializes in ER, ICU, Education.
that is nurse that needs her license taken away...

I'm sorry, but I could not disagree more. What is needed for her is good, caring advice. Not sunshine and roses that everything will be fine, nor a call to take away someone's license when they are thus far only guilty of naivete. I am her friend, and therefore have no desire to yank her license or to see her destroyed by this. It concerns me that instead of doing our best to mentor someone and to intervene when we see an unsafe situation, we would instead choose to be punitive. While we have a current surplus of nurses, every good nurse is valuable. We are under enough stress and pressure without dishing it out to each other.

She and I are close, so I fear that the reason my advice is not enough is likely due to this. I think most of us remember what it was like to be a new grad: full of hope, confident that while you don't know it all that you will never be "that nurse" who is exhausted, tired, and can't get everything done to the standard you aspire to. I suspect this is the case with my friend. She wants so much to do a great job caring for others, she is simply too inexperienced to know better. I fear it may be too easy to think "Well, they wouldn't hire me if I weren't qualified, would they?" This is sometimes the case in a first professional career experience, especially in nursing. I would have paid a million dollars as a new grad to know what I know now, but unfortunately it only comes with time. It takes time to realize that administration is NOT necessarily in this for the benefit of the patients (although there are rare gems who are).

Thanks so much for all those who have posted. I truly appreciate it and will direct her to a link to this thread. I am hoping that she will see that in the counsel of many, there is wisdom :)

And to address questions directed to me: she is ACLS certified, but you know how much time it takes to really understand the rationale and the science behind it. She has only "book" knowledge right now. Not the same at all.

She is not an agency nurse. There will be other RNs present, but to me this is almost MORE worrisome. There is something very wrong that the only RN willing to take the job is a new grad. Very wrong. It makes me fear she will encounter not only the nearly impossible situation of learning to be both an ICU nurse AND a charge nurse, but an unsupportive work environment with a strong possibility of resentment.

She did not pad her resume to my knowledge. I reviewed it before she submitted it and it was accurate at that time. She is very honest. I fault the hospital for this portion. She interviewed for a staff nurse position, only to be told she would be the new charge nurse. She accepted, and as another post mentioned, probably felt honored. To be honest, it really sickens me that this is even allowed by the CNO, hr, etc. I know several new grads in past years who have been offered charge nurse positions. It makes me angry. It is not responsible to your patients and to your employees, both the new grad and those who will be "supervised."

I wish I could just tuck her under my wing and protect her. *sigh*

And "T"- remember when you read this that I did this not to embarass you, but because I care.

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Specializes in ER/Tele, Med-Surg, Faculty, Urgent Care.

"Ignorance is Bliss" seems an appropriate phrase to describe new grads such as your friend who accept charge positions or hire into areas they have no business/no knowledge/no experience in.

I teach in a BSN program and many have had fairly new grads (less then 1, less then 2 years offered charge positions, they are so "thrilled" they have emailed me) I am amazed that they are clueless as to what the responsibilities and legal issues that go with being in a charge positions. One of them thought all she had to do was "make the assignments, assign new admits, schedule meal breaks.

I have had new grads hired into ICU's in one local facility but it is not a big hospital, it is a general ICU, but I also had one that accepted a position at U. of AZ in the CV ICU!!!

When I questioned her about this (she could not even interpret a basic rhythm strip, forget ACLS) She did her precepting in an ICU setting and after ony twelve 12 hour shifts realized she did not know 1/10th of what she needed & this was on a medical-surg ICU. Since part of her assignments was a journal, I commented that I did not think a CV ICU was where I would go, even with close to 30 years of med-surg/tele & ER experience, that I personally would start out on a Med-surg ICU to to learn the ICU stuff for about 2 years. She ended up calling U. of AZ and ended up on telemetry, a much better place to start.

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Specializes in Gerontology, nursing education.

She and I are close, so I fear that the reason my advice is not enough is likely due to this. I think most of us remember what it was like to be a new grad: full of hope, confident that while you don't know it all that you will never be "that nurse" who is exhausted, tired, and can't get everything done to the standard you aspire to. I suspect this is the case with my friend. She wants so much to do a great job caring for others, she is simply too inexperienced to know better. I fear it may be too easy to think "Well, they wouldn't hire me if I weren't qualified, would they?" This is sometimes the case in a first professional career experience, especially in nursing. I would have paid a million dollars as a new grad to know what I know now, but unfortunately it only comes with time. It takes time to realize that administration is NOT necessarily in this for the benefit of the patients (although there are rare gems who are).

She is not an agency nurse. There will be other RNs present, but to me this is almost MORE worrisome. There is something very wrong that the only RN willing to take the job is a new grad. Very wrong. It makes me fear she will encounter not only the nearly impossible situation of learning to be both an ICU nurse AND a charge nurse, but an unsupportive work environment with a strong possibility of resentment.

She did not pad her resume to my knowledge. I reviewed it before she submitted it and it was accurate at that time. She is very honest. I fault the hospital for this portion. She interviewed for a staff nurse position, only to be told she would be the new charge nurse. She accepted, and as another post mentioned, probably felt honored. To be honest, it really sickens me that this is even allowed by the CNO, hr, etc. I know several new grads in past years who have been offered charge nurse positions. It makes me angry. It is not responsible to your patients and to your employees, both the new grad and those who will be "supervised."

I wish I could just tuck her under my wing and protect her. *sigh*

And "T"- remember when you read this that I did this not to embarass you, but because I care.

Unfortunately, there are many novice nurses who will post threads here on AN about how they've been hired as new grads as supervisors, ask for feedback and get upset when experienced nurses try to tell them they're getting in over their heads. It is emotionally draining to try to suggest to someone that he/she might be better able to handle the job after a little nursing experience and be told that one is simply a bitter, angry old nurse who is jealous over someone else's opportunities or thinks everyone needs to pay his/her dues before becoming a supervisor, manager, educator, graduate student, APN, whatever. The thing is, while some will survive their trial by fire, most won't. Some will leave nursing altogether. Others will retreat into the ivory tower of academia or behind the clipboard and become part of the problem of the disconnect between education and practice, management and practice. I admire you for being such a good friend and wanting to provide mentorship to a new nurse. She is lucky to have you!

I cannot imagine why a CNO would even consider a new graduate to be charge in ICU. The only possibilities I see are that the CNO is utterly clueless, it's a toxic work environment, or administration thinks that a new graduate will be amenable to everything administration wants and will have no prior experience with which to compare the workplace so he/she won't realize that the practices are shoddy. I would so be afraid that when something goes wrong, your friend is going to be thrown under the bus.

But...I guess we all make our own mistakes. Again, your friend is lucky to have someone who cares as much as you!

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