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Discussion

Confidence issues in ICU

I'm a fairly new nurse approx 20 months. Right out of RN school I took on a critical care residency program with a hospital near my home. Initially I was rocking it, I was very knowledgeable and adjusted well into the flow of the unit. However, I then became the target of the main critical care doctor over unknown reasons. Some staff close to her told me that she disliked me because I made her feel stupid and that I often challenged her and I was mostly correct. All the other doctors loved working with me except her. She made some very poor choices purely in vein at the expense of patients safety. This MD no longer works with us, she was rightfully fired and escorted out of the unit. However, I was left scarred, she did a good job at creating a false reputation against me such as "not a safe nurse", "dumb nurse", etc. I then lost self confidence in my knowledge and skills. Even though i started ICU right away I've only had two patients under my care who coded in these past 20 months of my young career. And, both those codes were due to that critical care MD's decisions to "teach me a lesson"

Now, I don't want to leave my job, but I find myself second guessing my knowledge and I'm questioning if I should even be an ICU RN at all. Any suggestions on how I can regain my confidence?

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    You sound like your confidence is pretty well intact.

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    Some days it feels like I'm second guessing every single step I take. Other days, I need to read orders two to three times before I get comfortable with carrying out tasks. I'm not sure maybe I need some kind of reassurance that I am doing the right thing. I don't know í ¾í´·í ¼í¿»*♀️...

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    In my experience, a new grad 'rocking it' in the ICU usually means not messing anything up too badly and knowing when and how to ask for advice and assistance.

    I don't know you and don't know your practice, but I do know that 20 months out of school isn't very long, and that a reasonable degree of self-doubt and the caution it instills is a pretty healthy thing for any ICU nurse to have, especially a newish one. So I can't really tell whether you have undue anxiety now or whether you merely had undue confidence before.

    For whatever it's worth, you can't really judge your skill level by the number of codes you have (or don't have); with some patients the code is inevitable, and many ICUs don't give said patients to their less experienced staff.

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    You are so right about that!

    So, I've met all the requirements to take the CCRN endorsement test to my RN license. I think that these reviews and practice questions are empowering me to know my knowledge/skill boundaries better and thereby knowing when to ask/who to ask/or even what to ask for that matter.

    However, about the patients coding thing... unfortunately the culture in the unit I work at, take that a lot into perspective. Those nurses who have more "codes" in their history are usually not the 1st choice for assignments of the most acutely critical patients in the unit. And, the staff tends to not "trust" the judgment of said nurses thereby kind of ostracizing them... I'm trying to change this culture but it's not easy...

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