Crappy orientation

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Specializes in Gen Med, Pre-Op/Post-Op.

I'm having a tough time in Orientation. I tend to doubt myself because of a difficult clinical instructor, I'm older and my first job is in the ICU. My first Adult clinical with critical patients I had an instructor that singled certain students out to "ride like ponies" I was one of them...I'm older and have some doubts about myself when I'm demeaned, put down and made to feel stupid. I'm very self aware but it was hard to overcome this treatment and when two of us complained to the Dean...she basically said what do you want me to do about it? So I graduated with a BSN, passed the NCLEX and have been working on the Medical ICU for a month. My first preceptor was very lax and said things like "this isn't the way you were taught in school", and "if you were a spy I'd be screwed because this isn't how you're supposed to do this." Also the assignments... we got involved patients who were so critical that the preceptor just did everything and when I would ask she would say, "you'll figure it out as you go along" I went to our educator and said I felt uncomfortable with the comments. Then the opposite extreme, I was put with someone who was so anal about charting everything and there was never anytime to go over tasks...I would ask the same thing just to double check because I didn't want to make a mistake. Again, out of 4 days I was with the second preceptor, she was only available to teach me on two of those days. So then I go into work and they've switched me again...the manager and educator have a "talk" with me...."if you don't get up to speed we'll have to decide if this is going to work out. You're going to have to take care of two patients and you have to have an action plan to get yourself together." And they said you've got to stop asking so many questions because it's frustrating the preceptors. I mentioned the fact that the preceptors may not remember what it was like to be a new nurse and the manager said, "Are you blaming the preceptors? You've had two preceptors...maybe it's you who is the problem." So now I'm a month into my orientation and I'm scared to ask a question, I feel like I never should have gone to the educator with my concerns. Also, the next preceptor they put me with, they have already said that she has a difficult personality. It doesn't help that there were 5 orientees that came onto the unit at the same time, the other new RN's have stuck with their preceptors and are having a fine time. I don't feel like I have anywhere to go with this. I will spend the entire day with the educator on my next shift. Another issue, going straight from school to the ICU is a challenge...they used to have us go to the general floor for 3 months to get our foundation and then go to the ICU...that would have helped. I feel like if I ask about checking my Meds they look at me like I have 3 heads. I'm willing to learn and eager to stay on this floor but don't know how to handle this. I feel like my worst qualities are coming out and I feel stupid all the time...now I feel scared for my job and stupid.

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Please heed my advice:

GET OUT OF THE ICU NOW!!!

I, too, was a new grad that went to the ICU straight out of nursing school and it was a major mistake! I had SEVERAl preceptors and I went to the educator with my concerns regarding my first preceptor in particular. I asked to be placed with another one since I figured my learning style was not compatible with her teaching method. The educator got upset with me because I did not "stick it out" for 3 more nights until she found me a new preceptor.

The ICU is NOT a place for a new grad! I highly recommend starting off on a floor, getting 1-2 years experience, and then if critical care is your passion, go back to the ICU. The ICU is not a place to try to learn "basic nursing" skills that you could have easily learned on the floor. The patients are just too critical and I think the nurses are there to teach you how to be an ICU nurse, not to teach you the basics of nursing.

I left the ICU one week before my orientation was to end. I went to the ER, but I occassionally sit on "inpatient" patients in the ER, and I now see how having that one year of floor experience is so valuable.

It doesnt seem like it's a good learning environment and you could be set up for failure, so I would cut ties and move on. Take it as a learning experience.

Good luck to you!

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Specializes in Nursing Professional Development.

If you lack self-confidence ... the ICU is not the place for you. As you have noticed, some new grads do fine in an ICU environment. But it is not for everyone. Talk with your education and manager ASAP about the possibility of your transferring to a unit with a less critical patient population and an environment more suited to your personality and level of skill. Do it now, before your relationship with them deteriorates further.

ICU's demand self-confidence and the ability to learn quickly in a high stress environment. ICU nurses can have very strong personalities. If the environement doesn't suit you well, then stop beating your head against a wall. Find an environment better-suited to your needs.

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Specializes in Oncology, Med-Surg, Nursery.

Honestly, perhaps the ICU just isn't for you. That is not a negative thing, because I do not believe the ICU would be the place for me either. I think as with most areas, you are either made for it or you aren't. Lucky it is like that or else we'd all want the same jobs! :)

From what you have said, it doesn't sound like you have the support of your manager on your side and that is NOT a good thing. That isn't your fault, but it also isn't a good thing. It sounds like they are unwilling to accomodate different learning styles/personalities and I highly doubt it is going to get any better. It is going to get worse, and better you speak up for yourself now. Is there any way you can speak with someone about maybe transferring to another area? Perhaps a job on a Med-Surg unit?

As for self-confidence, well, we were all new once and the real world is a very scary place. Try to remember you got where you are today because of YOU and nobody else. You'll feel dumb a lot of days, but remember YOU have the ability to learn it and that is just one more lesson learned on the way to being a seasoned nurse one day. I was terrified when I started out, but I reminded myself that I had come that far and I would go the rest of the way. I've been a nurse 2 years now and it is amazing the progress and things I have learned in those 2 years!

My suggestion would be to see if you could possibly get placed in another, less stressful area and maybe that will be a better fit for you. Once you get being an actual nurse under your belt, then maybe you could one day try ICU again! It took me about 6 months before I started feeling somewhat comfortable in my nurse role. I have heard lots say the same!

Good luck to you!!

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Specializes in Gen Med, Pre-Op/Post-Op.

Thanks for all your replies. The manager is temporary until the new hire joins us, the educator has been behind me from the start. I am only 1 month into the orientation so I'm not jumping ship just yet. So I will go in Monday with an "action plan" and give it 100%. I am confident in my abilities, I just need a good preceptor.

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Specializes in Critical Care, Education.

Hmm - it would seem that the OP continues to believe that all problems are due to bad Preceptors. Maybe this is the case, but I doubt it. In my experience as an ICU educator, any time we had to switch preceptors more than twice -- the outcome was not successful. I believe that there's nothing wrong with new grads in ICU - if they have the right personality to thrive in that environment. The ability to rapidly process information & make decisions - is a key characteristic of successful ICU nurses.

ICU Preceptors expect the new nurse to 'get it' the first time. Having to provide repeated reinforcement on the same issue or still having to provide excessive feedback/affirmation after several weeks-- these are 'red flags' that indicate the new nurse is just not going to get it.

Excessive orientation is a drain on department productivity. It's not well tolerated in any clinical area, particularly when there are so many people clamoring for jobs.

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Specializes in Gen Med, Pre-Op/Post-Op.
Hmm - it would seem that the OP continues to believe that all problems are due to bad Preceptors. Maybe this is the case, but I doubt it. In my experience as an ICU educator, any time we had to switch preceptors more than twice -- the outcome was not successful. I believe that there's nothing wrong with new grads in ICU - if they have the right personality to thrive in that environment. The ability to rapidly process information & make decisions - is a key characteristic of successful ICU nurses.

ICU Preceptors expect the new nurse to 'get it' the first time. Having to provide repeated reinforcement on the same issue or still having to provide excessive feedback/affirmation after several weeks-- these are 'red flags' that indicate the new nurse is just not going to get it.

Excessive orientation is a drain on department productivity. It's not well tolerated in any clinical area, particularly when there are so many people clamoring for jobs.

Whew! Thank goodness you aren't my educator. Not everyone learns the same way. There are six nurses on the floor and 5 new grads...someone is going to get stuck with a less than ideal situation...but thanks for sharing your opinion.

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"Excessive orientation is a drain on department productivity. It's not well tolerated in any clinical area, particularly when there are so many people clamoring for jobs."

It's really unfortunate that a unit educator doesn't understand that the only way to learn is to be educated...

Anyways, I am a month and a half into my orientation in the ICU and it might make you feel better to know that I felt exactly the same way at first. And it did have to do with my preceptor. She was demeaning and rude and basically treated me like a dog. Didn't teach me but expected me to know everything. Just a horrible fit all around. But when I went to my unit educator with the problem she was so understanding and switched me immediately and now I'm really understanding things and actually am really enjoying my job. It's awful that your management is berating you instead of helping you. Is there someone you can talk to who's like the head of your orientation/residency program? We have someone like that, maybe you could talk to them and ask about a different placement because it sounds like you're not going to get the training you need to be successful in the ICU.

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Specializes in Gen Med, Pre-Op/Post-Op.

UPDATE: All is going well, I have worked with the Educator who is sympathetic and realizes what a disaster my first two preceptors were...I have had a great experience with two other people & I'm on track and feel positive that the ICU is the right fit for me. I agree that it's too bad that the orientee gets blamed for wanting to learn in a supportive environment.

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Specializes in CCU.

I'm glad things are looking up for you now. Preceptors can make all the difference. I had a pretty good preceptor but I was a little too slow for her, I didnt catch on to things as fast as she wanted me to. I am also a new grad in the ICU and my unit only orients for 12 weeks. I asked for additional time and was not taken seriously. So now I'm off orientation and my first night was a disaster, nurses on the floor knew that I was new but none offered to help me. I dont think ICU is for me because the learning curve is just too steep and I really needed to work on my basic skills, so I am wondering how to get out of this unit without leaving a bad mark on my record.

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Specializes in Pediatrics, ER.
I'm glad things are looking up for you now. Preceptors can make all the difference. I had a pretty good preceptor but I was a little too slow for her, I didnt catch on to things as fast as she wanted me to. I am also a new grad in the ICU and my unit only orients for 12 weeks. I asked for additional time and was not taken seriously. So now I'm off orientation and my first night was a disaster, nurses on the floor knew that I was new but none offered to help me. I dont think ICU is for me because the learning curve is just too steep and I really needed to work on my basic skills, so I am wondering how to get out of this unit without leaving a bad mark on my record.

Honesty is the best policy. I would look for another job, though you may have to go outside your current hospital because some places have a policy about working at least 6 months in a specific unit before being able to transfer internally. I would tell the nurse manager of the floor you're interested in that ICU is not a good fit for you right now, that you believe building your assessment skills on a floor first is in your best interest, and you're finding the ICU to be a steeper learning curve than you feel prepared for. I would also let your NM know this (once you found another position you're interested in). Good luck.

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Specializes in CCU.
Honesty is the best policy. I would look for another job, though you may have to go outside your current hospital because some places have a policy about working at least 6 months in a specific unit before being able to transfer internally. I would tell the nurse manager of the floor you're interested in that ICU is not a good fit for you right now, that you believe building your assessment skills on a floor first is in your best interest, and you're finding the ICU to be a steeper learning curve than you feel prepared for. I would also let your NM know this (once you found another position you're interested in). Good luck.

Yes I believe I will need to eventually make an appointment with the manager to discuss my concerns. I really had bad feelings about accepting this ICU job before starting but went against my gut feeling.

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