Am I ever going to get it?

Ruby Vee, BSN · Aug 11, 2016

New grads in the ICU have the double whammy of learning how to be a nurse at the same time they're learning critical care. I've always believed that starting on a Med/Surg unit or a step down unit was the best way to go -- it seems to promote career longevity and satisfaction above starting in ICU. That said, I have known and precepted many new grads in the ICU and realize that my viewpoint is now regarded as old fashioned.

The first year of nursing is rough. You will feel like you're stupid and useless, that you don't know anything. You'll feel overwhelmed, stressed out, anxious and depressed. Almost everyone feels that way the first year, and I'm not convinced that nurses who say they never felt that way aren't actually lying to me. It takes about a year before you start feeling like a real nurse; it takes about two years to become competent. It's rough, but the only way to GET through it is to GO through it.

CVICU patients are sick, but usually there's a "cookbook" for dealing with them. Make sure you understand your unit's protocols. Can you give fluid without calling, and if so how much and for what parameters? Does everyone get an insulin drip or just the diabetics? Which Doctor insists upon running your drips behind a carrier solution and what should that solution be? Which Doctor thinks you're killing your patient if you give them that extra fluid in a carrier? Who treats a hemoglobin

When you understand what is going on and why, instead of just thinking about a list of tasks to complete, it all falls into place. Just don't expect to feel competent until you've got some experience under your belt.

We've all been through it. We've all had the shifts or months or years when we felt stupid and useless. Trust me -- we remember it, too.

And another thought: those ten preceptors were probably almost as flummoxed as you were. They didn't know you, whether they could trust you, what you knew and what you needed to learn. I know it's asking a lot, but try to have a little sympathy for them. You're all in this together.

sugarmagnolia3 · Aug 12, 2016

It's hard to be a new grad, especially in the ICU. I felt like a fish out of water for at least the first 1.5 years. Every day I went to work in fear of what might happen on my shift. This was a healthy fear for me, because it made me extra cautious. I made many calls to physicians that more experienced nurses may not have made. Oh well. On my days off I spent a lot of extra time reading about diagnoses, labs, patho etc relating to the things I was learning. It helped me make connections and facilitated my critical thinking. I lived and breathed ICU. I loved it so much. I heard ventilators and red alarms in my sleep. I did not love that so much. Anyway, I think you belong there, because you said it is your passion! My suggestion is to try and accept the fact that feeling overwhelmed in the beginning is normal, and tell yourself that it is going to get easier the more experience you gain. Read about what you're experiencing on your days off, but also make time for healthy habits and try to disengage from work regularly as well. Finally, give yourself a pat on the back, hug and lot of credit for graduating nursing school, and getting a new job in ICU! :)