Demoted from ICU to IMCU

[TiffanyB1313]

So I'm a new nurse working in a 14 bed icu. I just graduated in May and started working there in late July. It was going well with my first preceptor on day shift training then I was assigned a new preceptor on midnights which is my assigned shift. And from the beginning she had an attitude with me which I just ignored because almost everyone there is mad because they just started hiring new grads and there is alot of jealousy because most of them had to start in a step down unit or med surg area. Understandable to be jealous just sucks they're taking it out on me.

So with my preceptor on midnights like I said she always had a terrible attitude or gave me a stupid look when I asked a question. I had a question about the IV medication that had a warning on the pump that said it should be in a glass bottle and it wasn't she just sighed loudly and snapped it's fine! And hit submit.

I got over that and then later she snapped on me for following her after she said to follow her to get the aid she yelled I should actually be doing something instead of following her.

So I went to do an assessment on a patient and she said she heard my preceptor and said my co-workers should be nice and that I should like where I worked.

I almost lost it I wanted to cry so bad.

So the next day I asked to meet with my manager to switch preceptors and she some how ended up turning it around to where I was too slow for critical care and talking me into going to IMCU which I knew would happen because they didn't want new grads in Icu and they're super short in Imcu they need to hire like 10 nurses over there so I seen it coming.

People were making up lies like saying I don't help out and I'm like....i definitely help. This nurse asked for help putting in a rectal tube and I was the only one who would volunteer. I could definitely feel the nurses eat their young.

I am just so bummed and disappointed. I feel like a failure. I don't even want to show my face. I'm going to be known as the girl who couldn't handle Icu.

I understand not having new grads in Icu I just wish I would have started in Imcu instead of icu so I didn't get demoted. It also hurts that nurses would lie about me to try to get me out. I was nice to everyone, listened, helped when needed, and brought in treats...i just don't get it. I feel like such a loser. I feel like I shouldn't be a nurse....

I also don't even think IMCU is for me....its not an area I ever thought to do nor have an interest in. But I love patients so I'll try...

I just wanted to vent thanks for listening.

Any advice is welcome

[TessLJ]

I wholeheartedly disagree.

New grads can and do thrive in a critical care area. It just requires a very regimented training program.

I worked in the Medical ICU unit as a new grad and thrived. I think it has more to do with finding your niche as a nurse. Yes, the patients are more critical, but then I had fewer patients than I would have on the floor, and was able to spend more hands-on time with them, honing my assessment and critical thinking skills. Not to mention having so much information right there: vent settings, monitors, arterial lines. I knew exactly what was going on with my patient with all that information available. Nothing would panic me more than arriving to my shift and being told I was floating to med-surg where I'd have anywhere from 8-12 patients. That being said, I think it can get to be a unsafe situation when there are too many new grads as opposed to experienced nurses, and that goes for any unit. One night I got a call from the house supervisor asking me if I could go down to the surgical ICU to assist a new grad with admitting a fresh craniotomy, because there were 3 new grads and one experienced nurse on the shift and the experienced nurse was dealing with the 2 most complicated patients in the unit and couldn't spare the time to help the new nurse.

[jdub6]

I worked in the Medical ICU unit as a new grad and thrived. I think it has more to do with finding your niche as a nurse. Yes, the patients are more critical, but then I had fewer patients than I would have on the floor, and was able to spend more hands-on time with them, honing my assessment and critical thinking skills. Not to mention having so much information right there: vent settings, monitors, arterial lines. I knew exactly what was going on with my patient with all that information available. Nothing would panic me more than arriving to my shift and being told I was floating to med-surg where I'd have anywhere from 8-12 patients. That being said, I think it can get to be a unsafe situation when there are too many new grads as opposed to experienced nurses, and that goes for any unit. One night I got a call from the house supervisor asking me if I could go down to the surgical ICU to assist a new grad with admitting a fresh craniotomy, because there were 3 new grads and one experienced nurse on the shift and the experienced nurse was dealing with the 2 most complicated patients in the unit and couldn't spare the time to help the new nurse.

This is an excellent response. I started in ICU and left after 2 years for personal reasons. At the time I left I thought I was thriving but looking back i wasn't, I had no idea how much or what I didn't know. that said i believe I would have made it there because there were many very experienced nurses who were great preceptors within a long and structured orientation program and staffing was always done with an eye on experience level mix. In another icu with different circumstances i would have drowned and probably made major errors. Certainly short staffing or low average experience of nurses would have been a setup for failure.

That said as the quoted post mentioned ICU has low ratios and lots of resources. Gen floors have high ratios where new grads can get lost and often avg nurse experience is 1-3 years. Step down varies by facility; if ratios are high it can be dangerous. The facility's practices regarding patient placement make a difference also; obviously if a hospital is cautious to step down and quick to step up then stepdown will be calmer than the opposite.

Either way stepdown has the prioritizing needs that gen floors do because the ratios are higher than ICU but also sees enough fancy equipment and procedures to be exciting. Stepdown patients (as well as LTAC) also are often very complex with prolonged stays and many severe chronic and acute issues. Also ICU gas more who are sedated and thus easier for physical care psych issues for example while in stepdown they are much more likely awake. i believe stepdown in general is not easier than ICU at all; you just won't see quite all the really fancy stuff (ecmo for example.)

[nurse_betty_]

awesome post. you said it best!

[beckster]

Work there a year for the experience and then you'll be in a position to decide about ICU. Or quit/transfer to ED, if that's your preference. Think of it as something you did for your resume. If you stay in nursing it'll be just another episode that will seem insignificant as the years go by.

[Dakeirus]

Why do people keep thinking that the ICU is be-all and end-all of nursing? It's so dumb. Different specialties require different set of skills and learning curves. If I were to suddenly transfer from the ICU to L&D, I would be freaking lost and would require months of orientation. If you were to float me to the floor out of nowhere, I'd freak out. Nurses (who have been there for decades) in my ICU get stressed out the moment we're short and they have to take 3 patients. I can't imagine just suddenly floating to the floor and taking 8 patients when I haven't worked there in years. I wish people would wake up and see this.