Disappointed New Graduate in Pediatric ICU

adventure_rn, MSN, NP · Jun 25, 2020

It stinks when timing/acuity doesn't work out during your orientation. Unfortunately, all you can do is go out of your way to learn whatever you can, and keep moving forward.

Not sure if you're at a facility that does peds surgeries, but once those resume, you'll probably see an increase in volume and acuity. At my hospital, PICU was down to < 1/4 census for over a month, but now there's a huge backlog of surgeries and procedures so they're slammed.

In a sense, it may be better that the major covid shutdowns occurred at the beginning of your orientation rather than at the end. For now, you really should be focusing on the basics, and soaking up whatever knowledge you can.

Even if things don't pick up, try to be kind to yourself. Your situation does stink, but I'm sure that your coworkers will be understanding. People recognize the current circumstances; if there are certain therapies you don't get trained to (ECMO, CVVHD, etc.), they'll make time to teach you whenever they come up. If the unit has a super-sick kid once you're off orientation, maybe you could ask to have a "buddy" shift to take that patient along with a more experienced nurse. I'm sure you're not the only one in this boat.

For now, try to learn as much as absolutely possible given the current conditions. If anything exciting does happen on the unit (like a code or a procedure), be proactive about watching/participating. Ask your preceptor if they can teach you about the pathophys of the most common conditions/diseases on the unit, even if they're not currently present. Depending on how your unit does code carts (I.e. if they restock/lock their own), perhaps they could let you go on a code cart scavenger hunt.

Also, If you have any downtime, read through the policies for the therapies that you haven't been exposed to yet (I.e. ECMO). Once you read through them, you can ask your preceptor questions, and maybe they can show you where to find supplies, how to set things up, etc. When I worked peds cardiac ICU, the nurses would occasionally have to cover for the unit secretary if we were short. Over a couple of 'secretary shifts,' I read through our entire policy book (30+ policies, 200+ pages). I ended up learning things that some of the most experienced people on the unit didn't even know, and it helped me figure out which questions to ask.

Chin up!

PureHoney327, BSN, RN · Jun 25, 2020

15 hours ago, adventure_rn said:
It stinks when timing/acuity doesn't work out during your orientation. Unfortunately, all you can do is go out of your way to learn whatever you can, and keep moving forward.
Not sure if you're at a facility that does peds surgeries, but once those resume, you'll probably see an increase in volume and acuity. At my hospital, PICU was down to < 1/4 census for over a month, but now there's a huge backlog of surgeries and procedures so they're slammed.
In a sense, it may be better that the major covid shutdowns occurred at the beginning of your orientation rather than at the end. For now, you really should be focusing on the basics, and soaking up whatever knowledge you can.
Even if things don't pick up, try to be kind to yourself. Your situation does stink, but I'm sure that your coworkers will be understanding. People recognize the current circumstances; if there are certain therapies you don't get trained to (ECMO, CVVHD, etc.), they'll make time to teach you whenever they come up. If the unit has a super-sick kid once you're off orientation, maybe you could ask to have a "buddy" shift to take that patient along with a more experienced nurse. I'm sure you're not the only one in this boat.
For now, try to learn as much as absolutely possible given the current conditions. If anything exciting does happen on the unit (like a code or a procedure), be proactive about watching/participating. Ask your preceptor if they can teach you about the pathophys of the most common conditions/diseases on the unit, even if they're not currently present. Depending on how your unit does code carts (I.e. if they restock/lock their own), perhaps they could let you go on a code cart scavenger hunt.
Also, If you have any downtime, read through the policies for the therapies that you haven't been exposed to yet (I.e. ECMO). Once you read through them, you can ask your preceptor questions, and maybe they can show you where to find supplies, how to set things up, etc. When I worked peds cardiac ICU, the nurses would occasionally have to cover for the unit secretary if we were short. Over a couple of 'secretary shifts,' I read through our entire policy book (30+ policies, 200+ pages). I ended up learning things that some of the most experienced people on the unit didn't even know, and it helped me figure out which questions to ask.
Chin up!

That is the best advice ever thank you! I will absolutely do everything you said. We do have surgeries but are yet to start them, I think it will be soon though. Honestly, thank you so much, definitely a sucky situation but I will make the best of it! ?

speedynurse, ADN, BSN, RN, EMT-P · Jun 27, 2020

On 6/19/2020 at 6:51 PM, Connor327 said:
I just started my job in PICU a few weeks ago and I am so unsatisfied with the unit. I love critical care and children, but our unit is so slow right now because of coronavirus (and it being Summer). I feel like I'm not learning anything. Just last week we only had 3 kids in the whole unit and they weren't even critical. I'm just scared I won't become a good nurse after orientation because I haven't been exposed to much! I'm off orientation in fall and that's when the unit starts to get busier with RSV cases. Any tips on how to bridge the gap so I can become competent later on? I'm just super defeated right now and don't know what to do.

I do understand your frustration as someone who also loves to learn. The low census is everywhere and it is definitely not an ideal time to learn for any new grad. I have been SO bored throughout COVID because of the low census (but the few patients are generally very HIGH acuity).....as an experienced nurse. Use the time to get to know your coworkers, ask questions, find some critical nursing/PICU books and study. There are often multiple ways to learn.