After having spent a good amount of time as a preceptor for new nurses to ICU, the difference between a new grad and a more experienced nurse who is new to the ICU setting is huge. I feel that nursing school does very little to prepare you for what nursing is really about. As a result, new grads have a huge learning curve - just to become a nurse. Many of the daily tasks and skills have never been done by the new grad. Much of their time is spent learning the "tasky stuff". How can we expect them to even begin to critically think when they are focused on completing tasks, developing basic nursing skills and getting organized??
The nurse who has spent time on the floor not only has their organization and skills developed, but now has time to begin to critically think about what their patients are going through and the pathophysiology involved - only now it is a much less critical/stressful situation. When these nurses come to the ICU, they can pick up the new tasks quickly and spend a lot more time thinking about the "why's", developing the knowledge to become good ICU nurses.
That being said, I truly feel that new grads have no place in the ICU. However, because of the current situation, we seem to be stuck with this. I do believe with the right orientation, preceptorship, mentoring and desire to learn, new grads can be successful in the ICU and it is our job to help them to succeed so we aren't saving their butts or cleaning up after their messes every day.
On a side note of this discussion, I agree that it takes at least a year for a nurse to begin (notice I said begin) to feel comfortable in the ICU. It makes me absolutely ill to see these people with only 2 or 3 years experience, who think they now know it all, training the new grads or taking charge. Is it any wonder that many new grads do not get the training they need from their preceptors?? How can somebody with so little experience in such a demanding field be expected to adequately teach others or actually be the resource person for the entire unit?!
Maybe this is just my experiences with ICU coming into play. When I started, nurses had to be on med/surg for a year before going to a telemetry or step down type unit, where they spent a year before applying to ICU. Typically nurses had to be in ICU for about 4-5 years before they were even considered to be a preceptor and another year before they were placed in charge. If only we had that luxury now.....
This discussion is really fascinating to me because I am a new grad nurse (incidentally the only new grad) orienting in a CCU and I have experienced some of the resentment (I guess that's the best word for it) coming from some of the experienced nurses. I understand where they are coming from (even more after reading this discussion), even if I don't agree. I am not in a position to know why my unit manager made the offer to me to come to the unit, I don't know what factors are in play, I do know the unit is short staffed, to the point where the vast majority of staff are working at least 1 extra shift each week. I feel like I am lucky because the preceptor I am assigned to came into the CCU as a new grad herself (although she was a paramedic previously) and she has been great about helping me learn how to be a nurse at the same time as being a critical care nurse. I know that I will be slower to catch on to things in the CCU, I also know that I have to work hard at it, which I do every night when I come home from work, looking things up, spending time on websites gathering information. I am a little disturbed to hear some of the experienced ICU nurses on this site say that they think new grads come in with an attitude like they know everything. I try to be confident and thick-skinned, but I know that I know next to nothing in comparison to anyone that has worked on the unit for any length of time, and I hope I have never done or said anything to make any of the nurses on my unit feel like I think I do. I am sorry if some of you are experiencing know-it-all new grads, but please don't judge all of us based on that experience. There are some of us who are making a huge effort to become a contributing nurse on the unit. That said, I sort of don't understand why an experienced nurse would allow that resentment/animosity towards new grads to show (as a few on my unit do), because as is clearly demonstrated here, it is happening, new grads are coming to ICUs, so maybe the focus should be on how units can provide training and orientation sufficient to get them (us) acclimated quickly. Alternatively, if you just believe absolutely and 100% that the ICU is no place for a new grad, regardless of the training provided, then maybe you need to approach management about it instead of taking it out on us. Don't get me wrong, I can handle it, one of the nurses said they thought it was "ballsy" for a new grad to think they could come into the ICU straight out of school, I guess if I'm ballsy enough to do that, then I'm ballsy enough to put up with the fallout from that decision, I just think it's counterproductive for nurses to engage in "eating their young," because even if you succeed in driving a nurse away, you are left with an empty position to fill, maybe you'll be lucky enough that management slots in an experienced nurse, or maybe you'll just get another new grad. It would just be nice to get, if not support, at least acceptance, because I am really sick of hearing for the 800th time from the same people over and over again what a bad idea it is. Message heard, let's move on. Sorry, I guess this turned into a rant at the end, but it's just another new grad's opinion.
Nicely said Rachel. I've been following this thread for a while. Your comments are spot on.
I'd like to add that not all units are anti new grad. After reading all the horror stories and bitter sentiments on the topic, I feel so fortunate to have had such an incredibly warm welcoming from the staff on my unit. I'm just one month into my 6 month orientation (class & clinical). I have a wonderful preceptor - she's supportive and protective, yet provides a lot of opportunity to challenge me. The rest of the staff, nursing and ancillary has been terrific. If something interesting or cool comes up, they go out of their way to seek me out so I can observe and participate in the event (codes, watching a bedside brain drain insertion, etc). I feel like everyone has taken me under their wing and see my successes as their successes.
Transitioning from a novice nurse to a profient nurse is tough - anywhere. Choosing to do so while taking on a speciality like critical care is even harder - as so many have already pointed out. But, that's what I love about it.
..... I have experienced some of the resentment (I guess that's the best word for it) coming from some of the experienced nurses.
..... That said, I sort of don't understand why an experienced nurse would allow that resentment/animosity towards new grads to show (as a few on my unit do),
.....I just think it's counterproductive for nurses to engage in "eating their young," because even if you succeed in driving a nurse away, you are left with an empty position to fill,
.....It would just be nice to get, if not support, at least acceptance,
Rachel, after 35 years in nursing I think I am safe in telling you a little secret.
No matter who you are, how old or young you are, how experienced or not, what unit you work on, what shift you work, male or female, wouldn't matter - cause there are always nurses who will not accept you, will show resentment and animosity, and there will always be those who won't support you and will try to make you miserable.
Then there will always be the ones who are jewels. Somehow the others take you attention, but there are also nurses who will nurture, encourage and support you. Treasure them.
If you are happy in the area where you are working, are trying hard and doing your best, don't worry about it. Leave only if you don't want to be there. Don't let others drive you away. Many times, once they realize your sticking around they will improve, or if not, at least leave you alone. Good luck to all you new grads, wherever you are working. Don't forget how badly you are needed, even if certain folk don't roll out the red carpet. :icon_hug: :kiss
As a new grad in an ICU, I can only add this...I would not have entered nursing if critical care weren't an option for my first job. It's the only place I wanted to work. If med-surg were an absolute requirement to get into ICU, this profession would be one person short(er). I'll take the complaining behind my back from those who think I don't belong. I put on my big-girl panties before I started this job, knowing there were people who think this way. However, a smile and recognition/respect for their point of view has served me well.
This I will say...of the 15 people in my critical care class, there were three of us going into ICU. Two of us were new grads. One of the three failed the class. I'll let you all guess who it was.
I am not a new grad and have just entered ICU..feel like I have just started all over again. My game plan? I come home and read-read-read. Get a good but thin Critical care book and show them who is who. I have been eaten..even if I didn't give report in the same manner as the other nurses (although still good) they have turned up their nose...my view? They can go do their own assessment everyday if they don't like mine.
Let me just tell you that some nurses are just XXXXX. I have been on the receiving end of nurses eating their young when I was a new grad, and it scared me so bad I left nursing altogether until I finally had the guts to give it another try.
I do agree that new grads might be better served doing at least a year of med-surg adults. I think that you really learn time management and basic skills and organization this way, and that will make your ICU time much easier.
However, if you are a new grad who enters the CCU/ICU without an attitude and have a willingness to learn and do the scut, then no "older" seasoned nurse should have the right to eat you alive. They should be greatful for the help and that you are there when they can be so short staffed.
If I had it to do all over again, though, I would have done a year of adult med-surg. I chose pediatric heart transplant because it was the toughest thing I could think of doing, and it nearly ruined my career because I gave up out of frustration.
As a new grad I understand why a lot of them choose critical care over "paying their dues, so to say" on the floor. We are absolutely terrified of the responsibility of taking on so many patients so soon. I realize that these pts. are "supposed" to be quote/unquote "stable", but we all know that all too often our Med Surg floors are occupied by pts w/ all levels of acuity, especially if the CCU's are full. I don't know how other nursing schools operate, but the most pt. load we ever had as students, even in our last smstr of school, was 2, but we always had our instructor or a nurse close by to come to our rescue. Every hospital I have interviewed w/ in this area range anywhere from 5-8: 1 w/ the exception of Children's. Even while I was a student I would see seasoned nurese running like chickens w/ their head cut off trying to keep up....how can they expect a new grad to keep up? Every new grads worst nightmare is the thought causing harm or killing a pt. and I think loading them down w/ such great responsibilty of so many pts. increases the likelihood of that occurring. I DO NOT in any way think I am above paying my dues or working on a floor, ie - Med Surg. but run away from it out of fear.
As a new grad I understand why a lot of them choose critical care over "paying their dues, so to say" on the floor. We are absolutely terrified of the responsibility of taking on so many patients so soon. I realize that these pts. are "supposed" to be quote/unquote "stable", but we all know that all too often our Med Surg floors are occupied by pts w/ all levels of acuity, especially if the CCU's are full. I don't know how other nursing schools operate, but the most pt. load we ever had as students, even in our last smstr of school, was 2, but we always had our instructor or a nurse close by to come to our rescue. Every hospital I have interviewed w/ in this area range anywhere from 5-8: 1 w/ the exception of Children's. Even while I was a student I would see seasoned nurese running like chickens w/ their head cut off trying to keep up....how can they expect a new grad to keep up? Every new grads worst nightmare is the thought causing harm or killing a pt. and I think loading them down w/ such great responsibilty of so many pts. increases the likelihood of that occurring. I DO NOT in any way think I am above paying my dues or working on a floor, ie - Med Surg. but run away from it out of fear.
However, let me point out that if you are gravitating to critical care to maintain a 2:1 ratio, that is a big mistake.
First, you should learn the curve of nursing and that requires the ability to care for more then 2 pts. Nursing school doesn't teach you how to be a nurse. It arms you with the knowledge to LEARN how to be a nurse, on the job. If expanding your comfort zones on a medical floor is too big a fear, then don't expect that you can avoid such growth in critical care.
2nd, 2 pts in critical care are by far and away a bigger assignment then the 2 pts you took care of in school. It's so apples and oranges as to not be on point.
If the concern is that you don't 'kill someone', personally, coming straight into critical care would be a much bigger concern in that vein.
I'm not totally against a new grad coming straight into critical care, or rather, I realize that reality is reality. But I think it is incumbent that those new grads have EVEN MORE of the heft and ambition to take on bigger challenges, not less.
Otherwise, you are setting yourself up for failure, or to use the phraseology of this thread: to be eaten.
I'm not saying that critical care is more challenging then the floor. I've worked both and both can tax me to my wits ends: but for different reasons. No, I AM saying that working med/surg will arm you with skills that will augment critical care. In fact, I'm saying that med/surg is a FUNDAMENTAL part of the skill set to excel in critical care.
Having to learn both types of skills sets at the same time is a huge challenge. But you WILL have to learn both types. Coming straight into critical care will not buy you a pass on that.
I just wanted to introduce myself I am a recent graduate hired in CCU
I have not been received well by the other nurses, and I am trying really hard to do the best job I can, but I wonder....
If there is such a nursing shortage, why am I having such a hard time with the other people who work on the floor?
I really want to know, maybe there is a bit of aprehension because I ma new, but I here this saying how nurses eat their young.
And I gotta say, it could be true in this case.
Any feelings or suggestions?
Thanks!
Some call it 'eating their own young.' Others call it 'proving yourself as a nurse.' And then, there is 'reality shock.'
Sometimes nurses DO eat their own young. But sometimes, they get tired of carrying the load of the young. And then, the reality is that nursing is not an easy profession and not everyone can be a nurse.
You almost brought tears to my eyes. I am not a new grad, but new to Critical Care. I am treated by my coworkers so poorly that I am thinking of quitting profession altogether.
Rachel, after 35 years in nursing I think I am safe in telling you a little secret.
No matter who you are, how old or young you are, how experienced or not, what unit you work on, what shift you work, male or female, wouldn't matter - cause there are always nurses who will not accept you, will show resentment and animosity, and there will always be those who won't support you and will try to make you miserable.
Then there will always be the ones who are jewels. Somehow the others take you attention, but there are also nurses who will nurture, encourage and support you. Treasure them.
If you are happy in the area where you are working, are trying hard and doing your best, don't worry about it. Leave only if you don't want to be there. Don't let others drive you away. Many times, once they realize your sticking around they will improve, or if not, at least leave you alone. Good luck to all you new grads, wherever you are working. Don't forget how badly you are needed, even if certain folk don't roll out the red carpet. :icon_hug: :kiss
It is not unusual for ICUCCU to be a difficult area to fit into. They are a pretty "tight" group. I don't think they intentionally "eat their young" but I know it sure feels that way. Be patient and you will earn the right and respect to be there. Been there done that. I know its not fun to be on the outside looking in. You can do it and you will be glad you did. Ask yourself, "How bad do I want it" Then don't let them drive you off.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
ha...i am an old new grad. new to nursing....old to the politics. i have seen where the "nurses eat their young." they do....sometimes. i have not had a problem with any nurse....older or younger than me. i feel for the older nurses though. there are these new 22 or 23 year olds that are trying to run the show. they want to be in charge all of the time. they think they know it all. they don't. i don't either....but i'm not like that. it almost pisses me off that the manager will put these young girls in charge...but i know it pisses off the senior staff. not quite a fair deal.
as far as the "eating our young" goes, i think it tends to be a self-fulfilling prophecy. newbies come in expecting to be catered to, spoon fed information and never critiqued. any negative feedback is decried as "eating of young." not all newbies are this way, but more and more each year. sometimes, you're gonna get critiqued just because you've done something stupid, and maybe this is the third or fourth time you've done it. sometimes you're gonna get critiqued because you've been here for months, this is a simple concept, and you'd rather do things your way than our way.
i've also heard managers state that they need to make sure the newbies get percs: charge shifts, advanced skills training, continuing ed opportunities, vacation during the holidays, etc. because "if we don't keep them happy, they'll leave." i'm sure you can imagine how this must feel to the nurse who's been there for 10 years, demonstrating loyalty and having patiently waited her turn for the percs that used to be assigned by seniority or merit and are now being given to the newbies to keep them from leaving.
studentnurserachel
141 Posts
This discussion is really fascinating to me because I am a new grad nurse (incidentally the only new grad) orienting in a CCU and I have experienced some of the resentment (I guess that's the best word for it) coming from some of the experienced nurses. I understand where they are coming from (even more after reading this discussion), even if I don't agree. I am not in a position to know why my unit manager made the offer to me to come to the unit, I don't know what factors are in play, I do know the unit is short staffed, to the point where the vast majority of staff are working at least 1 extra shift each week. I feel like I am lucky because the preceptor I am assigned to came into the CCU as a new grad herself (although she was a paramedic previously) and she has been great about helping me learn how to be a nurse at the same time as being a critical care nurse. I know that I will be slower to catch on to things in the CCU, I also know that I have to work hard at it, which I do every night when I come home from work, looking things up, spending time on websites gathering information. I am a little disturbed to hear some of the experienced ICU nurses on this site say that they think new grads come in with an attitude like they know everything. I try to be confident and thick-skinned, but I know that I know next to nothing in comparison to anyone that has worked on the unit for any length of time, and I hope I have never done or said anything to make any of the nurses on my unit feel like I think I do. I am sorry if some of you are experiencing know-it-all new grads, but please don't judge all of us based on that experience. There are some of us who are making a huge effort to become a contributing nurse on the unit. That said, I sort of don't understand why an experienced nurse would allow that resentment/animosity towards new grads to show (as a few on my unit do), because as is clearly demonstrated here, it is happening, new grads are coming to ICUs, so maybe the focus should be on how units can provide training and orientation sufficient to get them (us) acclimated quickly. Alternatively, if you just believe absolutely and 100% that the ICU is no place for a new grad, regardless of the training provided, then maybe you need to approach management about it instead of taking it out on us. Don't get me wrong, I can handle it, one of the nurses said they thought it was "ballsy" for a new grad to think they could come into the ICU straight out of school, I guess if I'm ballsy enough to do that, then I'm ballsy enough to put up with the fallout from that decision, I just think it's counterproductive for nurses to engage in "eating their young," because even if you succeed in driving a nurse away, you are left with an empty position to fill, maybe you'll be lucky enough that management slots in an experienced nurse, or maybe you'll just get another new grad. It would just be nice to get, if not support, at least acceptance, because I am really sick of hearing for the 800th time from the same people over and over again what a bad idea it is. Message heard, let's move on. Sorry, I guess this turned into a rant at the end, but it's just another new grad's opinion.