Experienced RN/New to ICU...Help!

[ZSimzNeuroNurse, BSN, RN, EMT-B]

Hey, all! The title may be slightly misleading, as my "experience" consists of only 1.25 years of nursing on a cardiac telemetry floor right out of nursing school. I became VERY good at a lot of cardiac nursing functions, assessments, and rhythm/rate identifications. I really enjoyed the cardiac aspect of care and I before I transferred to my current unit I felt extremely independent and was always on top of my game and I feel as though I was generally a good nurse all around (of course I had my off nights where I felt like I could have done better); however, about a week or so ago I started my job in the neurosurgical ICU. I work in a level 1 trauma magnet hospital in a major city in the U.S. and we get the sickest of the sickest. I thought with my bout of experience on my previous floor (being in the same facility, just a few floors up), I was well-prepared to quickly learn and adapt to the ICU setting. I am here to tell you that I have run into a few problems and I need some advice...

1. I know cardiac, and I know it well...but working in NSICU now, all we care about (unless the patient is actively in cardiac distress) is neuro, neuro, neuro...something I literally never really learned a lot about in my experience as a nurse and forgot a lot about since nursing school since I haven't been applying my neuro skills or full, in-depth neuro assessment.

2. I feel like, in general, getting used to where things are on the unit, getting used to where supplies are kept in the rooms, adapting to understanding their equipment and my new responsibilities and what I no longer have to do is absolutely throwing me off and it makes me feel incredibly stupid and worthless when someone is asking for a butterfly needle from the carts in the rooms and I don't even know which drawer to fling open to swiftly retrieve it, yadda yadda.

3. Lastly, the unit I left, I left with a heavy heart. I LOVED and adored ALL of my coworkers. They were amazing people and we all got along and worked very well together as a team. Now, I feel like 75-90% of my new coworkers are stuck-up and think they're better than me and they won't give me the time of day to even look in my direction. The only people I am getting to know are my preceptors (2 of them). Everyone seems so mean and rigid and I don't understand...I am always courteous, respectful, and humble in all of my interactions.

Essentially, I feel insanely dumb. I feel like I am just starting nursing all over again with no education and no prior experience. I feel like a failure, which is a feeling that hits me hard because I always prided myself on my last unit as being an aggressively active nurse who was consistently spot-on with assessment changes and reporting needs for rapid responses, codes, rounding incidents, etc. I was NOT a lazy nurse, by any stretch of the imagination. Please give me some advice as to where I should be in my head space and what I should do...I feel so lost and my preceptor has such a tight leash on me that she won't let me learn because she keeps micromanaging everything I do without providing me opportunities to do things for myself while she monitors.

TL;DR I have over a year of cardiac nursing experience that i felt that I excelled at, I just transferred to neurosurgical ICU last week, and I feel as though I know absolutely nothing and my new coworkers seem really mean and cold toward me. I really need some advice as to what I should do.

[smf0903]

I went from a med-surg/tele unit to ICU about a year ago. I can thoroughly understand the feeling like starting over/new nurse again feeling. Although I've come a long way, I still feel like there are ten bazillion things I don't know.

One of the first things I did was stock. Stock, stock, stock. This helped me learn where things were at.

I do a ton of reading and such on my days off. I keep a notebook of questions to ask someone if I don't understand something I'm reading at home. I review meds at home. I know there is a lot that can't be learned unless you're in the moment, but there are a lot of things I can review and brush up on to help me when i am at the bedside.

I wish you the best! I hope you end up enjoying your new position. I admittedly had many times that I wondered why I made the move when I was doing great where I was at (and I loved it, loved my co-workers, etc). But I'm glad I was afforded the opportunity and I have grown leaps and bounds. Hopefully you'll look back and think the same :)

[ZSimzNeuroNurse, BSN, RN, EMT-B]

Reading this gives me a lot of confidence, as it seems we are similar in our experiences! I will definitely make some time to begin stocking the room carts as they are already stocked so that I can help my memory when it comes to an urgent/emergent situation and so that I'm not flopping about to find the alcohol wipes haha I do currently question whether or not I made the right move, and I often think about the fact that I could transfer back to my old unit, but I do want to afford myself the opportunity to learn and grow before I make this decision; so, like you put it, hopefully I, too, will look back on these feelings with a fond smile and sense of humor lol

Thank you again for sharing :)

[gromit1084]

I had a similar transition to the ICU. Came with 2.5 years experience and felt like the dumbest, newest nurse. It was rough! But you have to give yourself at least a year. It does get better. There are so many emotions that one goes through during their "ICU growth", just remember that its normal, everyone has gone through that. Be patient and compassionate with yourself. And try your best to get through the preceptor part and the snarky co-workers. Once they get to know you and your work ethic, they'll (hopefully) come around. If they never do, then that unit is not a good fit but you will need at least a year to see how things settle.

For me, I had a few preceptors that we worked well together and some that it was just constant tension and it felt terrible. On days like that, or when I had interactions like that, I would almost just do as they say just to get through it and try to learn as much as I could, even if I knew I would do things differently on my own. As long as the patient is safe and their care comes first, the rest is just an art form. As a new ICU nurse, it can be hard but you have to be really humble and receptive to other people's feedback and style of working.

Mostly, just give yourself at least a year and lots of love and patience. It will come! thousands of other nurses have made it through, so you can too!!

[Here.I.Stand, BSN, RN]

Did you come out of nursing school with your cardiac knowledge? Of course not. You learned through experience. Neuro is extremely complicated as well, but you have demonstrated that you have the ability to learn. You will likewise learn this stuff.