Feeling very anxious about new job...

[leisa22]

Hi all,

I have been a med/surg nurse now for about 7-8 months and am moving into an ICU area. Im very scared and anxious because I took 3-4 months off between the transition and because my med/surg job was at a very small hospital with not so sick patients. The nurse to patient ratio was usually 4 to 1. Needless to say, it wasnt too difficult. My new job is in a much bigger hospital with very sick patients. The nurse to patient ratio is still low 3 to 1, but the acuity is so much higher. The manager who hired me said she never hires new grads, but I feel like a new grad in regards to my lack of experience. I would feel a little better if she did hire new grads but I feel like she will expect so much more from me just becuase Ive had those few months of med/surg experience. I start in Sept. and am getting more and more anxious as august slips away. Anyone else experience this anxiety when switching from med/surg to ICU or from low acuity patients to extremely sick patients?

thanks

[funinsun]

Hi leisa22 and everyone,

I have just graduated nursing school so am not licensed yet but just finished up my ICU rotation in school which was very different from my other med/surg rotations. I completed clinicals in the Cardiac ICU and the MICU and was very nervous about being there.. The patients I had dealt with had been much less in acuity in med/surg and it was definetly a change in the ICU but I loved it. I had never seen vents, drips or anything and had to learn it really quick (especially because I was so nervous!). The ICU environment is great, everyone works pretty closely because they are aware of the critical nature of all the patients and so are willing to help you out (they don't want anyone to code as much as you do!). I found out after a few weeks that there was almost always a pattern to what ICU patients were receiving and having done as far as having vents, NG tubes, Dubhoff tubes, foleys,3 or more pumps, rectal foleys/thermometers, continuous monitoring (ekg , O2 sat and cvp etc.) and rotation beds. (certainly not all but a lot) The more I dealt with those things the more comfortable I felt and I was only a student! A lot of the cardiac patients had dopamine drips, vasopression etc. and once you get comfortable with the titration on the machine and the monitoring it got 'easier' to manage though each patient is different (no patient is ever 'easy' because usually many body systems are involved unlike med/surg). I found you had a lot of contact with families and had to be ready to answer pretty indepth questions from a lot of them because a lot of them, since they were so acute, were pretty interested/involved in their loved one's care.. I gained a lot more experience with communicating with Doctors too because they were there more frequently ( it seemed) and I would ask them patho/phys questions..

Working with high acuity patients is pretty interesting and keeps you busy, makes your day go faster because you're always moving!! Good luck with your move to the ICU-you'll do great!!!

[leisa22]

thanks funinsun for your reply,

When you get licensed, are you planning on going into a critical care environment? I agree, its very interesting. I just hope I can handle it. Most ICU environments offer courses as part of there orientation/preceptor time, however this one doesnt so Im worried about learning about all the devices used in ICU without having the class. I really just should try thinking positive because Im always worried with new experiences and they always turn out ok.