Feeling inadequate

Hi everyone,

I have made it through nursing school with flying colors and graduate on May 2. I have a great understanding of patho, disease processes, labs, etc. but still feel inadequate.

All through nursing school I have wanted to go straight into an ICU and eventually to CRNA school. I am doing my preceptorship in the CVICU I have wanted to work in for so long. But, I just feel lost and overwhelmed. In some ways, I feel like I have made a lot of progress, but then something happens and I feel so bad about my performance. When I'm on the floor, I can understand WHY something is being done, but I have a hard time ANTICIPATING interventions, labs, etc. My preceptor is an awesome ICU nurse, and she has been nice to me, but sometimes I just get a weird vibe from her, although I know that this could just be my own crazy perception.

I try to tell myself that I am still a student, and it is unreasonable to expect to be able to do everything right by myself at this point. I also tell myself that I will be adequately trained by whatever institution hires me. But, I'm second-guessing my abilities and see all my hopes and dreams going down the drain.

I don't really have anybody that understands how I am feeling. Am I just being too hard on myself and making myself crazy? Or, do I need to give up on working in an ICU?

Hi everyone,

I have made it through nursing school with flying colors and graduate on May 2. I have a great understanding of patho, disease processes, labs, etc. but still feel inadequate.

All through nursing school I have wanted to go straight into an ICU and eventually to CRNA school. I am doing my preceptorship in the CVICU I have wanted to work in for so long. But, I just feel lost and overwhelmed. In some ways, I feel like I have made a lot of progress, but then something happens and I feel so bad about my performance. When I'm on the floor, I can understand WHY something is being done, but I have a hard time ANTICIPATING interventions, labs, etc. My preceptor is an awesome ICU nurse, and she has been nice to me, but sometimes I just get a weird vibe from her, although I know that this could just be my own crazy perception.

I try to tell myself that I am still a student, and it is unreasonable to expect to be able to do everything right by myself at this point. I also tell myself that I will be adequately trained by whatever institution hires me. But, I'm second-guessing my abilities and see all my hopes and dreams going down the drain.

I don't really have anybody that understands how I am feeling. Am I just being too hard on myself and making myself crazy? Or, do I need to give up on working in an ICU?

You sound normal to me, but fear of failure is the craziest thing - makes you feel like quitting before you've ever *really* failed. Since this involves your hopes and dreams, I think you should keep going until you're forced out of there. Make doubly sure that if the door slams on you, it was someone else doing it and not you thinking it might be coming and then slamming it on yourself.

[Perpetual Student]

It's my understanding that this feeling is pretty universal regardless of the specialty. It makes sense, given the level of responsibility and the vast amount of knowledge that one is responsible for as a nurse. Unless you've having major issues with lack of judgment or risk to patient safety, you should tough it out a while. There's a reason that most new grad ICU programs last many months. Experience and extensive ICU-specific training sounds like the perfect cure for your lack of anticipation of interventions and labs, and you should get plenty of both during your orientation.

If at the end of your orientation you still feel this horrible it might be appropriate to consider quitting, but until then it's the rational response to your inexperience in a very complicated, demanding environment. Just relax, be honest when you don't know something, and work hard. Learn what you don't know. There are some killer resources tacked up over in the critical care forums that might help you considerably if you haven't already perused them.

Good luck.

[Daytonite, BSN, RN]

you are still a student. it is unreasonable to expect that you will be able to do everything right by yourself at this point. you are second-guessing your abilities. your hopes and dreams are not going to go down the drain.

i and thousands of other nurses understand how you feel because we went through the same thing you are going through. we all go through it. if you didn't, i'd be wondering about you. we were all this hard on ourselves. it's because we want to be the best we can be and not make any mistakes. it takes time. i'm talking months, perhaps a year or so after you graduate before you begin to feel like you have some confidence in what you are doing. during that time you will do a lot of self-reflection and boning up. your learning doesn't stop with graduation; it begins. you just get paid in the process which adds a bigger element of stress.

and, no, you are not crazy. and, if you give up on working in an icu and becoming a crna i will send guido over to your place to have a little talk with you.