(I am using my very dear friends laptop and account to write this). She told me about how awesome this site/forum was and that it will help me through this tough time (I am also writing this on my break so I really am doing this to vent). I am a new grad ICU nurse, I thought this was where I wanted to be as a nurse but I am so depressed and feel like the dumbest person on earth. I am usually a relaxed person but I am very nervous going into work. My preceptor likes to work FAST, her motto is "I come to work to get paid, not work all night" so we have to move fast and do as little as possible. I think she is a very smart nurse (seriously i do!) and I think she's a good preceptor, I just think that I am so stupid and need to work somewhere with a slower pace.
I can have things written down but because I know it irritates her to wait for an answer (she has mentioned this MANY times) I just open my mouth without thinking instead of saying hold on and reading my sheet. I don't let things process before I blurt something out. For example I go to work really early, I check the order for G feeds under nutrition, I know that's where to look but as soon as my preceptor asks, I'll blurt out in the medications tab! SMH, I can't understand why I get so nervous.
One issue was during report a patient was to be titrated down from his levo. This patient had his MAPS above 100 the entire shift, while we were giving a bath he had a seizure, during his seizure his MAP tanked to 54 my preceptor yelled to change his levo. I asked: increase or decrease? Stupid question! This is my 5th week of orientation and I got so nervous and she even mentioned that I'm too nervous.
Another incident during report a nurse said a patients levo was on hold. I looked at the monitor (we use space labs) she had an A line and a cuff reading. I looked at the cuff pressure (MAP 52) and asked what the levo was on hold for. Well stupid me didn't look at the A-line reading and I didn't look at the time the BP cuff reading was from. My preceptor and the nurse looked at me like I was the dumbest person on earth. The nurse just looked at me and asked if I knew what levo was for in the rudest way possible.
Another incident was I was told to draw a venous gas. I got the ABG kit and was going to do a venous draw from it. She then stopped me and said that I can never do a veni poke for a venous blood gas, that can only be drawn through a central line. She said that she's mention this before in the past to me but I don't remember. She also had to remind me that the patient had a central line and that I could stop his fluids to draw the blood.
I was giving report and I gave the patients temperature readings during my report on neuro, she said ..I told you to report on neuro, NEURO not cardiovascular, temperatures are cardiovascular.
I am also suppose to cluster my tasks so we will look off his orders and will say "patients is getting these meds, tell me to get the meds, tell me the color tubes I need for labs, the vitals machine and IV fluids...that's way we don't go back and forth which is a waste of time. Well of course my luck, I ALWAYS forgot something! :-(
My preceptor will give a lot of "if you ever get a patient" "when you get a patient" and I honestly can't remember all of that when the time comes, which irritates her.
My preceptor is very blunt, she will straight out tell me who the "dumb nurses are"(I kid you not, that's howshe refers to them) I can only imagine what she's saying about me ...I overheard her talking about me today that I'm dumb and it makes me cry but she's right, I have done some very stupid mistakes.
I may now be out of a job, she said she can't guarantee I'll pass orientation (we get 6 weeks orientation).
She sounds like a *****, lol. I was a new grad in ICU, my orientation was about 3 months, and then even after that the other nurses looked out for me. I remember when I was off orientation, my patient was having increased O2 needs. I didn't think much of it, I just titrated up O2 from 2L to 4L to 5L. Then one of the nurses asked me what I thought about it. I didn't think much of it, sometimes patients need more O2 (I was so nieve). She explained that in the likely event that I needed to go up more, what would my plan me. I didn't know. She suggested intubation. I said noooooo, I don't think so. So she suggested I called Dr (I worked nights, so it would mean waking up the surgeon). It wasn't too late, but I said I didn't think that was necessary... About 10 mintues later I called the surgeon for increased O2 needs and we intubated. lol.
My point is, you're not dumb. You're new and inexperienced. You need to be nurtured (sp?).
You need a better learning environment, first of all. Where you can ask questions as far as rationale. You probably know a lot more than you think, but it might take another nurse to help point that out. This nurse isn't that person, it sounds like. I would actually look into another ICU floor or hospital. I wouldn't want to work around that person who just thinks so much of her own opinion and isn't willing to help you understand things.
And honestly, I didn't realize that chemistrys were always green tubes until I was a nurse for about a year lol I always just printed my labels and found the tubes color on the label.
None of these situations involve stupid mistakes. You aren't going to remember everything...good Lord, at 5 weeks in you don't even know what you don't know, especially on a critical care unit. This really shouldn't be acceptable. Your preceptor is a jerk.
I am also a new grad in an ICU and it is chaos and it's busy and it's surgical/trauma. I feel stupid often. I feel dread going into work often. I've contemplated leaving often. I've found this personality type to be a trend. I was also told when I was on orientation many times "didn't we go over this before?" "why don't you remember this?" but you have to shrug it off. I am only about 6 months in, 3 months off of orientation myself. I feel good until I don't...I feel competent because my patient does fine until I've asked why I've done XYZ without even realizing XYZ was a problem or contraindicated. A lot of nuances to be learned. None of your story surprised me except that she called you dumb. That's not okay. I can also only imagine what is said about me but I try to bring it up so it can be said right to my face rather than behind my back. I've been called slow and heard "shh" as I've approached nurses but you shouldn't be crying. I'd say try to tough it out as long as you can, when you've hit your wall get moving. I am pretty much at my wall around six months and I have a few interviews coming up. I will stay here as long as I need to just knowing in the back of my mind it's not forever. I feel dumb often too.
Aloe_sky being honest and trying to first establish a medium with your preceptor is a good way to start, if that fails than you can request a new one. If Icu is your passion, than don't give up. You will not feel this way forever.
You aren't dumb. You passed nursing school and the Nclex. Your preceptor sounds like she is lazy, and a bully. Talk to your unit manager about what is going on. They are not going to base your hiring on one nurse's opinion. It sounds more like she is using scare tactics, to remain the alpha nurse. They hired you knowing you can do the job. Don't let this idiot undermine you and take that from you. I also wouldn't even listen to a person who calls a coworker "retarded"; that alone, shows what little class she has. At end of the day, her rush rush rush work ethic to get this done and rest all night, will end up killing someone.
You aren't dumb. You passed nursing school and the Nclex. Your preceptor sounds like she is lazy, and a bully. Talk to your unit manager about what is going on. They are not going to base your hiring on one nurse's opinion. It sounds more like she is using scare tactics, to remain the alpha nurse. They hired you knowing you can do the job. Don't let this idiot undermine you and take that from you. I also wouldn't even listen to a person who calls a coworker "retarded"; that alone, shows what little class she has. At end of the day, her rush rush rush work ethic to get this done and rest all night, will end up killing someone.
I agree. This is truly bullying behaviour. When I was a fledgling ICU nurse, the unit educator was a similar type...always commenting loudly on other people's stupidity and implying her own brilliance, calling other nurses by insulting nicknames. I now recognize that this person set a terrible example. Part of the role of the preceptor is to model professional comportment, and this is not it.
I get I make stupid mistakes and ask the dumbest questions but it doesn't need to be shared with everyone on the unit. I think she is a smart nurse and I think I can learn a lot from her but that part is just inappropriate.
Nurses who don't ask questions kill people. It is normal to have anxiety with a new job, and to scramble things that you do honestly know. Any half-decent preceptor makes it a focus to work in a way that decreases your anxiety so that you can get your feet under you.
Nurses who don't ask questions kill people. It is normal to have anxiety with a new job, and to scramble things that you do honestly know. Any half-decent preceptor makes it a focus to work in a way that decreases your anxiety so that you can get your feet under you.
I will add to your excellent comment that anyone who knows anything about education knows that high anxiety hinders learning. An ICU nurse needs to learn how to function under pressure, but this is not the way to do it.
Sounds like you for sure need a new preceptor. I was a nurse for 5 years before I started in the ICU. I still was given 10 weeks orientation. You for sure need more than 6 weeks orientation. Your preceptor sounds like someone who is very disrespectful to you, and should not precept anyone.
She does intimidate me, I think that's why I'm so nervous around her. One night she was telling me that I shouldn't be afraid to over sedate my patients, she said it's to prevent the patients from extubating themselves and makes an easy work night (even with restraints, I think I will make a separate post to ask other nurses about this). She then listed the other nurses that bolus sedations and then the "dumb" ones that keep running into their patients room. There were 3 nurses on the unit one night that have been there for 1 year and she told me not to ask them for help because they are dumb and ask the dumbest questions. I said but they are new, her response was "that don't matter, they are just dumb" that type of response puts me off, I just say "oh ok" but inside I'm feeling like she thinks of me as soon dumb it bothers me to even ask her things, to even speak to her
An ICU that is a. hiring new grads and b. giving them only 6 weeks of orientation and c. assigning preceptors who are openly hostile and resentful of their preceptees?
There is a problem in this scenario, OP, but it isn't that you're a dumb nurse.
By the time a unit is hiring in the pattern shown here, this may be the last experienced nurse even theoretically capable of precepting available, though obviously she is not suited to the task.
I agree that you should go to your manager about this but I think you should also be prepared for the possibility that there will not be a happy outcome. This situation has a lot of hallmarks of a dysfunctional, desperate unit. If you are not able to resolve the issue satisfactorily or even if, in the worst case scenario, the manager takes your preceptor's view and declines to keep you on in that ICU, know that it is NOT because you are dumb, but because you were not remotely given the appropriate training to the task. On a better run unit with an appropriate preceptor, you might well find you aren't struggling to give simple answers out of sheer nervousness. If it comes down to it, finding such a unit to start your career, even if it isn't ICU, might not be a terrible idea for you.
Yes, the manager and clinic coordinators were new grad ICU nurses and they do not believe you have to have worked on another unit for a certain amount of years to work in ICU. they say some nurses from other units can't handle ICU were some new grads excel.
Most nurses on the unit do not want to precept, I don't know if it's a ICU culture, just a unit culture or just my bad luck of running into horrible/hostile nurses.
I hope the manager keeps me but I do agree 6 weeks is way too short!
OP, I'm very early into my icu orientation. Six weeks is awful short depending on what kind of icu you are in, but your preceptor sounds awful. It's not conducive to learning.
I will say many seasoned nurses do not understand that nursing school teaches you nothing these days. Their focus is NCLEX and not what actually being a nurse is. Clinicals are a joke and that is due to accrediting bodies for nursing programs. Not the actual programs. You are trained on the job.
I'm lucky to have a great preceptor. I've made simple, dumb mistakes. I ask lots of questions, and I write everything down. I carry a notebook with me. I'm sure I look like a dork. I don't care. Writing helps me remember.
If I was in your shoes, I would sit with my educator. That's what they are there for. You may not be the first having an issue with this nurse. If you say nothing, the behavior continues. Maybe your preceptor doesn't understand she is doing wrong. Don't you think she deserves the courtesy of knowing? The chance to fix it?
She does deserve to know and I think giving her my feedback may help but at the same time I will admit she makes it hard to tell her anything!!!! I feel so belittled the thought of saying anything to her makes me nauseated.
...I overheard her talking about me today that I'm dumb and it makes me cry but she's right, I have done some very stupid mistakes.
emb92250
170 Posts
She sounds like a *****, lol. I was a new grad in ICU, my orientation was about 3 months, and then even after that the other nurses looked out for me. I remember when I was off orientation, my patient was having increased O2 needs. I didn't think much of it, I just titrated up O2 from 2L to 4L to 5L. Then one of the nurses asked me what I thought about it. I didn't think much of it, sometimes patients need more O2 (I was so nieve). She explained that in the likely event that I needed to go up more, what would my plan me. I didn't know. She suggested intubation. I said noooooo, I don't think so. So she suggested I called Dr (I worked nights, so it would mean waking up the surgeon). It wasn't too late, but I said I didn't think that was necessary... About 10 mintues later I called the surgeon for increased O2 needs and we intubated. lol.
My point is, you're not dumb. You're new and inexperienced. You need to be nurtured (sp?).
You need a better learning environment, first of all. Where you can ask questions as far as rationale. You probably know a lot more than you think, but it might take another nurse to help point that out. This nurse isn't that person, it sounds like. I would actually look into another ICU floor or hospital. I wouldn't want to work around that person who just thinks so much of her own opinion and isn't willing to help you understand things.
And honestly, I didn't realize that chemistrys were always green tubes until I was a nurse for about a year lol I always just printed my labels and found the tubes color on the label.