(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).
Without knowing anything more about your preceptor, it sounds like she's the kind of person who's forgotten how stressful the first few months of work on a critical care unit can be. We have a ton of autonomy to make nursing judgments and decisions, especially with titrating medications. That responsibility alone is enough to make me somewhat nervous. Add to that a preceptor that is essentially taking part in "nurses eating their young" (hate the phrase, but it's a good descriptor)...and you have a recipe for disaster. Obviously, as a new grad nurse myself, I don't believe it's necessary to have floor experience prior to going to ICU/SICU, but I do believe new grads in specialty units need a little extra time to settle in and learn their trade. Give yourself some grace, obviously you're qualified or they wouldn't have hired you in the first place. YOU just need to remember that.
I had a similar problem, my preceptor was nice enough but she wasn't patient with me. She took over everything I did because she did it faster, which left me feeling less than adequate when I was finally off orientation. It's not fair, it's not right, and honestly I wish it were easy to ask for another preceptor but you and I both know that it's not. You have control of your destiny. You know your knowledge base. Try to give yourself some time to think about clinical pictures and answers before you speak (your preceptor can wait, seriously). And hopefully you have people on your unit that you feel comfortable going to when you have questions (never stop asking questions!). If you have any doubt that you'll be keeping your job after orientation, get ahead of it. Ask your manager for more orientation or for more resources. They want you to be a good, prepared nurse when you are off orientation. Good luck!
Thanks you, I feel that I need extra time and I honestly hope I get it. It isn't easy to ask for a new preceptor and I am trying to hold on and get thru these next couple weeks (if I get them) with her. Everyday i get a horrible feeling thinking about work. I will hang in there because I know once orientation is over, I will focus on my patients and turn to other nurses for help.
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.
Thanks you!!! I will tough it out, my worry is that they won't keep me in the ICU, she has said that many times to me. I feel threatened. Its nice to hear from people that understand what I'm going through. Atleast you don't have that preceptor on your back and can turn to other nurses for help. It's not forever, that's what I also keep telling myself.
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.
It is scare tactics because she does mention she doesn't know if she can pass me to work in ICU. But it works, i stay up all night worrying that ill be out of a job, it is sickening. I go in everyday thinking ok i'll be good today, im feeling confident...then hearing her talk just breaks me. She does have little class and is very unprofessional.
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.
High turnover, several nurses with only one year's experience, most of the nurses do not want to precept, one very burntout preceptor, are all red flags that it's a poisoned workplace, you might be better off finding a new employer.
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.
Lol she I think she is one!! I have never used the word dumb so much in my life till I met her, now I even use the word to describe myself, this is just crazy.
It's good when you have other supportive nurses to turn to. All nurses need that but especially new nurses.
High turnover, several nurses with only one year's experience, most of the nurses do not want to precept, one very burntout preceptor, are all red flags that it's a poisoned workplace, you might be better off finding a new employer.
I agree, my preceptor has only been a nurse for 3 years also and considers herself "an old nurse" " veteran of the unit" :/
I agree, my preceptor has only been a nurse for 3 years also and considers herself "an old nurse" " veteran of the unit" :/
Give serious thought to finding another job, there is no one to adequately mentor the staff. If you stay, there is a high possibility that you will see and/or be a part of preventable sentinal events and cases where nurses failed to rescue patients because they did not have the clinical competence necessary to intervene in time. These kind of work environments can haunt a nurse.
I apologize for barely skimming your long post, but your preceptor doesn't exactly sound like the greatest nurse ever, but rather one who THINKS she's the greatest. And no, you're not the dumbest - I could tell you 3 things from my workplace from the last week that would surprise you, especially one of them, but I don't want to risk a co-worker seeing this here ... so just know you're not dumb. You're just having to learn a great deal about a lot of complex stuff in a relatively short amount of time. Hang in there.
The unit is dysfuntional, I would suggest the OP only hangs in there if the clinical educator agrees to work on the unit and provide hands clincal instruction and mentoring to the OP and the other beginner nurses. The manager and educator have to take responsibility for ensuring the safety of the patients and for the competent training of the nurses in order to fix this messed up unit.
I am an ER nurse, and I'm damned good at it. I ask a ton of "stupid questions". I've saved more than a few lives by asking those questions and then hearing the answer of "well that isn't right" from the person I was asking. I draw VBGs from veins, not arterial lines (thus the name VENOUS blood gases!). Central lines rarely happen in the ER. I haven't done TPN since nursing school. I don't have to worry if something is important enough to call MDs at home at 0300. They are all at the desk with me at 0300.
Ask me me about venticulostomies and I start shaking in my danskos. While I have caught an occasional precipitous baby, don't ask me to check dilation or feel a 30 week belly for fetal positioning. Don't ask me to juggle 35 sun downing patients and do a med pass at the same time. I certainly don't know anything useful about CRRT.
I'm sure that your questions can't be any more stupid than mine would be.
Personally your preceptor sounds like an a-hole. I love students and precepting. I don't pretend to know stuff that I don't, I would certainly never call a survivor of nursing school stupid, and sometimes the answer to a student's "stupid question" is "I don't know. Let's find out."
HUGS! You are not the only one who thinks your orientor is a jerk. Previous posters have the right idea. I hope it works out for you because you sound like a good nurse in training.
...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.
Aloe_sky
179 Posts
Thanks you, I feel that I need extra time and I honestly hope I get it. It isn't easy to ask for a new preceptor and I am trying to hold on and get thru these next couple weeks (if I get them) with her. Everyday i get a horrible feeling thinking about work. I will hang in there because I know once orientation is over, I will focus on my patients and turn to other nurses for help.