From Ambulatory Nursing to ICU--Adjustment Problems

[HeatherAmorelli]

Hi, everyone!

I am writing this one for me to be able to get some feedbacks and words of encouragement if possible.

This is my 6th year working as an RN. I've worked in various areas in nursing before (med-surg, oncology, OR- all 4 years in Malaysia and ambulatory nursing- 1 year in California) and I felt so blessed this year for acquiring my dream job position-- Adult ICU. I am on my first month of unit orientation right now. However, these past few weeks were very stressful for me. At first I was so excited about the idea of starting to work as an ICU nurse but right now, I would honestly say that I am having second thoughts whether I did the right decision of choosing this job. It all started when I first met my preceptor, I would say that he is very smart, however, I just get intimidated by his mentoring style (eg speaking in a loud voice, unpleasant facial expressions). There are times when we were providing bedside care to patients (with family members around) and he would ask me questions that I usually don't know the answers (because I am still on the process of learning and re-learning the ICU stuff through books and hands on training) and I would end up feeling ignorant after telling him the wrong answer or telling him 'I don't know'--and patient and family members witness that, which made me more embarrassed. I am also having a hard time adapting to protocols, handling 2-3 patients and most especially the computer charting system. Back in California, we were using a very simple computer charting program for an ambulatory surgery unit of a tertiary hospital in which I don't recall having trouble learning. I so miss my ambulatory nursing job, it was a very fast-paced area but the mental stress was not that high. I am intellectually stressed as of now due to the volume of topics I need to read and learn by heart to be able to fit in the ICU world. It's as if I fell out of my comfort zone. I thought I was ready for this since this has been my dream job after arriving here in the USA. I also thought that my over 5 years working as an RN are more than enough to be confident for this job but it doesn't seem like it. I'm on the verge of quitting right now but I am doing my very best to hang on tight because I don't want to ruin my name and credibility at work especially I'm not even half-way through my orientation period. I know that I am at a learning curve right now but I just don't like the feeling of getting cold feet going to work. At present, I am looking for an ambulatory RN position within the area just for a backup. I am really confused... I want to quit right away and be back to my comfort zone (ambulatory nursing) but I am worried that I would have a hard time explaining to my potential employer about quitting the ICU job after 1 month... I really don't know what to do... I apologize for this lengthy post, I really need to vent out and I don't have anyone to talk to.

[Lev, MSN, RN, NP]

1 month is seriously not enough time to give ICU a chance. Have you asked for feedback from your preceptor and manager? How do they think you are getting along? I think you should be open with your preceptor and let him know how you feel. Sometimes a simple conversation is all it takes. It's natural to feel intimidated when some knows much more than you. But keep in mind that your preceptor has spent many more months than just one in ICU and therefore will have more knowledge than you. Next time your preceptor asks you a question in front of family that you are not sure of the answer to, just say "I'm not sure of the answer but I will be happy to find out and let you know." This shows a willingness to learn and an interest in your new specialty.

[Wave Watcher]

I don't think it is appropriate or professional to quiz you on your knowledge in front of family members or the patient. He can easily ask you questions once you step out of the room or talk with you before going in. Hang in there it has only been a month. If it is your dream.....don't give up and don't let someone make you feel incompetent. You are worthy and deserving of all good things!

[enuf_already]

If you had all of the answers, you wouldn't need an orientation! Take a deep breath. You can do this!

Do you have an education specialist who can help you with any areas where you feel lost? Maybe there are some upcoming educational workshops that can help you. Ambulatory to ICU is a big change. A month is not nearly enough time to determine you can't do this and quit.