From school to ICU...What was I thinking?

[ArtOfNursing]

I graduated in August and was hired in October to a neuro ICU unit. How excited I was.

Now, in January, I wonder what I was thinking. I'm so nervous at work, on the way to work, on the way home, even at home. I realize I don't know even half of what I should to be effective. The other nurses on my unit keep telling me its good that I'm scared. I worry so much that either I'll do to wrong thing and my patient will suffer or I'll not notice something and my patient will suffer. I'm constantly checking IV pumps. Six IV's going at once almost sends me into a panic.

My poor husband does his best to comfort me but I know he's worried I'll give up.

I tried to leave the unit. I asked if I could transfer to a Tele unit to build my experience level. The ANM said yes but the manager said I was an ICU nurse and she wouldn't give me to a Tele unit with 11 weeks of ICU training. She said to give it 6mo.

I cried the other day during report when I realized I didn't make sure ABG's and Chest X-rays were completed. The oncoming nurse probably thought I was crazy. I thought I was crazy. Why is it like this?

I want to help people and comfort them, not be afraid to do anything for them.

Advice is greatly appreciated.

[middleageNP]

I'm a new grad to a level 1 ICU and I'm a nervous wreck 90% of the time. I was told by my nursing supervisor that I should be able to handle two patients by the 6th week of orientation. I'm at the end of my 7th week and I can barely handle one patient. My first preceptor showed me to chart one way and the second tells me to chart another. And both are anal retentives and adamant of their ways. I'm so tired of being told I'm to do things this way and that way that I shut down my memory; which makes things worse because now I not only am charting "wrong", I'm forgetting things I have to so i.e. wounds locations, check for new orders or write down SaO2.. I feel so inept and brainless... I'm thinking of quitting, but ICU is where I think I want to be at... Should I be able to handle two critical patients after 7wks of orientation or am I really in over my head? Doesn't help that they gossip behind my back either.

[jjjoy, LPN]

It doesn't seem like an ICU vs. non-ICU position in regards to the ease of transition from student to nurse. While the patients are more critical in ICU, you've got more than twice as many in a non-ICU unit any of which could go bad at any time... but half of your patients are down the hall and you haven't seen them in 90 minutes or longer as you've been busy with the other patients... If you read the "first year in nursing" forums, you'll find plenty of non-ICU nurses dreading going to work, feeling underprepared, unsupported, incompetent, afraid of not being able to provide safe care for their patients, etc...

I'm in no way diminishing your struggle. I'm just pointing out that it may not have been any easier had you chosen not to start in ICU. I think a lot depends upon the unit, the support the new nurse receives and if staffing levels are more than bare minimum.

[jjjoy, LPN]

I was told by my nursing supervisor that I should be able to handle two patients by the 6th week of orientation.

I always wonder who decides what a new grad is supposed to be able to handle by what time & how they decide it. Given the struggles so many new grads have, it certainly doesn't look like many of these expectations are reasonable or based on the reality of new grad needs. I think it is more about the cost to the facility than about what a new nurse is realistically expected to be able to handle. That is, the facility isn't willing to pay for more than 12 weeks of orientation/preceptorship, therefore, the new grad "should" be able to handle it all by then. Add to that there aren't any real options out there to build on one's skills for an otherwise intelligent, hard-working, capable new nurse who for whatever ISN'T able to "get up to speed" quickly enough. :angryfire