Can't handle the ICU

missmollie, ADN, BSN, RN · Oct 16, 2017

I didn't get the ICU job that I wanted out of school, and instead was offered PCU job. I've been that that job for 2.5 years and I am so grateful, because as a fresh grad I know now that I wouldn't have made it.

Accept the PCU job, go and provide the nursing care you want to provide, and don't get discouraged when you realize PCU is not as easy as you thought it would be. After a year there, you'll be more comfortable. After 2.5 years, you'll start to consider which ICUs you would apply to.

Good for you for recognizing this isn't for you, and even though part of you doesn't want to leave the ICU, if a job makes you absolutely miserable, how long do you think you'll continue as a nurse? Step down units are amazing. Best of luck in your decision!

Rags2Riches RN · Oct 17, 2017

I was hatched as an RN in the OR. I was a scrub tech that got sponsored through nursing school by the hospital that I worked for. When i graduated i was all puffed up thinking, hey I know surgery, I've worked in the OR. I can do Surgical ICU! Right! Heh heh heh....WRONG!! I lasted just under 4 months. i went home after every shift and cried. I met some nurses that were colossal *******. Those same nurses were also some of the most clinically fantastic nurses I had ever seen. My puffed up balloon got popped real fast and i crawled back to the OR with my proverbial tail between my legs. Fortunately my nurse manager was willing to take me back.
What did i learn from that experience? I don't think the ICU (especially the big teaching hospital, fresh liver transplant type ICUs) is the place for new grads. Such a new grad would be better suited to go through a residency program where they are exposed to less sicker patients and then transitioned into the ICU after they have a few months of experience under their belt. The other option is to not hire a new grad fresh out of school. Require a year on PCU or other such floor. Dumping a newbie into such a position does a disservice to both the new nurse and the patient. Just my opinion.

The bolded sounds just like me. I recently left the OR and transferred to the surgical intensive care unit, and eight weeks in and I'm ready to go back to the OR. Fortunately, I have been in touch with my old manager who pretty much would welcome me back.

To the OP, listen to your gut. What do you think would be best? Do you think you can handle the stress of the ICU right now? Remember just because the ICU might not be appropriate at this time doesn't mean you can't go back after you've got experience in a less acute unit. The PCU would mean learning new things too, however I feel like it will not be as fast and stressful.

Crush · Oct 17, 2017

Usually, when your manager offers you an option to transfer, it means you should transfer.

Agree with above. They see potential and they believe in you. Are there other areas you might want to try? Relearning on another floor can be scary but think of all the new skills you can learn too. We are always learning and that you are concerned for your patients speaks highly of you. You'll make a wonderful nurse wherever you end up working. Nothing wrong with PCU.

Simonesays, BSN, RN · Oct 17, 2017

I don't think I'm cut out for the ICU as a new grad because there is so much I need to look out for to protect my patients, and I am so task oriented that it is impossible for me to see the big picture and truly take care of my ICU patients. The patients are too critical for me to actually give them good care, when I don't even have my basic nursing skills down.

I think you've actually answered your own question. ICU is a very challenging environment where a focus on critical thinking (rather than a preoccupation with skills) is essential to positive patient outcomes. As a new grad, you're likely going to spend more time and attention on your skills than a more experienced RN. You are also honing your critical thinking. This is expected. However, the critically ill patient population is fragile and can't necessarily withstand the learning curve that comes with being a new grad.

You should congratulate yourself for being self aware and acknowledging your own limitations. You are prioritizing the safety of your patients and that should be commended. Your manager probably recognizes your potential and is guiding you towards a unit that, at this point in your career, is likely to be a better fit.

Let us know how everything goes! Good luck to you!

addieshaf · Oct 17, 2017

Follow your gut instinct. I was a new grad that went right into ICU and my biggest regret is that I didn't LEAVE WHEN MY HEART TOLD ME TO. I waited and waited and waited until my depression had hit an all time low (couldn't eat, sleep, bathe, take my meds). I thought people would see me as a quitter. I never told anyone how I was feeling. Then one day I spoke up to my manager who also mentioned I should have spoken up sooner. I left work at 7am and FINALLY told 2 nurses how I was feeling after they asked how orientation was going. One of them started in ICU and went to tele for a while! The other? Her husband did the exact same thing! You are NOT alone in feeling like this. I ignored everyone else warning me about starting in ICU because I was stubborn and wanted to prove everyone wrong.

hnwarden · Oct 17, 2017

So did you happen to stick with the ICU or switch to somewhere new?

addieshaf · Oct 17, 2017

I am in the process of making the switch to telemetry as our PCU is piggybacked on to another unit where they use their own nurses. I realized that "just sticking out the first year" is NOT something I felt was appropriate for the ICU, especially with my limited knowledge and experience. If it came down to not liking someone/a policy, then yes I would have stuck with it.

JessiJam · Oct 17, 2017

I've found myself overwhelmed, with new found anxiety, in over my head, and making mistakes that I'm afraid can hurt my patients.

Underwater with a brick tied to your foot isn't a good way to learn how to swim. If you're that overly uncomfortable with what you're doing, it's best to take the transfer before a misjudgement happens at someone else's expense.

hnwarden · Oct 22, 2017

How long have you been in the ICU before you asked to switch?

hnwarden · Oct 22, 2017

How long were you in the ICU before you decided to switch?