Demoted from ICU to IMCU

Nurses General Nursing

Published

So I'm a new nurse working in a 14 bed icu. I just graduated in May and started working there in late July. It was going well with my first preceptor on day shift training then I was assigned a new preceptor on midnights which is my assigned shift. And from the beginning she had an attitude with me which I just ignored because almost everyone there is mad because they just started hiring new grads and there is alot of jealousy because most of them had to start in a step down unit or med surg area. Understandable to be jealous just sucks they're taking it out on me.

So with my preceptor on midnights like I said she always had a terrible attitude or gave me a stupid look when I asked a question. I had a question about the IV medication that had a warning on the pump that said it should be in a glass bottle and it wasn't she just sighed loudly and snapped it's fine! And hit submit.

I got over that and then later she snapped on me for following her after she said to follow her to get the aid she yelled I should actually be doing something instead of following her.

So I went to do an assessment on a patient and she said she heard my preceptor and said my co-workers should be nice and that I should like where I worked.

I almost lost it I wanted to cry so bad.

So the next day I asked to meet with my manager to switch preceptors and she some how ended up turning it around to where I was too slow for critical care and talking me into going to IMCU which I knew would happen because they didn't want new grads in Icu and they're super short in Imcu they need to hire like 10 nurses over there so I seen it coming.

People were making up lies like saying I don't help out and I'm like....i definitely help. This nurse asked for help putting in a rectal tube and I was the only one who would volunteer. I could definitely feel the nurses eat their young.

I am just so bummed and disappointed. I feel like a failure. I don't even want to show my face. I'm going to be known as the girl who couldn't handle Icu.

I understand not having new grads in Icu I just wish I would have started in Imcu instead of icu so I didn't get demoted. It also hurts that nurses would lie about me to try to get me out. I was nice to everyone, listened, helped when needed, and brought in treats...i just don't get it. I feel like such a loser. I feel like I shouldn't be a nurse....

I also don't even think IMCU is for me....its not an area I ever thought to do nor have an interest in. But I love patients so I'll try...

I just wanted to vent thanks for listening.

Any advice is welcome

Trust me it has nothing to do with jealousy! That's a huge stretch. You don't really believe that??

It has everything to do with safety of the patients.

As a new Grad, you are at a distinct disadvantage because you haven't a clue what you don't know.

You haven't had enough experience to realize that fact yet...you'll has a light bulb moment one day and realize how little you knew!

You feel you are carrying your weight...trust me you are not.

You haven't had enough experience to quickly assess and react to symptoms of 'downturns' before they become acute emergencies.

ICU is a fast moving environment with immediate life and death consequences.

This comes with nursing experience, of which you've had very little, although I'm sure you feel otherwise and quite competent.

All members of an ICU team have to trust one another's judgement...a trust that is earned through experience.

ICU nurses know what consequences an inexperienced nurse missing a sign or symptom creates.

It increases the stress level double fold

I personally feel that experienced nurses, not new inexperienced untested Grads belong in ICU....imho!

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
It is my professional opinion that no new graduate should ever be hired to work in any critical care location. .

I wholeheartedly disagree.

New grads can and do thrive in a critical care area. It just requires a very regimented training program.

Trust me it has nothing to do with jealousy! That's a huge stretch. You don't really believe that??

It has everything to do with safety of the patients.

As a new Grad, you are at a distinct disadvantage because you haven't a clue what you don't know.

You haven't had enough experience to realize that fact yet...you'll has a light bulb moment one day and realize how little you knew!

You feel you are carrying your weight...trust me you are not.

You haven't had enough experience to quickly assess and react to symptoms of 'downturns' before they become acute emergencies.

ICU is a fast moving environment with immediate life and death consequences.

This comes with nursing experience, of which you've had very little, although I'm sure you feel otherwise and quite competent.

All members of an ICU team have to trust one another's judgement...a trust that is earned through experience.

ICU nurses know what consequences an inexperienced nurse missing a sign or symptom creates.

It increases the stress level double fold

I personally feel that experienced nurses, not new inexperienced untested Grads belong in ICU....imho!

I completely disagree with this post.

Of course the OP knows she doesn't know everything.

Believe me, when I was a new grad working in the CVICU, I was WELL aware of what I didn't know. Why do you think I realized I was in the wrong spot? It was because with each shift, it became clearer and clearer what I didn't know.

Even in my present position, working in Med-Surge, I am well aware that there are still lots of things that I don't know. No where in the OP did I get the sense that this new nurse is overly confident, or believes she is carrying as much weight as seasoned nurses.

Yes, new graduates can succeed in the ICU. I know of the graduates that were my cohorts in CVICU, the ones who did the best and would make it were the ones who had previous experience in the unit, via a Capstone, or through working as a tech.

Yes, it can be done. But as others have stated, it takes a regimented, lengthy orientation and a management team that actively helps new graduates to succeed.

Most new nurses don't need a "light bulb" to go off in their head cluing them into what they don't know. Most new nurses possess enough self-awareness to know that the learning curve is steep.

Of course, there are always a few exceptions. I went through nursing school with a few of those folks. They were completely obnoxious.

Specializes in Pediatric Critical Care.
it seems that every commenter missed the point that they lied about her.

Well its not that everybody missed that, its just not particularly relevant to the advice OP needs. They may or may not have lied to/about her. Thats now in the past, and OP needs to focus on the future and succeeding in her new IMCU role.

Specializes in Anesthesia, Trauma, Palliative, Tele.

In nursing and in life we all too often find ourselves disappointed because things tend to not go as we planned. You do have a perfect opportunity though to hold your head high and make the best of the situation right where you are. Sometimes our detours end up being the best things for us and our career. So focus on learning as much as you can--you can learn things from everybody, good or bad, and focus on taking excellent care of your patients. All the other stuff is just noise and distraction. Rock out where you're at and you'll be a better nurse for it. You have a long career ahead of you this is just a temporary season, make the best of it!

IMCU is (I think) an acronym for Intermediate Care Unit (aka ICU step-down). Its' for those patients that are too sick for Med/Surg or Med/Tele but not sick enough for an ICU bed. Because of this "intermediate" place, they can get overflow from either department and the pace can be quite demanding.

Thanks. I appreciate it. Everywhere I've worked just called it stepdown.

Thanks for all the input.

IMCU is going extremely well.

I know how to do everything and am able to think clearly.

The only thing that sucks is the patient ratio.

Manager said 2 to 3 but I've had 5 every night.

I'm sure other places have more it's just alot to juggle when they're on the borderline of care status like kinda icu.

I never really wanted to be an icu nurse my dream is to do trauma/emergency department.

So I think I'll do this to get some skills and education on my belt then go try for what I really want.

Thanks again.

Specializes in HIV.

Yeah, you considering the step-down unit as a demotion is setting this off on the wrong foot, in so many ways. ICU is not the top of the nursing ladder. It is just another area for nurses to train and work in. I work on an ICU step-down unit and if you came to us with that sort of attitude, you wouldn't fit in too well with us.

Specializes in CrItical Care, Street Medicine/PHM, School nurse.

IMCU nurse here! I originally had a job offer for a level 1 trauma ICU as a new grad but I declined it because I felt the IMC will be able to give me a better mix of experiences before a possible ICU position later on. Boy was I right! I love my unit! I have a mix of stable and critical patients. My unit also crosstrains and floats its RN's to the MICU, CVCU, and the trauma unit. I couldn't of asked for a better position! What you would have considered a "demotion" is actually better than expected.You never know what jewels are hidden in other units until you actually try.

My concern here is that you may be coming off as cocky, what with your talk of jealousy and demotions, which will help you nowhere.

I've been there with a bad fit with a preceptor. After the second day with the one I had at my last job, I had to go speak to my manager because I had never been spoken to in such a way and wasn't able to learn anything from being barked at nonstop, being undermined, being told I was doing something wrong when I'm absolutely positive I wasn't and was doing them exactly as I was told. This behavior drove my anxiety level way up and I was afraid to even breathe because I didn't want to be yelled at for doing that wrong. When I went to the manager, I was told I was being too sensitive. These things didn't stop, although they did decrease a little. I did the best I could until even she had to admit that I didn't suck. Unfortunately I was not allowed to succeed in this position as all this had driven my anxiety about doing the job so high that I didn't feel like I could continue. Sometimes that happens. Sometimes your preceptor isn't what you'd wish, but that's often a reflection on them instead of you. But sometimes it is you. This is where having solid collegial relationships are important, where you can ask someone outside the situation if it's her or you. You can gain insights from this about both your practice and how to get along with difficult people from those who have dealt with them for a longer period than you have.

It is my professional opinion that no new graduate should ever be hired to work in any critical care location. That means ICU, ER, NICU, etc. A new grad needs to hone his/her skills so that they are sharp and can be utilized at a moments notice. Basic nursing skills, assessments, and techniques need to be fully developed before going to work in such a critical, specialized area. These are fast paced environments that often do not lend themselves to "teaching." Most facilities are short staffed and with the addition of a "new" nurse, with no previous experience, it is frustrating for the staff as well as the new employee. They are working short and now have to train someone who isn't able to pull a full load. They probably don't see that as "help" but a hinderance to them being able to get the work done. I know staff can be rude to new grads, been there, done that, but I think being assigned to such critical areas only fuels that flame. If this IMCU is a bit slower paced then maybe it is a better environment to learn and get prepared for your final assignment in an ICU setting. Look at it as a way to sharpen your skills so that in the end, your patients will receive care from a qualified, well-trained nurse.

That's your professional opinion but it's very judgmental of new nurses that you don't know. That's like saying "only nurses with BSNs should be hired because they have more education therefore they are smarter than ADN nurses" total bologna. A new nurse could be much smarter and more handy than a nurse with some years under her belt. Seniority doesn't always rule and don't hire somebody just because they have more years on them. My cousin got hired right out of school to work in a NICU in charlotte and she now travels, she's been called "a gift" by her fellow coworkers because she's just that awesome at her job. You could be missing out on hiring an excellent nurse because of that mentality.

Hey... same thing happened to me. I started in the CVICU, and after 5 months of orientation hell, they decided I needed experience in the CVIMC and advised me to return to the ICU in one year. I will probably not do that, because even though I learned a lot of great things in the ICU during that short period of time, I feel like I need 5 years in the IMC before I could return to that kind of acuity. I was a new grad learning balloon pumps, ecmo, vads, etc. It was exciting at the time, but in retrospect, too stressful to tackle all that when I was still learning the basics such as how to talk to doctors, how to navigate the hospital bureaucracy in order to help the patient get what they need.

I also dealt with my fair share of nursing buttheads, and I felt horrible and bitter after I was let go. Definitely let it all out to someone who understands. Of course you are upset! It really does take a great preceptor to help a new nurse to be successful. Even the nicest ones can take themselves so over the top seriously that they forget how to be relatable and that orientees are simply human. There might be another nurse on the floor you go to who will relate to your experience. Fortunately the IMC nurses welcomed me, as this situation happens quite frequently at my hospital. It's great to become a master in confidence as a bedside nurse, and you will get so great at it that eventually you won't care so much about other people's personality issues. Someday you can tackle another specialty if you want, and your experience won't hurt you.

By the way, I have a friend who was dismissed from the ICU as a new grad on her third shift. She was so upset obviously. She was hired on the stepdown and spent a year there honing in her skills. There are a lot of politics where I work, and she couldn't get back into any of the other ICU's even with excellent references from colleagues. I advised her to move to a local shock trauma hospital where she recently began as a multi-trauma SICU nurse. I couldn't be more proud of her. If you want it, you will get it. Give yourself time and bounce back.

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