ICU - Should I stay or go?

Nurses General Nursing

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Hi all,

This is my first post but I have read posts for over 2 years. I am having some issues in my new job and need your advice. I graduated in Dec 2004 and began working on a Med/Surg Trauma floor. I was there for 8 months and gained great experience but applied to the hospital's CVCC since I would eventually like to apply to CRNA school. Anyway- I have been there for almost 4 months and about to quit. Here are some of what I have gone through:

1.I was told I would have 1-2 preceptors during orientation - I am now on #7.

This creates issues b/c each preceptor has their own way of doing things and I am constantly corrected (ex- one preceptor writes her VS, etc on notebook and then transfers to chart, she said to do this b/c taking the chart in the pts room is an infection control issue- when I did this with another preceptor- she acted like I was a moron and actually wrote a bad eval on this).

2. I was told I could remain on my Tues, Fri, Sun shift like on my original unit ( I need this schedule due to babysitting issues) but instead I am on Sun, Tues, Thurs. (My husband had to drop out of nursing school in order to accomodate this)

3. I was told on orientation, I would start with one stable patient and over 12 weeks build up to taking 1-2 more critical. I have always had 2 critical pts and the first few weeks my preceptor was so busy I might as well have been on my own.

4. I met with my mgr 3 weeks ago to discuss getting off orientation and she told me that one of preceptors said I was not SOCIABLE enough b/c on my down time I prefer to catch up on the hours of required computer training instead of chatting with the other nurses! ( I am not making this up!)

5. At my latest meeting with administration, 2 days ago, my preceptor said I had improved 150% in the last 2 weeks ( I have been taking 2 patients on my own, talking with every nurse I see on the unit, and improving my time management, etc.) then she says that what concerns her is that she does not see the PASSION she is looking for. She stated that we had a lung transplant come back from surg and I did not come over to "get the scoop" on what was going on like the other nurses. Sorry- I was too busy taking care of my own 2 fresh post-op pts.

At this point I am on orientation for at least another 2 weeks when we will all meet again and discuss my PASSION. I am about to give up. Since I have been there I have seen a nurse hang a bottle of insulin for one pt in another pt's room b/c she did not order the other pt's med in time, one nurse give a pt so much pain meds she had to give Narcan only to find out his real problem was that his O2 was not plugged in, I come in at least 1 shift a week to find that the off-going nurse has not charted a single thing all day but I am in trouble for a lack of PASSION. So my ? to you all is Am I crazy to stay on this unit? I know there are issues everywhere but this is making me miserable. Any advice?

Go with what your gut is telling you. But the nurse that wrote the numbers on a separate piece of paper was actually correct, and it dhould have been taped to the glass, and not taken out of the room. No charting at all should enter that room, whether by nursing or even the RT taking care of the vent. And easy thing to do is just print a copy from your monitor that prints at the desk, if you have the capabilites. Or even design a flow sheet that you just fill in the numbers each hour and gets used all shift.

This is actually required if the patient is in strict isolation.

Now to the next problem. I suggest going to another facility where you will get the training that you need. If you think about it, you would need another 8 months in this unit before your manager writes the letter of recommendation, and remember that you need to have that to submit with your application. Do you think that you could comfortable go for another 8 months with things the way that they are? And would you be able to get the letter that you need? Something to think about.

Have you explored what other facilities in your area have to offer?

Don't go quietly. Establish yourself as a critical thinking, caring, safe RN who's willing to argue their case without emotion. I mean, whenever something ridiculous presents itself and you are certain about your facts - represent yourself, demonstrate that your not a push over. Challenge their *judgements* of you. Who are they to judge your passion. Good grief. Bunch of little primadonas... and they're a dime a dozen so might as well practice the art of deflating their hilarious notions with evidenced based practice and theory in a unit you may leave cause you'll be faced with this again and again. Become your own advocate without seeming arrogant. Keep to objective non-emotional responses. Don't allow them to bait and hook you. It's all fun and games for the tenured staff. So NEVER let them see you sweat :)

1 in 14 posts imply that this situation is caused by YOU! What CRAP! Follow your heart and listen to the majority of your peers, make something happen. Make those in your unit see and realize how unfair this training is to you and the unit, or find another place to get the training you need and want..but DON'T let anyone blame you for this.

Specializes in Vents, Telemetry, Home Care, Home infusion.

Awaiting for an update from OP to be able to offer advice to them.

IMHO you should go to a general Med-Surg floor and put in 2 - 3 years before even thinking beyond that.

What you are describing sounds more like a social issue in that you are new on the Unit and not taking ownership of what happens there.

You MUST get a handle on this now. Commit to solving the situation, whatever it takes.

I'm not getting what going to a Med/Surg floor has to do with anything here.

It is all about politics and social issues on that floor, nothing to do with skills or patient care issues.

Not socializing properly enough as a reason for being punitive or keeping someone on orientation longer is a sign of a toxic, clique-ish ICU that is more concerned with potlucks and hen-clucking than actual nursing ability and performance.

Specializes in Critical Care, ER.
I'm not getting what going to a Med/Surg floor has to do with anything here.

It is all about politics and social issues on that floor, nothing to do with skills or patient care issues.

Not socializing properly enough as a reason for being punitive or keeping someone on orientation longer is a sign of a toxic, clique-ish ICU that is more concerned with potlucks and hen-clucking than actual nursing ability and performance.

Exactly.

I'd leave.If you feel you are not even being supported in management during your orientation....what do you think will happen AFTER you get off orientation. Listen to your internal instinct.

Thank you all for your posts! I am sorry I have not replied earlier than now but my plate has been full. As for the ICU I was in - I did make the decision to leave. I will float to another unit starting this week and will also look at other ICU positions. The final straw this week was when my preceptor told me that she had deliberately set "traps" for me. In a meeting with her and my manager - my preceptor showed me a "secret" evaluation she had filled out. In it, she commented on how she had tested me on several things (one in particular- disconnecting a chest tube from suction to see if I would notice) and whether I had picked up on all of them or not. Apparently, I did miss some things - I do not know what they are as she did not comment on them. After getting over the initial shock of this - I told my preceptor and manager that I did not feel this was the right place for me and that my preceptor's actions were unprofessional, unethical, and unsafe nursing and I could not stay in such an environment. I am deeply saddened over the whole ordeal - I had never before encountered the "older nurses eating their young" syndrome commonly associated with nursing and so I was really not prepared for this. Dont misunderstand me - I take FULL RESPONSIBILITY for not noticing the disconnected CT (it was disconnected from the wall suction for 2 hours per my preceptor) but I was not prepared to be sabotaged by my preceptor. After all is said and done - this is not the place for me- and while I am a bit crushed - I will go on, find another position and chalk this up as experience. Again thank you all for your kind replies.

Specializes in Med/Surg, Geriatrics.
Thank you all for your posts! I am sorry I have not replied earlier than now but my plate has been full. As for the ICU I was in - I did make the decision to leave. I will float to another unit starting this week and will also look at other ICU positions. The final straw this week was when my preceptor told me that she had deliberately set "traps" for me. In a meeting with her and my manager - my preceptor showed me a "secret" evaluation she had filled out. In it, she commented on how she had tested me on several things (one in particular- disconnecting a chest tube from suction to see if I would notice) and whether I had picked up on all of them or not. Apparently, I did miss some things - I do not know what they are as she did not comment on them. After getting over the initial shock of this - I told my preceptor and manager that I did not feel this was the right place for me and that my preceptor's actions were unprofessional, unethical, and unsafe nursing and I could not stay in such an environment. I am deeply saddened over the whole ordeal - I had never before encountered the "older nurses eating their young" syndrome commonly associated with nursing and so I was really not prepared for this. Dont misunderstand me - I take FULL RESPONSIBILITY for not noticing the disconnected CT (it was disconnected from the wall suction for 2 hours per my preceptor) but I was not prepared to be sabotaged by my preceptor. After all is said and done - this is not the place for me- and while I am a bit crushed - I will go on, find another position and chalk this up as experience. Again thank you all for your kind replies.

Hi there,

I've been reading about your situation with the preceptor. I see that many folks do not believe it but I do; I've been in nursing for 15 years and I know how crazy some of our colleagues can be. ANYWAY, the reason that I am writing is to suggest that you notify the physician of this nurses' actions. While I admire you taking responsibility for your lapses, what she did was wrong both professionally and ethically and it was also dangerous. And the physicians whose patients she was caring for need to know this. Be sure to include a copy of the eval in which she wrote this. Send a formal letter to the physicians and cc the nurse manager, the DON, and the hospital CEO. Please, for the safety of the patients. I would be livid if that were my family member she "tested" you on.

Good luck,

Sharon

IMHO you should go to a general Med-Surg floor and put in 2 - 3 years before even thinking beyond that.

What you are describing sounds more like a social issue in that you are new on the Unit and not taking ownership of what happens there.

You MUST get a handle on this now. Commit to solving the situation, whatever it takes.

huh?

****

I think the unit's culture sounds entirely unprofessional & that you should leave asap.

Thank you all for your posts! I am sorry I have not replied earlier than now but my plate has been full. As for the ICU I was in - I did make the decision to leave. I will float to another unit starting this week and will also look at other ICU positions. The final straw this week was when my preceptor told me that she had deliberately set "traps" for me. In a meeting with her and my manager - my preceptor showed me a "secret" evaluation she had filled out. In it, she commented on how she had tested me on several things (one in particular- disconnecting a chest tube from suction to see if I would notice) and whether I had picked up on all of them or not. Apparently, I did miss some things - I do not know what they are as she did not comment on them. After getting over the initial shock of this - I told my preceptor and manager that I did not feel this was the right place for me and that my preceptor's actions were unprofessional, unethical, and unsafe nursing and I could not stay in such an environment. I am deeply saddened over the whole ordeal - I had never before encountered the "older nurses eating their young" syndrome commonly associated with nursing and so I was really not prepared for this. Dont misunderstand me - I take FULL RESPONSIBILITY for not noticing the disconnected CT (it was disconnected from the wall suction for 2 hours per my preceptor) but I was not prepared to be sabotaged by my preceptor. After all is said and done - this is not the place for me- and while I am a bit crushed - I will go on, find another position and chalk this up as experience. Again thank you all for your kind replies.

This is the most bizarre nursing story I've ever heard. How disturbing. You did the right thing in leaving.

Specializes in Nephrology, Cardiology, ER, ICU.

I don't think this is the "hill to die on" Roland. I think this is a situation where you step back and learn from. I still find it very difficult to phathom why a nurse would remove a patient's chest tube from suction to teach someone else. Not saying it didn't happen, just that I would not want to continue employment at this facility. Good luck...

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