Hate ICU after 8 months! Considering new options or sticking it out!?!

[Murse933]

Hello, new here and wanted to write and see if someone can relate or give any feedback. 

I recently began a job in the ICU, with a background of a year and a half experience as a med/surg nurse.  I've been in this position for 8 months, only on my own for 5 months, and I'm already drained and exhausted and I hate nightshift; I feel depressed and have anxiety going to work. I've never been the type to want something "easier." When I initially started in the ICU, I did my orientation on the day shift and was happy. I had several preceptors, and this was all in middle of COVID too. During dayshift; I was really eager and excited to arrive at codes and procedures, I wanted to learn so much and experience ICU; be the best nurse! I wanted to help everyone and hop from nurse to nurse to learn from them about their unique patient cases and have them give me tips.  I've been on my own for 5 months on night shift, and I have completely changed, my family and girlfriend see it in me; I lost weight and I am always tired or lazy and I'm not sure why. I dread going into work to the point where I tear up sometimes before my shifts and really need to drag myself to go. I hope, before going in, that I have more stable patients. I'm no longer am excited about codes or anything in the ICU happening. I worked days on med/surg, and I feel exhausted from switching to night shift, but I know I'm not ready to go to days in the ICU because of several reasons; one of them is because I feel like the nurses compete to see whos the better nurse/smartest. Alot of “cliques” during dayshift and favoritism. On my med-surg floor; we were all so close and like family. The managers basically don’t care; I expressed how I feel to them and talked to the educator and 2 managers and they basically said to stick it out and it will get better as time goes. I feel so incompetent and useless, where on my other floor I felt so confident, successful, and happy. I was one of the people would go to for questions and help out if needed. I used to love to talk to my Pts. I realize that it takes a long time to even feel remotely comfortable in the ICU, but I hate going into work constantly feeling like a failure. On nightshift I lose 2 days of my life basically because I am sleeping. I keep thinking about how much nicer it would be to work somewhere else? and have normal hours (days). I can’t leave ICU to transfer to another unit until July because thats when my 1 year in ICU will be and its hospital policy.

I was thinking maybe PACU or ED? Or go back to med surg? Anyone been like this or is in the same boat as me? Thank you in advance! 

[JBMmom, MSN, NP]

Yes, many other people have been in the same boat. There are numerous threads with similar experiences, so you're not alone. Not that it makes is any easier. 

Is your only difficulty with the position that you're on nights? I can't tell from your post whether your change in attitude is due to night shift itself, your sleep schedule disruption or the ICU environment. I know one of the things that I love about nights is the autonomy that we have to have because of the lack of resources. Even if we call a code, it's going to take a provider 5-10 minutes to arrive so we have to be able to get everything up and running on our own. If I have any issues short of a code/rapid response, it could take a provider much longer to respond so again, I have to use my critical thinking and judgment to provide the best care. We come together as a team and get it done. I love nights. But then again, I'm able to survive on short naps for extended periods of time so if I only get more than 4 or 5 hours of sleep once or twice a week, I'm okay with that.  

You went from a competent med-surg provider to a new learner in the ICU. GIve yourself a break, it's going to take some time to feel as proficient as you did in your old position. Are you sure you're not dealing with any medical/physical issues other than sleep? You might consider just getting a check up to make sure there's nothing going on that you could easily address. If none of those things do it, then you're left with figuring out the night/sleep thing. Are you able to get yourself a quality chunk of time to sleep? On nights something does have to give, you can't maintain a night schedule and day schedule simultaneously. Get yourself some blackout curtains, a sleep machine, maybe try some melatonin, but get yourself a time set aside to sleep. 

If you go to PACU or ED are you still going to be on nights? If you're not interested in your work now, why do you think PACU or ED will be better? In the big scheme of things, July isn't that far off. If you can give yourself a few more months, you'll feel more competent, you'll have a one year of ICU experience that can open many doors and maybe you'll find it's not so bad. But if you really physically can't do it, then figure out where you can move on. Good luck. 

[LibraNurse27, BSN, RN]

If you can go back to med/surg on day shift with a wonderful team and you felt super happy, no shame in that! What you learned in critical care will always serve you. Patients in a lower acuity setting can quickly become ICU pts, and having a nurse with some critical care knowledge there to stabilize and wait for the team is great. If you don't care about being an ICU nurse I would go back, but if you're passionate about critical care maybe get your one year and look for day shift somewhere where there is good teamwork? Unit culture is so important, and sounds like your old unit was great. Going to a new unit is always a chance, but sometimes it works out great!

[JKL33]

@Murse933,

Your post sounds like distress related primarily to the learning curve you are on. It isn't a great feeling for most people, it just isn't. You were happy and hopeful on day shift because you were on orientation, which is a situation where there is an obvious buffer and safety net; you have responsibilities but are simply not in a position to feel the entire weight of responsibility. Your post says you were able to hop from nurse to nurse to avail yourself of different learning opportunities. It was good that you pursued knowledge in that way...but that's not the same scenario now. You have more weight upon you and you are feeling it. That's why you're getting teary-eyed and dreading sick patients/critical situations.

I think you can do this.

If anything I've said above rings true to you, then be empowered. It will NOT feel this way forever. You just need to get your feet under you a little bit more. Don't worry about the competitions or the cliques, we all have (or can find) the inner power to not participate in that BS. Don't even go down that road. Right now your goal should be to hang in there, keep learning, and take the best care of patients that you can. Don't be intimidated by others. Just be professional, eager and kind.

July will come quickly. Between now and then give yourself some grace, let yourself not worry, be empowered. ??