HELP! New ICU Nurse

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I graduated nursing school two years ago. I went and worked as a step down nurse for one year and a half. I felt confident as a step down that I was ready to transition to the ICU. I got a job at another hospital working in the GICU. I’ve been in orientation for 10 weeks. I have two weeks left and I’m terrified. The closer I get to the date I feel like I don’t know enough o be on my own. I’m constantly upset with my self because I haven’t mastered how to critically think as a ICU nurse. Recently, I just started studying and writing down tip to help me for when I’m out on my own. I’m worried about missing prominent trends that I’m not use to seeing as a step down nurse. I’ve never been a person that doubts myself, but I’m seriously stressing. I really want this to work out for me because I have so many goals that I would like to accomplish as a nurse and the critical care experience will help me achieve those goals.

Is it normal for me to feel this way? I feel like sometime I’m not thinking fast enough because I’m trying to process what I’m doing and why I’m doing it. Even my co worker who have been working on the unit 8 months get it at a faster rate that I do. I’m afraid my manage r will not extend my orientation since I’m not a new graduate nurse. Heck, I feel like even new graduate nurses on my unit know more than me and they just came out of orientation.

I work in an unit with a lot of nurse who have been and ICU nurse 3-5years who a constantly making jokes about how smart they are and the fact that they know so much. It’s extremely intimidating. This is the lowest I’ve felt in my nursing career. Any suggestions ? Should I stick it out? Any advice would help!

Thanks

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10 hours ago, EBCollins said:

I feel like sometime I’m not thinking fast enough because I’m trying to process what I’m doing and why I’m doing it. Even my co worker who have been working on the unit 8 months get it at a faster rate that I do.

I would think they do...right? Eight months is something.

10 hours ago, EBCollins said:

Heck, I feel like even new graduate nurses on my unit know more than me and they just came out of orientation.

Okay, if you haven't been counseled or had repeated meetings about how you aren't progressing during your current orientation, then this sounds more like internal demons than reality.

10 hours ago, EBCollins said:

I work in an unit with a lot of nurse who have been and ICU nurse 3-5years who a constantly making jokes about how smart they are and the fact that they know so much. It’s extremely intimidating.

Well, on the one hand, they do know quite a lot. On the other hand = ??. Believe it or not, these behaviors are often borne out of at least some degree of insecurity, for no one who actually knows a lot and is capable of reliably putting their knowledge into useful action needs to go around constantly talking about that fact and making little jokes to encourage others to see how great they are. The behaviors are basically these people reminding themselves out loud, constantly, that they are doing better than what they feel inside. The fact that the behaviors can be a little intimidating to others is the subconscious icing on the cake for these insecure types - - when they can intimidate others they can look on and say all the more, "I'm doing better than him/her!"

What others say about themselves is not necessarily the accurate picture of reality, and therefore it has absolutely nothing to do with you. It is not a reliable measuring stick.

So yes. It very much sounds like this is rooted in your insecurity, not your actual abilities. You need to spend some time thinking about your growth and you need to acknowledge what you have learned already and what you do know. Stop comparing yourself to loudmouths. Stop worrying about everyone else, in general (with regard to this matter).

You are worrying about things that every nurse needs to learn (for example, picking up on ominous trends as early as possible) instead of recognizing that you likely have the basic skills to do it(!)- knowing that you have resources all around you!

It is scary to approach the end of an orientation; you are letting that really mess with your head. Realize that everyone goes through it to some extent, and yet people come off orientation every day and just put one foot in front of the other and are ultimately successful. You can do it, too.

Best of luck ~

It'll be okay??

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Specializes in Tele, ICU, Staff Development.

Have you thought about journaling? It helps build critical thinking. Journal about what happened clinically. What happened, what was ordered, what worked, what didn't. You'll gain insight as you reflect. Best wishes.

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Specializes in Pediatrics, Pediatric Float, PICU, NICU.

I started as a new grad in the PICU years ago, and we had an amazing 1 year new grad residency program. A big part of what helped me improve my critical thinking skills was to practice using case studies. Case studies allowed me to critical think through various scenarios and also understand the rationale. It may benefit you as well.

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

I am more concerned about nurses that they felt they know everything and are totally ready to come off orientation than those that still feel there are many things they don't know. Because after a set orientation period, there ARE many things you still won't know. But, it sounds like there haven't been concerns raised to you about your performance, so you're probably more prepared than you think you are. It's unfortunate that you have some coworkers that sound like they are more competitive than helpful, do you have some that you can go to with questions? The key to success is being sure that you can find someone as a reference when you're on your own so you can still get the support you need. I hope that you continue to work through it, you can be successful, as long as you don't psych yourself out before you find success. Good luck!

1
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On 7/5/2019 at 9:29 AM, JKL33 said:

I would think they do...right? Eight months is something.

Okay, if you haven't been counseled or had repeated meetings about how you aren't progressing during your current orientation, then this sounds more like internal demons than reality.

Well, on the one hand, they do know quite a lot. On the other hand = ??. Believe it or not, these behaviors are often borne out of at least some degree of insecurity, for no one who actually knows a lot and is capable of reliably putting their knowledge into useful action needs to go around constantly talking about that fact and making little jokes to encourage others to see how great they are. The behaviors are basically these people reminding themselves out loud, constantly, that they are doing better than what they feel inside. The fact that the behaviors can be a little intimidating to others is the subconscious icing on the cake for these insecure types - - when they can intimidate others they can look on and say all the more, "I'm doing better than him/her!"

What others say about themselves is not necessarily the accurate picture of reality, and therefore it has absolutely nothing to do with you. It is not a reliable measuring stick.

So yes. It very much sounds like this is rooted in your insecurity, not your actual abilities. You need to spend some time thinking about your growth and you need to acknowledge what you have learned already and what you do know. Stop comparing yourself to loudmouths. Stop worrying about everyone else, in general (with regard to this matter).

You are worrying about things that every nurse needs to learn (for example, picking up on ominous trends as early as possible) instead of recognizing that you likely have the basic skills to do it(!)- knowing that you have resources all around you!

It is scary to approach the end of an orientation; you are letting that really mess with your head. Realize that everyone goes through it to some extent, and yet people come off orientation every day and just put one foot in front of the other and are ultimately successful. You can do it, too.

Best of luck ~

It'll be okay??

I agree, that most of my anxiety is coming from my own personal insecurities. Thank you for your advice. ?

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On 7/8/2019 at 10:39 AM, JBMmom said:

I am more concerned about nurses that they felt they know everything and are totally ready to come off orientation than those that still feel there are many things they don't know. Because after a set orientation period, there ARE many things you still won't know. But, it sounds like there haven't been concerns raised to you about your performance, so you're probably more prepared than you think you are. It's unfortunate that you have some coworkers that sound like they are more competitive than helpful, do you have some that you can go to with questions? The key to success is being sure that you can find someone as a reference when you're on your own so you can still get the support you need. I hope that you continue to work through it, you can be successful, as long as you don't psych yourself out before you find success. Good luck!

My preceptor is great with answering any questions I have, but it’s always someone around that want to chime in. Then it becomes a conversation to prove who knows the most ?

thanks for your advice ?

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3 minutes ago, EBCollins said:

I agree, that most of my anxiety is coming from my own personal insecurities. Thank you for your advice. ?

3 minutes ago, EBCollins said:

I agree, that most of my anxiety is coming from my own personal insecurities. Thank you for your advice.

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On 7/7/2019 at 8:22 PM, Nurse Beth said:

Have you thought about journaling? It helps build critical thinking. Journal about what happened clinically. What happened, what was ordered, what worked, what didn't. You'll gain insight as you reflect. Best wishes.

I have not tried journaling. I’ve only looked at YouTube content and made notes. I will try journaling!!! Thank you ?

1
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On 7/8/2019 at 8:29 AM, JadedCPN said:

I started as a new grad in the PICU years ago, and we had an amazing 1 year new grad residency program. A big part of what helped me improve my critical thinking skills was to practice using case studies. Case studies allowed me to critical think through various scenarios and also understand the rationale. It may benefit you as well.

How is it going for you now in the PICU?

Any website suggestions for great case studies?

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