HELP!?! New in a SICU... already cried... totally terrified

[jlv613, RN]

Hi All,

I just started a clinical care training program at a county hospital. It's a 13 week program with a mix of didactic and clinical time.

There are about 35 of us in the program. The majority of the people are new grads... some have a couple years or less experience in a different discipline.

I graduated in 2015 and started working in a chronic outpatient dialysis clinic in addition to doing some registry work. I've never worked in a hospital.

This job basically fell in my lap... I never had huge ambitions to work in a hospital and never ever imagined I'd want or be in an ICU. My self esteem is such that I would never think I have the competence or ability to do what I consider such advanced and sophisticated nursing (God, just disclosing this opens all kinds of invitations into my broken thinking). So while I am super grateful for the opportunity I have also entered this with a somewhat paralyzing amount of fear and trepidation.

I have just completed two days with one of my two preceptors (my primary preceptor).

First impressions: she absolutely terrifies me. She's fast, talks fast, does fast, moves fast, has a thick accent that is sometimes challenging. She's incredibly intimidating. She's abrupt, abrasive. She's a "take no prisoners and take no ****" kind of gal. She's knowledgeable, experienced, proficient. She is required to precept and she openly disclosed to me she avoided it for years. She's impatient, particular, and hard around the edges.

Yesterday, my second day on the unit, we were in conversation... I can't remember the exact content of the conversation, but whatever it was she told me I responded with, "I don't think I'll be ready for that." She quickly shut me down, told me that is the wrong attitude, told me I should reconsider if I want to be in the ICU, told me the NM would flip out if she heard me say that. I, in turn, began to cry. I felt so small. So embarrassed. So weak. So incompetent. So useless. And so incredibly lost. And I was thinking, "****, i'm the girl that cries. I don't have what it takes to be and ICU nurse... my second day and I'm already in tears. I'm too sensitive, too vulnerable....."

Now, in all fairness, while by and large her personality and mine clash, she does show me certain things, she pushed me into a room with a fresh heart patient straight from OR to see how that all looks (I didn't understand a thing about what was going on at all)... but I feel like her expectations of me might be a little unreasonable.

I don't do super well with the "tough love" method. I freeze. I buckle. I don't have enough of a foundation to feel confident and secure. When i worked in dialysis long enough to feel my footing I was not so sensitive to being challenged or yelled at.... but here, I just don't have a clue. I'm overwhelmed... I feel like a nursing student again. I feel like I'm being set up to fail. I don't know how to prioritize. I don't know **** about the meds, the procedures etc.... And I noticed today that we haven't gone exactly according to the orientation program schedule of what were supposed to be doing Day 1 and Day 2. She had me charting yesterday - in Epic.... my god, none of it is intuitive and she would yell at me for forgetting things or tell me I'm charting too little or too much and I don't really understand where I'm supposed to get into detail and where I don't need to get into detail. I 'm getting mixed messages.

I don't feel comfortable or "safe" with her.... I mean emotionally. I know she's not there to coddle me. And I can appreciate that I need to put in the work, too. I get that. But I look around at some of my peers in the program with me and their preceptors seem so much more gentle, more patient, soft spoken....

Should I not be expressing my fear? Should I reconsider the ICU? When is enough time to know it won't work?

She did suggest I write down questions/concerns we can discuss next time. I go back Saturday and will be with my other preceptor. I've met the secondary. Truthfully, she doesn't seem much better. .... but I'm open to see what happens Saturday.

I can't help but imagine the secondary will already know I've cried....

God, I'll take any feedback or guidance or help.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

May I ask why you accepted this position if you had no desire to work in a hospital? "The job just fell in my lap" how? Was it required of you or did it come with an attractive benefit package? Understanding your reason for being there might aid in your decision to remain.....or leave. Perhaps a transfer to med/surg might be better for you, or an inpatient rehab unit.

I'm sure your preceptor is trying to bring you up to speed as quickly as she can. I wouldn't rush to judgment just yet regarding your perception of her personality or abrasiveness without first understanding her culture (you indicated a very strong accent; so I'm assuming a non-US native).

[cocoa_puff]

If you never really wanted to work in a hospital, and especially not in an ICU, why did you take the job? Where you happy with outpatient dialysis? I'm not saying you should quit, but is it possible for you to go back to your old job at this point?

[RNDarling]

I'm sorry that you feel so vulnerable and that you don't seem to mesh well with the personality type of your preceptor. While it may be embarrassing that you cried, ultimately that doesn't really matter. What does matter is that you do everything you can to try and learn what is being taught and ask questions when you don't understand something. It may be a scary and intimidating environment for you, but you will be off training in the near future and taking in as much as you can now by way of experiences with your preceptor at your side will only benefit you (and your patients). You don't want to experience some of that for the first time when you're on your own.

Give it, and yourself, some time and you may find yourself surprised by what you can do. Don't let fear restrict you. If it's not for you after you give it your all, that's ok too but just give it a fair chance.

[Esme12, ASN, BSN, RN]

((HUGS)) The ICU can be a frightening place. Many, many years ago I remember felling like you do right now. I would cry all the way home and talk to myself about going back all the way into work. Don't throw in the towel. Spend time with your other preceptor and see if it is different. I would make an appointment with your educator or manager about how you are feeling and that this present preceptor has made it clear she isn't enjoying this experience. You ARE in an area that you are a new grad. It takes time, and a good preceptor, to learn the ICU. Yes, it is very overwhelming at first but don't toss in the towel yet!

ICU nurses are fast, (somewhat) abrasive (LOL) take no prisoners kind of people. We are anal retentive, obsessive compulsive kind of people....it's how we keep patients safe in an ever changing environment. However I have found that people who are truly proficient, knowledgeable, and experienced aren't afraid to share what they know.

Honestly, my vote is for you too stick it out. It is only 13 weeks and there is plenty to learn. It will make you more marketable if at that time you discover ICU isn't for you and move on to another area. If you have questions that aren't being answered post them in the MICU/SICU area for us to answer. You can always PM me and I will be happy to help.

[jlv613, RN]

This is a reasonable question. And I appreciate you asking. I was always afraid of hospital environment. But I would go on these binges and start applying to hospitals just to see. I was shocked when I was asked to come in for an interview. When they offered me the position I felt like it was such an incredible opportunity. Although I initially intended not to work in a hostile, I felt like it was almost divine providence that an opportunity like this presented itself and I'd be a fool not to take it. And the more time I spend in the classroom setting critical care nursing in the more excited I become. It's just been daunting on the floor. I don't want to go back to dialysis. I felt like I was very limited. However, I loved the patients and I loved the patient interaction and the continuity of care. Icu feels like it will open doors for me that otherwise wouldn't of been opened on my current trajectory.

[TheCommuter, BSN, RN]

Thread's been moved to the Critical Care forum: https://allnurses.com/critical-care-nursing/

[LovingLife123]

Coming from an ICU nurse, you need to pull yourself together. You have only done two days so far. Two whole days. Nobody expects you to know things in two days. You do however, need to be eager to learn.

Things in an ICU can change in a minute. You need to pay attention to detail and be quick on your feet. Yes, it's scary. I'm a couple years in and my stomach still drops when things go crazy. But you never, ever, let them see you sweat. You remain calm at all times. There are days I'm losing my mind on the inside, but I'm calm, cool, and collected on the outside and get it done. And truly, that's how it should be. You should always be a little nervous. It keeps you careful.

Its normal to feel overwhelmed. It's a brand new environment. You are learning all new skills. It's going to take some time to feel comfortable, but crying and telling yourself you can't do it, just won't work.

[jlv613, RN]

((HUGS)) The ICU can be a frightening place. Many, many years ago I remember felling like you do right now. I would cry all the way home and talk to myself about going back all the way into work. Don't throw in the towel. Spend time with your other preceptor and see if it is different. I would make an appointment with your educator or manager about how you are feeling and that this present preceptor has made it clear she isn't enjoying this experience. You ARE in an area that you are a new grad. It takes time, and a good preceptor, to learn the ICU. Yes, it is very overwhelming at first but don't toss in the towel yet!

ICU nurses are fast, (somewhat) abrasive (LOL) take no prisoners kind of people. We are anal retentive, obsessive compulsive kind of people....it's how we keep patients safe in an ever changing environment. However I have found that people who are truly proficient, knowledgeable, and experienced aren't afraid to share what they know.

Honestly, my vote is for you too stick it out. It is only 13 weeks and there is plenty to learn. It will make you more marketable if at that time you discover ICU isn't for you and move on to another area. If you have questions that aren't being answered post them in the MICU/SICU area for us to answer. You can always PM me and I will be happy to help.

I can't begin to tell you how grateful I am for your kind words and encouragemen, Esme12 . Yes, it is a terrifying place. And yes, I should definitely let go that I cried. I am only human. I didn't know exactly where to put this post, I haven't had a long history of posting and interacting on this website mostly just reading. But it feels so good to seek encouragement and guidance and feedback here. And yes I would absolutely love to chat privately if that's an option.

[Been there,done that, ASN, RN]

"I have just completed two days with one of my two preceptors".

You have completed 2 days in a 13 week orientation. You WILL be able to succeed with the proper guidance.

Go to management and nursing education.. tell them EXACTLY what is going on.

You can do this with a decent preceptor.. I wish I could precept you.. you would make it.

[jlv613, RN]

"I have just completed two days with one of my two preceptors".

You have completed 2 days in a 13 week orientation. You WILL be able to succeed with the proper guidance.

Go to management and nursing education.. tell them EXACTLY what is going on.

You can do this with a decent preceptor.. I wish I could precept you.. you would make it.

Im on the fence though about going to management....I don't want to cause rifts or rock the boat. Do you think maybe the clinical educator?

Thank you! I can totally appreciate people telling me I have to keep it together. And I really appreciate the kindness and encouragement. I'm really my worse critic - I'm incredibly hard on myself - and I want desperately to feel supported and encouraged here. It's such a fine line between getting thrown in the deep end and being coddled.

I just hope I didn't set myself up by already crying! Ugh - hard to let that go.

I totally wish I had a more gentle preceptor. But since I don't I feel like I need to find a strategy to make it work with the one I have.

[RNNPICU, BSN, RN]

ICU environment is very fast paced, things move quickly and things change rapidly. It sounds like your preceptor is trying to tell you that you can't say I am not ready for that, but maybe next time say, How do we proceed. By saying I am not ready for that does send a message that you aren't ready. Instead, when faced with the many new things you will see and do say, how can I proceed, what steps do we take? You may not get a second chance at an exposure to certain thins and t be able to see something, maybe even participate a little on a rare procedure will enhance your skills and experience.

You have only had two days on the unit. TALK to your preceptor. In any new environment you want to be ready for new experiences. EVERYTHING will be new, and many things you may not be ready for, but you should get a chance to see and do. Remember you are being precepted. No one should be expecting you to know how to draw up meds in 2 seconds. You should be able to say "I would love to watch!" You are only on day two, this is a great opportunity, take advantage of every new situation, you want to take in all the experiences you can get. It is scary because as with many aspects of nursing it is life and death.

Don't sell yourself short, close your eyes, take a deep breath, and take a look around at all of the new exciting experiences awaiting you.