Sorry this is so long..............I have been a nurse for almost 5 years. I started in oncology and it was just okay...I didn't love it but knew it wasn't home for me. Had my dreams set on NICU and couldn't wait to get a job there. After a year and a half in oncology I got a job in a Level III NICU. Spent about 9 months there...hated it. Dreaded work, knew it wasn't for me, and I wanted out. At this time I thought I maybe I would leave nursing altogether. I was discouraged because other people loved their jobs and I didn't love mine. Maybe that meant I wasn't supposed to be a nurse afterall. I decided on a whim to apply for a position in the OR. It was a different type of nursing so maybe that was more my style. And I loved it...I enjoyed my coworkers, I felt comfortable, I was happy.
Then I started to get an itch to go back to school..to do MORE with my career while I was still young. I considered NP..but couldn't imagine leaving the OR setting...so I thought I would be a Clinical Nurse Educator in the OR...or even a manager one day. Then I started thinking CRNA...I worked side by side with them every day...I had seen A LOT of what the job entails and it looked challenging. All the CRNAs seemed very happy and it made me feel inspired that I could do it. I applied for some jobs and landed a job in a Level 1 Trauma/Surgical ICU. I'm still on orientation and it has been a struggle...the transition from OR to ICU has been huge...I have been faced with the reality that I am rusty on everything to do with bedside nursing.
But I've stuck it out almost 3 months and my orientation ends in about a month...but I don't enjoy this. I miss the OR and every day want to go back. I love to learn and love to be challenged but I feel like my unit hasn't been very conducive for the best experience. First of all..in the 3.5-4 months I will be on orientation, I will have had 8 PRECEPTORS. I have been tossed around and of course everyone does things differently. That alone has been the hardest part. Secondly, my educator has been all over the place. She makes my schedule..only 2 weeks in advance so I never really know how to plan my weeks, she keeps adding and changing my class requirements..just when I think I am done, she adds on another class or requirement that is due shortly after she tells me. My managers have apologized on the educator's behalf saying she is "stressed" and "stretched thin"..but no one really seems to be supporting me?! I don't feel like I can go to anyone and say "hey..I am not getting a great experience"....and lastly, I have been planning on working nights...I worked nights on the floor and in the NICU and I know it's a better place to get your feet wet. And financially, I need the money as I took a pay cut to come to the ICU...Now they want one of the orientees (3 of us total) to go to dayshift when we are off orientation. Financially...I will not be able to afford this..I will have to pick up OT or pick up in the OR. And for my sanity, I hate dayshift in the ICU. I feel like I just run all day long and can't keep my head above water.
I am just so disappointed in this experience. I feel I have learned SOME but I have only had 2 patients on pressors and that was my first 2 weeks on the unit. My preceptor and I have been pulled to another ICU and to progressive care. I have spent a whole shift with 1 patient who was downgraded to acute care and we never picked up another patient. I have admitted 3 or 4 patients, all who were stable. This isn't teaching me anything!!!! I need sick patients so that when I am alone..I feel somewhat capable.I'm so frustrated and while I still want to be a CRNA...maybe I don't want it bad enough. I can still see myself as a manager or Nurse Educator in the OR and being happy. But this is just frustrating beyond belief. Should I go back to the OR, stick it out, or look for another ICU job completely? Please advice....
- Most new ICU orientees have a high degree of stress and anxiety - it's normal.
I'm speculating here, but this could be why the charge nurse is assigning lower acuity patients in the beginning. They may be "feeling" her out and watching how she can handle stress prior to assigning the really sick ones.
I appreciate all of your individual input. I guess it's more of the orientation as a whole that's got me down. I have been at the same facility for my entire career and this is the only setting where I have felt like I'm not getting the most bang for my buck. I know I won't see or do everything on orientation...I simple want/need a foundation and that's where I feel I've been shorted so far.
I've invested a lot of time with classes and online training (ECCOs, anyone?) outside of my typical shift and I feel I've put in a lot of effort to be successful on my own time. I worked hard to get this job and despite setbacks I have still pushed through the craziness. But I can only learn so much without the exposure firsthand. I've spoken up at every progress meeting..everyone on my unit knows I need higher acuity...but there's always some reason...so and so had this patient yesterday or you can help admit if a trauma comes up. I feel like I'm getting the scraps..the assignments other people don't want to do. They don't wanna get pulled so they pass that off on my preceptor and I for my "experience"...they don't wanna admit or take a fresh liver transplant so that's also passed off. But the patients I need to take...the patients I'll have when I'm on my own, no one offers those opportunities.
Maybe it's just me....but I feel I've taken it all with stride so far. Unfortunately as I mark another day off my calendar the anxiety is setting in that I will have not even met the basics. In my last progressive meeting I asked my manager and educator what would be the plan if I wasn't comfortable at the end of orientation or if there were still several things I need to see/do. They said they could give me another week. Thanks? I guess. Haha
i don't expect anyone to hold my hand through this experience. i just want to meet the basic standards I see other orientees meeting. Just because I can hang propofol drip and suction an ETT and remember to pass my meds on time doesn't make me an ICU nurse anymore than a nurse pulled from acute care who could do those same tasks. I don't want to feel pressured to be "on my own" before I'm ready just for the sake of them needing a body to fulfill a shift need. That's how unsafe practice occurs and people die and lose their jobs. Just my 2 cents.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I appreciate all of your individual input. I guess it's more of the orientation as a whole that's got me down. I have been at the same facility for my entire career and this is the only setting where I have felt like I'm not getting the most bang for my buck. I know I won't see or do everything on orientation...I simple want/need a foundation and that's where I feel I've been shorted so far.
I've invested a lot of time with classes and online training (ECCOs, anyone?) outside of my typical shift and I feel I've put in a lot of effort to be successful on my own time. I worked hard to get this job and despite setbacks I have still pushed through the craziness. But I can only learn so much without the exposure firsthand. I've spoken up at every progress meeting..everyone on my unit knows I need higher acuity...but there's always some reason...so and so had this patient yesterday or you can help admit if a trauma comes up. I feel like I'm getting the scraps..the assignments other people don't want to do. They don't wanna get pulled so they pass that off on my preceptor and I for my "experience"...they don't wanna admit or take a fresh liver transplant so that's also passed off. But the patients I need to take...the patients I'll have when I'm on my own, no one offers those opportunities.
Maybe it's just me....but I feel I've taken it all with stride so far. Unfortunately as I mark another day off my calendar the anxiety is setting in that I will have not even met the basics. In my last progressive meeting I asked my manager and educator what would be the plan if I wasn't comfortable at the end of orientation or if there were still several things I need to see/do. They said they could give me another week. Thanks? I guess. Haha
i don't expect anyone to hold my hand through this experience. i just want to meet the basic standards I see other orientees meeting. Just because I can hang propofol drip and suction an ETT and remember to pass my meds on time doesn't make me an ICU nurse anymore than a nurse pulled from acute care who could do those same tasks. I don't want to feel pressured to be "on my own" before I'm ready just for the sake of them needing a body to fulfill a shift need. That's how unsafe practice occurs and people die and lose their jobs. Just my 2 cents.
Thanks again.
Just a thought, but have you been vocal about your plans to pursue anesthesia school as soon as you have that ICU experience on your resume? If management and charge nurses know you're "on the two year plan" as opposed to being in ICU because you want to be in ICU, there's no incentive to them to give you the interesting patients or the best assignments. You're going to leave at the first possible opportunity no matter how happy you are. They might as well try to keep the senior nurses happy because they're the ones who may stay for awhile. Even newbies who have expressed an interest in staying put in ICU will get the "good assignments" ahead of someone who has a professed desire to just put in some time to qualify for CRNA school.
Be very careful not to fall into "the grass is always greener" hole. While many people feel generally fulfilled in a given career, that's not the same as always "loving it." It's called WORK for a reason.
CRNA school and the early years afterwards are no walk in the park. Are you sure you don't want to go back to OR and advance in that field (apart from CRNA)? It sounds like the only field you weren't constantly dissatisfied with. Even your "dream" of NICU quickly lost its luster.
Ruby Vee...I have not spoken to anyone regarding future career plans. I did my research before transferring and know that it never looks good to view a job as a stepping stone and be vocal about it. Managers don't like that...your coworkers don't like that...so I just kept quiet and planned to bring up my goals after I gained some experience. I think it was just not a great fit from the beginning...But that does make sense! Thank you!
Horseshoe...you know, you make a valid point. It is something that has weighed heavy on me and on Sunday morning I woke up with a strong feeling that I needed to walk away from this job. I feel that CRNA was a realistic goal...something I could have achieved if I had stuck with that plan... but at the end of the day, I wasn't enjoying critical care nursing and that's the foundation for becoming a CRNA. I discussed with my family and thought it over for a few days and that gut feeling remained. I gave my resignation today for the ICU position. No hard feelings...I didn't discuss the disorganized orientation or the number of preceptors, etc...just explained it wasn't working out like I had hoped it would. My manager and I parted ways respectfully and I feel a weight has been lifted from my chest. I have already made arrangements with my OR manager to come back to work next week. Luckily my position in the OR is still there. Some people will say the OR "ruined" me..."it's not REAL nursing", "you only count sponges" etc, etc. I've heard it all...but at the end of the day, it's where I am the happiest and I am lucky to have found that. I don't know where the career path will take me from here..I plan to go back to the OR and work for a little while and give myself some time to decompress after this ICU experience. Next year I may pursue travel nursing and later enroll in an MSN program for either Clinical Nurse Educator or a Nurse Management position and continue this journey in the OR. I am a little sad to walk away from the CRNA profession...but I feel good moving on because I know in my heart is wasn't for me. Thanks for everyone's advice! I am content with the way my dilemma turned out :)
Horseshoe...you know, you make a valid point. It is something that has weighed heavy on me and on Sunday morning I woke up with a strong feeling that I needed to walk away from this job. I feel that CRNA was a realistic goal...something I could have achieved if I had stuck with that plan... but at the end of the day, I wasn't enjoying critical care nursing and that's the foundation for becoming a CRNA. I discussed with my family and thought it over for a few days and that gut feeling remained. I gave my resignation today for the ICU position. No hard feelings...I didn't discuss the disorganized orientation or the number of preceptors, etc...just explained it wasn't working out like I had hoped it would. My manager and I parted ways respectfully and I feel a weight has been lifted from my chest. I have already made arrangements with my OR manager to come back to work next week. Luckily my position in the OR is still there. Some people will say the OR "ruined" me..."it's not REAL nursing", "you only count sponges" etc, etc. I've heard it all...but at the end of the day, it's where I am the happiest and I am lucky to have found that. I don't know where the career path will take me from here..I plan to go back to the OR and work for a little while and give myself some time to decompress after this ICU experience. Next year I may pursue travel nursing and later enroll in an MSN program for either Clinical Nurse Educator or a Nurse Management position and continue this journey in the OR. I am a little sad to walk away from the CRNA profession...but I feel good moving on because I know in my heart is wasn't for me. Thanks for everyone's advice! I am content with the way my dilemma turned out :)
I work OR prn, and I find it to be a very nice change from bedside nursing. Who cares what other people think?
Have you considered getting your RNFA? Sounds like you have some other good ideas. Glad you found a solution you can live with!
No hard feelings...I didn't discuss the disorganized orientation or the number of preceptors etc...just explained it wasn't working out like I had hoped it would. My manager and I parted ways respectfully and I feel a weight has been lifted from my chest. I have already made arrangements with my OR manager to come back to work next week. Luckily my position in the OR is still there. Some people will say the OR "ruined" me..."it's not REAL nursing", "you only count sponges" etc, etc. I've heard it all...but at the end of the day, it's where I am the happiest and I am lucky to have found that. I don't know where the career path will take me from here..I plan to go back to the OR and work for a little while and give myself some time to decompress after this ICU experience. Next year I may pursue travel nursing and later enroll in an MSN program for either Clinical Nurse Educator or a Nurse Management position and continue this journey in the OR. I am a little sad to walk away from the CRNA profession...but I feel good moving on because I know in my heart is wasn't for me. Thanks for everyone's advice! I am content with the way my dilemma turned out :)[/quote']
definitely giving you lots of props for putting in your resignation. It's never easy, but it was for the best. ,and so glad that they'll take you back in OR. working as a nurse in OR is still nursing. And that's the great thing about nursing is the ability to work in different fields. I would love to work in the OR assuming they'll train me since i have only tele and medsurg experience for more than 6 years. Floor nursing is tough, ICU nursing even tougher.
Thank you! It was one of those tough decisions that felt like 1000 pounds was lifted off my shoulders once I went through with it. I am blessed to have a job to go back to and great managers in the OR!
you should look into OR! I had ZERO OR experience...I worked in oncology and NICU when I applied for the OR job. Find a hospital that offers an OR internship or periop 101 program where they want brand new nurses or nurses without OR experience. I trained for 6 months and it gave me the foundation I needed. It's a whole different world but I don't really love the bedside interaction as much as other people. I have good relationships with my coworkers and I don't give meds or monitor vitals or any of that. But I get paid the same, if not more than bedside nurses because I take call and pick up OT! I was at the end of my rope ready to leave nursing and luckily I didn't because there is an area for everyone. If you aren't happy..branch out. Do case management...catch lab...IR...go back to school...do outpatient surgery if that's your thing. I love the air because I get to work 7a-5p 4 days a week. And unlimited OT when I want it. When I pick up shifts I always pick up 9a-5p or 9a-3p. Rarely any days or weekends except for occasional call shifts! Let me know if I can help!
Sophie, maybe I'm over simplifying, but its not like you're fresh out of nursing school. You've been in it for 5ish years and in that time, only found one area that you were happy with (I know the feeling). I say start applying for openings in the OR. If you go back to school for CRNA, you can get all vital experience/learning for that from your program and clinicals. Life is short. Good luck.
- 8 isn't really a problem. It's frustrating, perhaps, but you get to know your coworkers and see that there's more than one way to skin a cat.
- Not getting any sick patients on orientation can be a bigger issue. It's often easy to fix though. Speak up if you haven't done so yet. Figure out who makes the assignments for your shift and tell them directly you'd appreciate sicker patients. In a 12 bed ICU, it's often kind of feast or famine as acuity goes anyway, but most ICUs are happy to oblige a request for higher acuity. And it's possible that your apparent distress may have been misinterpreted as you actually wanting lower acuity patients unless you've stated otherwise directly.
- No one is particularly competent by the end of orientation in an ICU. That takes a year or more. You'll rely on your coworkers at times in the meanwhile. This is one of the reasons why having 8 preceptors isn't necessarily a bad thing.
- Were you hired specifically under the understanding that you will work nights? If so, a talk with your boss is definitely in order. Not too many places will fire you for holding them to that kind of agreement. If that was not an agreement at the outset, you've got less leverage. Talking with your unit director still wouldn't hurt. Truth be told, in a lot of places you learn more on the day shift.
I can't advise you on whether you should stay in an ICU or give up on the CRNA thing. That's up to you. FWIW, there's nothing in your post that strikes me as egregious mistreatment from your particular ICU, so I don't really recommend trying another ICU in hopes of greener grass there yet. Critical care is hard; it's supposed to be hard. Most new ICU orientees have a high degree of stress and anxiety - it's normal. It tends to get better a few months after the end of orientation as you develop more competence and confidence.
Having 8 preceptors is EXACTLY the reason she is not succeeding. OP needs nursing education, one preceptor and management to guide her .
I can somewhat relate to your experience. I'm going to give you my honest opinion. You should have stayed in OR if you truly loved it. I started my career in med/surg then moved on to case management. I too got the itch to go to grad school, but then recognized that being a FNP was not for me, at least at this time in my life. Shortly after, I was incredibly blessed to have landed my dream job, which I am completely happy with at this time.
Having 8 preceptors is EXACTLY the reason she is not succeeding. OP needs nursing education, one preceptor and management to guide her .
Wish I could do it for ya OP. Good luck.
Oh. Well, when you say it all confidently and without any kind of backing like that, I guess it must be true.
I agree it's not the absolute ideal situation. It might be a particular problem for the OP if she particularly benefits from consistency or has weaker or disinterested preceptors. But I've seen people do just fine switching preceptors often. I don't mean to shame the OP if it didn't work for her; everyone has different needs and priorities while learning, and there's nothing wrong with that.
Much more importantly and more to the point, switching to a different ICU as the OP was considering is no guaranty of having only one preceptor either. Or two. Or three. Or even four.
The question I was trying to answer is whether having 8 preceptors in a 3.5-4 month orientation is such egregiously bad and unusual practice that switching to another ICU would fix the OP's problems. The answer is it is not. Having a single preceptor is not the norm.
MikeyT-c-IV
237 Posts
I'm speculating here, but this could be why the charge nurse is assigning lower acuity patients in the beginning. They may be "feeling" her out and watching how she can handle stress prior to assigning the really sick ones.