I need some serious advice!

[tgirl84]

What to do!? That is the question...

I just graduated from an Accelerated Nursing Program in May of this year in Florida (it was a 1 year program). I relocated to California because my family lives here. I took a job at a small hospital near my parents house in the ICU. When I started, I was told that the hopsital's orientation in the ICU was only 6 weeks, which concerned me, but I was assured that because the hopsital was so small, I wouldn't have a problem... 6 weeks later, that is not so. I don't know what it is, but I think that it might be that I did not get enough experience due to the short duration of my BSN program, but I still don't feel comfortable. I spoke with the nursing manager and he agreed to given me 2 more weeks, but that doesn't seems even close to long enough.

Plus, my preceptor and manager seem upset that I haven't learned how to read EKG strips or administer meds like heparin, when I haven't even had the chance to do so in orientation yet! My preceptor gets angry when I ask her questions that she feels I should already know, or are as she says, "Are common sense...". I feel confused, because I am willing to do the work, but feel that the resources are not available for me. And I know for a fact that I'm not stupid. Not to mention, that when I speak to my friends from nursing school, they are in 4-6 month orientations!

My mother said that I should go to the floor, but I honestly HATE floor nursing, which is why I wanted to go to the ICU. I've been thinking about calling around the other hospitals, to see if they have longer orientations, but I'm feeling guilty, because the hospital payed for me to move back and everything... I really don't know if I should just switch to the floor and suffer, or if I should go to one of the other three local hospitals and feel like an unreliable jerk... HELP!

[llg, PhD, RN]

You're in a tough situation, but I feel you already have a pretty good understanding of it. Talk with the recruiter of your current employer and see what your options are there. Maybe you can find another unit that won't be as bad as you think it might be. Also, when you explain your problem to the recruiter, she may be able to give you some good advice about the hospital culture in general that could help with your decision.

Also, investigate your options with other employers in the area. Investigate them thoroughly before you assume that the "grass is greener" at one of those other hospitals. You might find that the situation is no better there -- and you will be paying a penalty for leaving your current employer, but ending up no better off.

After you do all your investigation, then make your tough decision and be prepared to live with the consequences.

Good luck!

[kcalohagirl]

You've got a tough decision to make. The first year out is tough no matter where you go. I have a lot of classmates that went to ICUs when we graduated 18 months ago, and most of them had orientations that lasted anywhere from 12 weeks to 6 months.

As far as tele strips go, that's a skill that gets better with practice. I only had a couple days of tele during my critical care course in nursing school. Not even enough to begin to get a handle on it. There is a book called (I think) "EKGs Made Incredibly Easy". It is a good resource, and puts things in simple, easy to understand terms. Although it may be hard to "study" now that you are on the unit and out of school, it may be what you need to do to survive.

Are there drugs/drips that are common on your floor that you weren't familiarized with during NS? Take a night to look it up, what it is used for, how it works, etc. Put it into practical terms so that you aren't just memorizing facts. Ex: Mrs. Smith had really lousy urine output. The doc put her on dopamine at 3 mcg/kg. Why?

I know that's kind of a mickeymouse example, but those are the things that helped me when I transitioned onto a fast-paced cardiac step-down. Not quite as intense as an ICU, but I definitely ran into a lot of drips I hadn't seen before.

Good luck, and keep us posted!

[deeDawntee, RN]

6 weeks orientation as a new grad, are they crazy?? OK, we will give you 2 more weeks...give me a break, that is entirely insufficient. Are they in the real world? If I were you, I would go to the floor for 6 months to 1 year, learn those basic skills, like telemetry etc and then do ICU. Even then, 6 weeks is hardly enough, unless all of your heavy patients get transferred off to bigger hospitals?? Even so, very scary. You won't regret doing the floor first, hopefully you will get an orientation where your needs are met.