I still feel lost- any suggestions?

[beyondmeasure]

I have been in the CCU/MICU for almost 1 year. My question..... when does it get better? Many times I still feel completely unorganized and worst of all just plain stupid. All I have ever wanted to do was be a nurse, or so I thought. I have question muy decision almost daily since passing the NCLEX. I have been told I am too hard on myself. I just want to be so good at this. I am still afraid of codes, I can't remember max rates on pressors. I do look things up and ask plenty of questions. I do not want to leave this unit but I am wondering if I am a good fit? Can anybody give me some words of encouragement that it will get better?

[dorimar, BSN, RN]

Please be patient with yourself. If you are not getting adequate support, then you considered leaving that unit, but not ICU... It takes more than a year to feel comfortable (for those nurses who are actually concerned for their patient's well being). I am fine with codes that I have been trying to prevent for quite some time and so am on top of everything, BUT I still freak a bit when my patient suddenly and unexpectantly arrests (which doesn't happen often for me, but sometimes drastic suddne things like PE, etc. does happen). You will never know all the answers and never be perfect. You will improve with time and get more comfortable. Keep looking stuff up, keep asking. Maybe consider finding a more supportive environment, but hang in there.

[athena55, BSN, RN]

Oh my goodness, been there, sometimes STILL feel that!

Ya know what I did? I had a notebook that I would jot stuff in, like how to calculate a dopamine drip, the actions of a drug that I might not use all that much, or something interesting that I read in a professional critical care nursing magazine. Little stuff...pretty soon I was onto my 2nd book, which I kept in my lab coat pocket or on me.

Now jump ahead to now..And I see that other nurses did the same thing and they published their tips and hints.... I am thinking of places on line like www.icufaqs.com or check out amazon.com for kathy whites little book.

I agree with Dorimar: don't be so hard on yourself. The very fact that you recognize there is still so much to learn tells me something about you. Don't leave the unit! Is there someone there that you trust that would give you an honest answer if you ask her or him...."how am I doing?"

Keep reading. Empower yourself. Take possession and own who you are. You are a young, critical care nurse in a very stressful environment....Think back, if you can, to your first few days,, weeks, months in the unit....Don't you feel as if you have grown, even a wee bit? Haven't you had one day or night where you went home and thought to yourself, "Today I made a difference in my patients life"? Haven't you had one family member or patient say Thank You and ask, "Are you coming back tonight? Will you be my nurse again?"

Hold on to those moments when you start to doubt yourself.

Then look in the mirror and be PROUD of yourself!

{{a big cyber hug from one critical care nurse to another!}}

athena

[ICUNurseCline]

I feel the same way sometimes. I am in a MSICU and it's my first job. Focus on the positive moments. School only teaches us enough to keep us from really hurting someone. We don't have to have all the answers, we just have to know how to find them. Look for a mentor: a nurse that has is together and someone you feel you'd like to model yourself after. Once you've identified him or her, approach them and ask if they'd mind meeting with you. Tell them how you are feeling and see if they'd be willing to mentor you for a while. I bet they probably will! I read Your First Year as a Nurse by Cardillo, and it has helped me a lot! I highly recommend it-it's a quick read. Good luck to you!

[mnurse3139]

Just stick to it, i didnt feel comfortable till about my 4th year of ICU, dont feel stupid about asking questions and just get to know the nurses you can always rely on. Soon you will be walking to the hospital strutting as if you know it all, just remember, you dont.

[Bella RN, BSN, MSN]

I think a good suggestion is to getting into the habit or mindset of preventing a code vs running it.

Alot of us put pressure on ourselves to "adequately" run a code. But your best bet is to come in early look through your labs-Big indicator as to what may or may not happen. Or what needs to be replaced to prevent a code.

As far as pressors check in see if your unit has a table that states the min and max of each one. Or you can research it yourself and carry it in your bag.

The more you get exposed to things the more you will retain it. Most importantly when you need help--ASK FOR IT!!! I have seen alot of newer nurses try to play super nurse and then something happens that could've been prevented but because they were scared to ask their peers they--scared the peers would think they were dumb they didn't ask.....

Remember with lives--NO question is ever dumb, heck sometimes i drill the docs because I really want to understand the etiology.

[cloister]

Be patient with yourself. Hell, it's a tough environment.

I think I was 5 years into being an ICU nurse when the phrase "doesn't wig out as much" appeared on my eval. By then, I was a little more comfortable. At 10 years, it actually started to be kind of fun. Some people are more comfortable early on. Some of us aren't. Sounds like you're doing all of the right things, and that you're concerned for your patients' safety. That's the crux of the matter, as far as I'm concerned.

My advice? Keep plugging. Eventually, some things will come automatically, which will make the inevitable surprises easier to deal with. And, no, I don't like codes either!