I suck at nursing :(

CrunchRN, ADN, RN · Feb 13, 2016

They wouldn't even let us near icu when I was in school lol. No worries. There is no way a student could competently manage that. Just do what it takes to graduate and then get a residency program. You will be fine.

UnicoRN611 · Feb 14, 2016

That's actually exactly what I am planning to do is find a nurse residency program... Well you make me feel better about my lack of experience for sure.. Thank you

vanilla bean · Feb 14, 2016

There are no tips to be able to give you so that you can "handle ICU on your own." You're a student. You are not expected to be able to do handle it all on your own. That said, you need to be knowledgeable about your patient's medications, pathophysiology, basic ventilator settings and troubleshooting problems (the respiratory therapist will be a huge resource for you here and many like to teach and share what they know) IV pumps, wound vacs, etc. You need to stay organized and try to be proactive. It will frustrate your preceptor(s) to no end if they constantly have to prompt you to do things that they feel you should know to do by now (I'm talking basic stuff, not performing ACLS on your own, lol).

I know all clinicals are organized differently, but I'll share some things that I did while in my preceptorship and maybe some of this will help (or not, lol). I would arrive to my clinical site early and look up all my patients so that I could familiarize myself with them and look up unfamiliar meds and/or medical conditions. I designed a specific brain sheet for that placement and included a top sheet that acted as a timeline for a quick reference to tell me that something needed to be done at a certain time for specific patients. I'd load up my pockets with supplies like tape, flushes, alcohol swabs, chlorhexidine caps, etc. to be sure I was ready to hit the ground running as soon as the previous nurse finished report. I can't stress enough how important it is for you to be proactive. Do not wait to be asked or prompted to do any tasks that you are allowed to do on your own, even basic stuff like making sure you go collect all the supplies you'll need for a dressing change or grabbing the transport monitor if you're going to be taking a patient on a road trip, etc.

PP is right, you need to "just do what it takes to graduate," but, presumably, you want to make the most of this experience and not live in constant fear that you are on the bubble of passing/failing your clinical. Keep your focus and take one shift at a time. Don't beat yourself up about perceived or real failures - learn from them and move on.

Lev, MSN, RN, NP · Feb 14, 2016

I'm in my capstone of my accelerated program. All of my clinical experiences so far have been on med surg floors and the nurses treated us as techs and basically we weren't allowed to act as nurses. Now I'm in my final semester and I'm in an ICU and I'm supposed to be "flying solo" and I'm just completely frozen when I'm there. I'm overwhelmed by the drips and vents... I don't even know where to start or what to do when I'm there. I'm constantly leaning on my nurse for guidance, and every time my instructor checks up on me, she rips me a new ******* for not taking charge of my patient. And I don't blame her!
But I'm so incredibly intimated by this entire experience. I'm afraid of doing something wrong. It's been a rough school experience for me because Ive had a lot of family issues including a horribly messy divorce and having to move myself and my two kids in with my parents... I just don't know what to do. I wanted to be in the ICU so that I could have a more challenging experience, but I'm not stepping up to the plate. My other class mates are so far beyond me, I just feel completely defeated.
And it's not for lack of trying. I'm really trying hard, but at this point I just feel like I'm never going to be self-sufficient as a nurse and I just want to quit... In my final semester, no less.
Idk what the point of this post is.. I guess I just need to vent. Maybe some other people can give me some tips on how to handle the ICU on my own? Oh, also, I have ADHD, so I'm not inherently organized, and I've come to realize that organization is the key to being an ICU nurse. I've also come to realize that ICU is not the place for me, but I still need to make it through this clinical experience alive. If anyone could just give me words of encouragement or tips for success, I would really appreciate it.......

It is normal to feel intimidated. ICU is a very complex, stressful environment especially for a student/new nurse. It is ok to be dependent on your preceptor to an extent and you should be as a student, but you will find that in nursing to succeed you need to learn how to be self motivated. This means learning things on your own too. You might find icufaqs.org helpful. Specifically the notes on Vents and Pressors. http://www.icufaqs.org/PressorUpdate.doc & http://www.icufaqs.org/ventFAQ.doc. I find some of the information a little outdated, but most is still very relevant. Don't be so hard on yourself and don't compare yourself to others. Competency takes time!

As a student I would focus on knowing your patient's:

Relevant history and progression of the current disease process - how did they get to occupy a bed in the ICU

Physical assessment - your head to toe assessment - compare with preceptor

Level of sedation and orientation level - are they on any sedatives?

Current labs and what are you doing to correct them?

Cardiac rhythm - stable or unstable?

Vital signs trends - are they stable? What are doing to correct or maintain them?

Plan of care

Skills will come along the way. Critical thinking comes with knowledge and experience and will make you a whole lot more comfortable with the critical care environment.

You may find that the ER is more your speed, but I wouldn't give up on the ICU just yet.

Emilyblair · Feb 14, 2016

I feel the exact same way as you do I'm in my last semester and I'm in my CCU rotation and I have ICU next. I've been so down on myself because I feel like idk what I'm doing and I look at my other class mates and they are so way ahead of me. I also was thinking about the nurse resident program

cupcakeluver · Feb 15, 2016

Well, I feel overwhelmed frequently too. I'm in my last semester also. I start my preceptorship in 2 weeks. Our instructors have expected us to "be the nurse" since day one this semester. The issue is that half the things they're expecting us to do have never been covered in clinicals before. We have done a lot of different skills and assessments, but usually with prompting and an instructor along with us. It's a difficult transition for sure.

My first piece of advice is to stop beating yourself up. You need to have some confidence. You have to know something. You made it to your last semester. The knowledge is in there. You just need to put it all together and use it. I understand this takes time and experience. You can't get down on yourself. If you don't know something then just say it. Then make a point to find out. You have to stay positive and not get freaked out. It almost happened to me. I was questioning whether or not I should even be a nurse. I finally managed to calm myself down. No way am I giving up after I've made it this far. I will be a nurse if it kills me. Lol! If you want to be a nurse then do what you need to in order to make it happen! My point is, you can be your own worst enemy. Don't let it happen.

Also, be as prepared as possible. Go in early. Get your information. Look up what you don't know or understand clearly. You don't have to know every single thing but a basic understanding is good. Try to review those drips and vents that you don't understand at home. Look it up online and review your textbooks. I did all of this when I had a super tough instructor on my last rotation. I still didn't know everything and I still did dumb stuff. I was able to show her that I had made an effort and had a thorough understanding of medications and disease process. This helped me feel more confident and less nervous.

What does your preceptor say? Are you getting feedback from her? If so, use it. If not, then talk to her.

You can't give up now. You're so close to finishing. You have made it so far. Just take some slow deep breaths and try to be confident. You know stuff!!! It's in there. I hope things start getting better for you soon.

UnicoRN611 · Feb 16, 2016

Thank you so much everyone for your tips and encouragement... It's helpful to hear that other have felt the same way as I do! I'm still nervous as hell.. My instructor is really smart and a really good teacher, but she is very tough and gets aggravated when people don't know the answers. I've cried like 3 times at this clinical ay yi yi... I'm just gonna work on being as prepared as possible these next few days and do my best. There's really not much else that I can do!