I don't think I can take it anymore.

Triddin · May 22, 2018

Give it time. Icu is a big enough learning curve without being a new grad at the same time. You will learn what papers you need for which events, and incidences like this will happen because you are still learning. You're only 4 shifts in. Unless they've started to make hints about letting you go, I'd wait it out. Your manager shouldn't have yelled at you and next time you can be more proactive when you approach her with similar situations. For example, " pt z is transferring to this facility, xyz is done and signed. What else needs to be done so this patient can be transferred out."

Asking your colleagues in situations you don't have experience in can also be useful to make sure you aren't missing things. You will make mistakes because you are learning, but be kind to yourself that those who have been in the specialty for decades are still learning new things and miss things sometimes.

guest769224 · May 22, 2018

Sorry that happened to you. I would never work somewhere where a nurse manager was so unprofessional that she yelled at me. The environment you're in sounds like they need to be more supportive and teach new graduates, not get pissed off at them. I'd try to stick it out for at least a year. Then you'll have the golden 1 year of ICU experience and can have more more opportunities to transfer to a better unit.

Rocknurse, MSN, APRN, NP · May 22, 2018

Here's a tip from a veteran nurse that took many decades to figure out. Do not take anything personally. When vitriol is directed at you, build a glass wall in front of you. Imagine the words bouncing off you and going over your head. These words and emotions are not meant for you, but they are a manifestation of someone who is miserable and unable to employ an emotional filter. Stay calm, steadfast and look them in the eye and smile. Do not take those words and direct them inwards. Deflect. Smile...force one if you have to, breathe, and focus. Now you know about the foley and the midline you'll never make that mistake again. You couldn't possibly have known about it but now you do, so file that away in your memory bank and move on to the next thing. There will be another time and that's when you can get to practice this skill. You'll never know everything in the ICU, and that's ok. It's how you deal with it that matters. Be Teflon. Just say "thank you for telling me" and move on. Never, ever, let those words hurt you because they were never meant for you in the first place. The best way to survive as a nurse is to build a glass wall around you and only let through what you decide to let through. Don't let the facade slip. And never let any single person chase you out of a job...to leave must be your decision alone, so do what you have to make it through and ignore the noise.

meanmaryjean, DNP, RN · May 22, 2018

Hey guys,
just feeling down about the start of my nursing career. I am 4 months into my nursing career, i am in the ICU at a small community hospital. I am 4 days of orientation, orientation was 12 weeks. I just feel like i am constatly being screamed at and being belittled. I want to leave but its hard to find a job here and I dont know if ill ever get into the icu again as a new grad. yesterday I got yelled at by my nurse manager because i was not prepared when EMS came to transfer my patient to hospice. The thing was I told her that my patient was going to be transferred to hospice about an hour before EMS came, the family had signed the papers and then I went to let her know. Well, when EMS came they required a few documents such as the patient DNR sheet, face sheet, H&P, etc. I did not know this. She just kept saying, see.. this is why you let us know ahead of time just being very unprofessional in front of the EMS workers. I did let her know and she know I did, at some point before the EMS arrived the patient family even spoked to her and thanked her for our service here she hugged the family members. so how the heck did she not know (annoyed). I guess I should have asked for help with the process, because the patient still had their foley and midline in. I didn't know the patient could not be transferred with those things. anyways, I am thinking of looking for another job, before they let me go.

You 'feel' like you are being 'screamed at' or you are actually being literally screamed at? The two are different, and while I don't deny there are crappy managers out there- sometimes your 'feelings' do not reflect reality.

JKL33 · May 22, 2018

I'm very leery of people who make an issue when there is literally no reason for doing so, and this was certainly one such case. Speaking to you like that repeatedly in front of EMS was playing dirty. So now you know (or if you don't I will tell you): She feels better about herself by trying to make others look lesser. This reminds her how much better she is. Be proactive with these types (if you can't ignore them completely) by inviting them to have a little skin in the game as appropriate. If she is your point person (as opposed to a charge nurse, for example) then go to her next time and have her come with you to review the new scenario you are handling.

Some people's pride is hurt by doing this sort of suggestion ^ but I'm telling you that your path will be much smoother if you learn how to handle people just as much as you learn how to do your nursing role. It shouldn't be a hit to one's pride to be able to control the situation by being one step ahead. Keep your head on and be smart about it. People in positions of relative power who don't really feel great about themselves can and will escalate situations and cause extra trouble - because they can.

All those above me have given you sound advice and various angles to consider, not the least of which is not exaggerating occurrences in your own mind - which will make it virtually impossible for you to think clearly about how to handle things and is not good for your own well-being.

Good luck ~

Ruby Vee, BSN · May 22, 2018

Hey guys,
just feeling down about the start of my nursing career. I am 4 months into my nursing career, i am in the ICU at a small community hospital. I am 4 days of orientation, orientation was 12 weeks. I just feel like i am constatly being screamed at and being belittled. I want to leave but its hard to find a job here and I dont know if ill ever get into the icu again as a new grad. yesterday I got yelled at by my nurse manager because i was not prepared when EMS came to transfer my patient to hospice. The thing was I told her that my patient was going to be transferred to hospice about an hour before EMS came, the family had signed the papers and then I went to let her know. Well, when EMS came they required a few documents such as the patient DNR sheet, face sheet, H&P, etc. I did not know this. She just kept saying, see.. this is why you let us know ahead of time just being very unprofessional in front of the EMS workers. I did let her know and she know I did, at some point before the EMS arrived the patient family even spoked to her and thanked her for our service here she hugged the family members. so how the heck did she not know (annoyed). I guess I should have asked for help with the process, because the patient still had their foley and midline in. I didn't know the patient could not be transferred with those things. anyways, I am thinking of looking for another job, before they let me go.

ARE you being screamed at and belittled? Voiced raised, face purple, spit flying? Or just an interaction that you don't like? Your feelings may not be the best indicator of what is going on.

Sour Lemon · May 22, 2018

Hey guys,
just feeling down about the start of my nursing career. I am 4 months into my nursing career, i am in the ICU at a small community hospital. I am 4 days of orientation, orientation was 12 weeks. I just feel like i am constatly being screamed at and being belittled. I want to leave but its hard to find a job here and I dont know if ill ever get into the icu again as a new grad. yesterday I got yelled at by my nurse manager because i was not prepared when EMS came to transfer my patient to hospice. The thing was I told her that my patient was going to be transferred to hospice about an hour before EMS came, the family had signed the papers and then I went to let her know. Well, when EMS came they required a few documents such as the patient DNR sheet, face sheet, H&P, etc. I did not know this. She just kept saying, see.. this is why you let us know ahead of time just being very unprofessional in front of the EMS workers. I did let her know and she know I did, at some point before the EMS arrived the patient family even spoked to her and thanked her for our service here she hugged the family members. so how the heck did she not know (annoyed). I guess I should have asked for help with the process, because the patient still had their foley and midline in. I didn't know the patient could not be transferred with those things. anyways, I am thinking of looking for another job, before they let me go.

Smile and nod and focus on the point and what you learned, not how it makes you feel. As such a new nurse, you need everyone possible on your side and can't afford to look for faults in others. After you have more experience, you'll have more confidence and be better able to deal with snide remarks.

Zhuriel, MSN · May 24, 2018

Its going to be really hard the first year. Be strong and if you feel overwhelmed, confused, or something ask for help all the time. If you have a gut feeling that something is missing always ask for help or ideas what they would do in that situation esp. that you are new. We all don't know how the process works until you actually do it the first time around with other people. Someone training you and telling you how to do it the first time doesn't count. When it is your turn to do something think about it and ask yourself if you are prepared to do it on your own. If not that's when you ask "Hey, I have this and this who's transferring over here can you please help me with the process and what needs to be done... etc. etc. I don't want to miss anything" And on an ICU floor there should be checklists anyways on the screen for a transfer patient (or so we can hope they have a check list there lol). Anyways don't be so hard on your self. I was like that too... overwhelmed and wanted to quit. It's bad I'm telling you the first year it will be. It's nothing like nursing school. Take care :)

Libby1987 · May 24, 2018

Screamed at? Constantly?

People embellish to be heard, be prepared to experience exaggerated accusations from patients, families and coworkers, but it's usually not an objective perspective.

First year as a new grad and even first year in a new field is very stressful. Nursing is stressful in general and learning how to navigate while being open but not taking things personally is very challenging when on a steep learning curve but it is the way to success.

I wouldn't quit over what you described, I just wouldn't give it away that easily. I would dig deep and invest in myself by preparing for each week with reviewing a section of the policies and resources over the course of the next year.

Cowboyardee · May 24, 2018

... She just kept saying, see.. this is why you let us know ahead of time just being very unprofessional in front of the EMS workers. I did let her know and she know I did, at some point before the EMS arrived the patient family even spoked to her and thanked her for our service here she hugged the family members. so how the heck did she not know (annoyed). I guess I should have asked for help with the process, because the patient still had their foley and midline in. I didn't know the patient could not be transferred with those things.

Bolded for emphasis. If you see a problem coming or can't figure out how something is going to work as planned, you have to ask for help. Don't let it ride. Don't assume someone else will see the problem coming and fix it for you without being asked. Don't just tell someone what's about to happen and expect them to fill in the blanks for you. New ICU nurses can't afford to do that. Specifically tell your boss or more experienced coworkers that you don't know the process for what you're about to do and need them to make sure you've got your bases covered.

Your patient has a problem? It's your responsibility, period. Fix it or ask for help from someone who can. New ICU nurses aren't expected to know everything their more experienced coworkers do; they are expected to admit it when they have a problem or don't know what to do and ask for help pre-emptively.

As for the rest of your post, I wasn't there and can't really comment on how your manager behaves toward you. If she is abusive, yes, look for another job with a less dysfunctional manager. If, on the other hand, she is merely displeased (and says so) when you botch the plan of care, then your problems will follow you to most other nursing jobs you might take, and certainly to other ICUs.

Daisy4RN · May 24, 2018

First year nursing is very hard, and I am sure that ICU is even harder. Try not to take things personally. Learn what you can from the experience and continue to move forward. Be proactive, ask questions and ask for help prn. I am just curious as to why you were doing all the paperwork yourself, no medical secretary/clerk to help? Also, why DC the foley and IV prior to Hospice, people in Hospice have these all the time for comfort measure etc. Anyway, you can do this!! Good luck!