Icu nursing just not for me

[Wvurn15]

I'm 2 years and some change into my first nursing job as a MICU nurse...I've tried to give it time to feel more confident in myself, but I just don't think I'm made for icu level stress. I work at a large teaching university hospital and we receive all the transfers from other hospitals in the state and surrounding area for higher levels of care. Our staffing levels are good (for the most part), we are magnet, and I never care for more than 2 ICU patients..but I still feel overwhelmed many days.

At a little over 2 years in, is it still normal that I get shaky drawing up epi in a code? Or that I don't have all the receptors memorized for what each pressor acts on? That I still don't fully comprehend all the different ventilator changes (I know the mode basics but feel dumb when RT tries to discuss peak pressures or p high on bivent, etc)..I am still even nervous transporting patients to scans with just respiratory and patient transport as the only RN when a patient is vented and on drips.

i just feel like some nurses that have only worked a short time longer than myself are so much more educated and never appear to feel the nerves that I do. I never walk in and hope for a shift that I'm titrating pressors with cvvhd running and the vent on 100% bivent or performing ToF and tirating paralytics and I DEFINITELY am not an adrenaline junky for codes.

But then I also hate shifts with walkie talkies that I am cleaning poop or getting someone up every 10 minutes to the bathroom.

I enjoy the thinking aspect of my job but I find in critical care you don't often have time to think and my nerves cloud my thoughts. I dread going to work. 9x/10 I don't enjoy the hands on tasks either, like putting in IV's, NGs, catheters....I am thinking of doing NP in a clinic where the patients are much more stable and I have time to think (which is the part I enjoy, schedule sounds great also). Is there anyone else who feels like this Or has suggestions?

[WestCoastSunRN, MSN, CNS]

At a little over 2 years in, is it still normal that I get shaky drawing up epi in a code? Or that I don't have all the receptors memorized for what each pressor acts on? That I still don't fully comprehend all the different ventilator changes (I know the mode basics but feel dumb when RT tries to discuss peak pressures or p high on bivent, etc)..I am still even nervous transporting patients to scans with just respiratory and patient transport as the only RN when a patient is vented and on drips.

i just feel like some nurses that have only worked a short time longer than myself are so much more educated and never appear to feel the nerves that I do. I never walk in and hope for a shift that I'm titrating pressors with cvvhd running and the vent on 100% bivent or performing ToF and tirating paralytics and I DEFINITELY am not an adrenaline junky for codes.

You are still a newbie ICU nurse. It is going to take you years to feel like you have a handle on things, and even then you will always realize the need for continual study and the reality of the challenge. If anyone isn't nervous transporting vented patients on pressors around the hospital halls and elevators and such, they are either stupid or haven't had something gone wrong on one of those little field trips. They are not Super Nurse. Also MICU at a level 1 teaching hospital is big guns for a new nurse. Sounds like you're probably doing as expected. It's a tough job. It will get better.

That said, ICU nursing certainly isn't for everyone. And there's no shame in that either. Primary care advanced practice might be a great fit for you. The ICU experience will help you get into a good school. That world has a steep learning curve all of its own, but if you like to study and learn constantly and can handle the responsibility of being the medical provider (this is a biggie!), but like hanging with stable patients -- you could do great. There's a LOT that goes into that (and it's mostly the stuff that happens AFTER grad school), though. I urge to count all costs 10 times over before committing to that path.

[ArmaniX, MSN, APRN]

The idea of being the provider and potentially making an error that could result in patient harm does not scare you?

[livingkennedy]

While it may not make you like your job any more, perhaps it will reduce stress: Much of what you might be scared about in the ICU is taken care of by fundamental things. 9 out of 10 problems a patient encounters in the ICU can be dealt with by fluid/blood, pressors/inotropes/vasodilators, and alternate modes of ventilation (bipap/vent). It really is as simple as that. It's recognizing problems and intervening appropriately that is more difficult, but most of the problems really do boil down to the above.

[KeepinitrealCCRN]

hmm imo a lot of what you mentioned you should feel comfortable with at this point, especially vent settings and drip titration. NP may be worse, you are responsible for more and you are the final word on someones health. also, the NPs i know are just as overwhelmed as RNs and they see many patients a day so they hardly have much time for thinking. if you don't like walkie/talkie patients and you don't like ICU patients have you thought of working on a step down unit? Or maybe psych, school nurse, infusion, home health?