ICU - Should I stay or go?

[OahuRN]

Hi all,

This is my first post but I have read posts for over 2 years. I am having some issues in my new job and need your advice. I graduated in Dec 2004 and began working on a Med/Surg Trauma floor. I was there for 8 months and gained great experience but applied to the hospital's CVCC since I would eventually like to apply to CRNA school. Anyway- I have been there for almost 4 months and about to quit. Here are some of what I have gone through:

1.I was told I would have 1-2 preceptors during orientation - I am now on #7.

This creates issues b/c each preceptor has their own way of doing things and I am constantly corrected (ex- one preceptor writes her VS, etc on notebook and then transfers to chart, she said to do this b/c taking the chart in the pts room is an infection control issue- when I did this with another preceptor- she acted like I was a moron and actually wrote a bad eval on this).

2. I was told I could remain on my Tues, Fri, Sun shift like on my original unit ( I need this schedule due to babysitting issues) but instead I am on Sun, Tues, Thurs. (My husband had to drop out of nursing school in order to accomodate this)

3. I was told on orientation, I would start with one stable patient and over 12 weeks build up to taking 1-2 more critical. I have always had 2 critical pts and the first few weeks my preceptor was so busy I might as well have been on my own.

4. I met with my mgr 3 weeks ago to discuss getting off orientation and she told me that one of preceptors said I was not SOCIABLE enough b/c on my down time I prefer to catch up on the hours of required computer training instead of chatting with the other nurses! ( I am not making this up!)

5. At my latest meeting with administration, 2 days ago, my preceptor said I had improved 150% in the last 2 weeks ( I have been taking 2 patients on my own, talking with every nurse I see on the unit, and improving my time management, etc.) then she says that what concerns her is that she does not see the PASSION she is looking for. She stated that we had a lung transplant come back from surg and I did not come over to "get the scoop" on what was going on like the other nurses. Sorry- I was too busy taking care of my own 2 fresh post-op pts.

At this point I am on orientation for at least another 2 weeks when we will all meet again and discuss my PASSION. I am about to give up. Since I have been there I have seen a nurse hang a bottle of insulin for one pt in another pt's room b/c she did not order the other pt's med in time, one nurse give a pt so much pain meds she had to give Narcan only to find out his real problem was that his O2 was not plugged in, I come in at least 1 shift a week to find that the off-going nurse has not charted a single thing all day but I am in trouble for a lack of PASSION. So my ? to you all is Am I crazy to stay on this unit? I know there are issues everywhere but this is making me miserable. Any advice?

[RN34TX]

Not sure I'd use the word outdated...if the nursing shortage was to end tomorrow, I personally believe it would be required again. I've only seen the recent trend of hiring new grads in ICU and other speciality units because they couldn't find anyone else. I doubt hospitals would be willing to spend the $$ training new grads extensively, when they could get someone with experience up and running much cheaper. And we all know how much hospitals are wanting to save a buck :)

I agree.

However, if the nursing shortage were to end, it would simply put managers in a better position to be pickier about their candidates in all areas, not just ICU.

We'd be going back to new grads basically getting the jobs where people experience burn out faster and are the least desirable nursing jobs.

The new grads would once again be looking at jobs like LTC and even some med/surg positions would be at a premium.

[Gennaver, MSN]

Caroladybelle,

This is a wonderfully inspiring post. I for one and so glad to read it, congratulations and thank you for your advice to the OP, (which I will take also. :))

Gen

Sometimes it pays to go somewhere that nurtures you more, and allows you to develop more self confidence for a while. That way, manipulative wretches like this preceptor will not feel that they can behave that way and get away with such as this. They feed off of good and well meaning coworkers, frequently. And they are found in every career field, we just like to think that nursing is above that..and are saddened to find that perception wrong.

Working in role that may be less stressful will allow you to become stronger than them, when/if you return to the ICU. It is much hardly to breakdown someone with good solid experience, and that knows it.

While you may choose to just go to another floor for time, eventually it would be good to go to another facility. Soemtimes it is good to prove yourself a bit and then go on to be fabulous at another facility.

I was eaten as a student nurse - chewed up and spit out by a couple of nurses on the floor that I wanted to work on. I ended up on an ID ward, full BKAs from diabetic sores, decubes and liver failures, just the dregs of the hospital. I worked my butt off, for 18 monthes and then transferred to another facility. When I returned a few years later, the nurses that were evil to me were considered bad nurses and I was the sought after one (and they also didn't even remember what they did to me).

About 4 years ago, I was being treated badly by my nurse manager. No matter how much my coworkers respected me, how my patients, MDs ravedabout me, she called me in for the most trivial things. I finally quit because I could not even get up for work without feeling sick and nauseated at the thought of going in. I was going to quit nursing but took a traveler position to give me time to figure out my next move.

Virtually every manager that I have worked for since has wanted to hire me, made me really good offers and invited back. I have references from 3 hospitals listed in the nation's top 15. I have worked with published MDs that are tops in the field. And when I got ill in Manhattan, one of the attendings at Cornell immediately saw me as a patient.

The problem sometimes is the Workplace.

Give yourself the time and a chance to gain the confidence that you need so that in another year or two, or three, you can set the world on fire.

And remember that G-d has a plan for us. It might not be what we would like it to be. Sometimes bad things happen to guide our footsteps onto the right path and in the direction that we need to go.

My thoughts and prayers are with you.

Carolina

[fancythatRN]

]As a new grad who started in an ICU float pool internship and was treated as a "less than", I can empathize with your story. I witnessed many things there that went against everything that we were taught in school - number one being COMPASSION for the patient and families of the patients. I was ridiculed continuously for being too nice, and basically caring too much. It was okay for a nurse of more than 20 years to have her patient paralyzed with no sedative, and don't dare ask her why! Because I didn't fit in the "click", I no longer work in the float pool. Although I didn't realize it at the time, it was the best thing that has happened to me since graduation! I now work in medical stepdown/PCU with a WONDERFUL group of nurses who work together as a team, treat everyone with respect, and don't look down their noses at me in the event I have a question or four to ask during my shift. I am a new nurse. Since my experience of being treated like the "deer in the headlights nurse", I have set myself a new goal: I am looking forward to the day that I can become a preceptor. I can't wait to help guide new nurses without hesitation and without judgement. I realize it will take some time for me to get to this point, but it will come, I have not doubt. As far as staying or going - if it's truly something you enjoy doing and can tolerate the treatment there, I would highly recommend that you stay. Don't be bullied around! However, if you're not happy there, I would look at your options. Only from experience do I know that there really are better places to work - atmospheres to work in. I hope your husband can get back into school soon - what a team you would make! Good luck!! :Holly1:

[kadokin, ASN, RN]

Don't go quietly. Establish yourself as a critical thinking, caring, safe RN who's willing to argue their case without emotion. I mean, whenever something ridiculous presents itself and you are certain about your facts - represent yourself, demonstrate that your not a push over. Challenge their *judgements* of you. Who are they to judge your passion. Good grief. Bunch of little primadonas... and they're a dime a dozen so might as well practice the art of deflating their hilarious notions with evidenced based practice and theory in a unit you may leave cause you'll be faced with this again and again. Become your own advocate without seeming arrogant. Keep to objective non-emotional responses. Don't allow them to bait and hook you. It's all fun and games for the tenured staff. So NEVER let them see you sweat :)

Good answer. Although I only know about your unit from what you described, here's my guess: The staff is resentful and jealous b/c they know you will soon be moving on to anesthesia school and they want you to know that being a critical care RN is no picnic. As for bringing up social issues in your eval, I wonder if that is even legal. Granted, you have to be able to work as a team, but isn't it more important to be able to care safely for your pts? Had a similar situation myself, although not in an ICU-CRNA situation. My sup mentioned in my 1st eval as a new nurse that I shouldn't be so "standoffish" HUH? It was the existing staff who were supposed to be precepting me that were making ME feel like an outsider. And I mean I went OUT OF MY WAY to be friendly. Granted, sometimes, I took down time to study meds, disorders, etc., but I was in no way standoffish. My first instinct was to tell you to run away as fast as you can from this toxic environment, but maybe you can learn some new skills as this poster suggested. I stuck it out and now I work w/some of these people as colleagues. I can't imagine we'll ever be close friends, though. I know how s***** they can be, and, frankly, I don't need friends like that.

[kadokin, ASN, RN]

Thank you all for your posts! I am sorry I have not replied earlier than now but my plate has been full. As for the ICU I was in - I did make the decision to leave. I will float to another unit starting this week and will also look at other ICU positions. The final straw this week was when my preceptor told me that she had deliberately set "traps" for me. In a meeting with her and my manager - my preceptor showed me a "secret" evaluation she had filled out. In it, she commented on how she had tested me on several things (one in particular- disconnecting a chest tube from suction to see if I would notice) and whether I had picked up on all of them or not. Apparently, I did miss some things - I do not know what they are as she did not comment on them. After getting over the initial shock of this - I told my preceptor and manager that I did not feel this was the right place for me and that my preceptor's actions were unprofessional, unethical, and unsafe nursing and I could not stay in such an environment. I am deeply saddened over the whole ordeal - I had never before encountered the "older nurses eating their young" syndrome commonly associated with nursing and so I was really not prepared for this. Dont misunderstand me - I take FULL RESPONSIBILITY for not noticing the disconnected CT (it was disconnected from the wall suction for 2 hours per my preceptor) but I was not prepared to be sabotaged by my preceptor. After all is said and done - this is not the place for me- and while I am a bit crushed - I will go on, find another position and chalk this up as experience. Again thank you all for your kind replies.

Setting traps? Disconnecting chest tubes to see if you would notice? OH MY GOD These people need to leave nursing to the professionals and get a job at Disneyworld. I am sure Mickey Mouse would appreciate the way they do things. Honestly. I CAN NOT believe it. !

[bluesky, BSN, RN]

Listen, what your ex-preceptor did was completely unsafe, unprofessional and unbecoming of a nurse. I would also pursue any type of action that would hold the irresponsible RN accountable.

All that said, you can take home a little lesson here. Now I am just guessing here so don't flame me and please forgive me if I am wrong... but your husband often refers to your future plans to go to CRNA with such ambition and confidence that such behavior has the potential to offend seasoned nurses if you step up to them with the same attitude, especially as a new nurse in the ICU. Now, mind you, I am in no way justifying what your preceptor did. Keep that in mind. However I'd like to suggest that your ICU experience is a valuable one in which you will meet many clinical champions who will help you on your way to being a great CRNA. Boasting about your grades or your future plans is not going to help you in that environment until you prove that you are a strong nurse, period.

[OahuRN]

Again, thank you all for your kind replies. I also wanted to note that I never told any of my co-workers about my plans to attend CRNA school or talked about my grades to anyone. I learned through this board that many people have had issues when they told others of their plans and so I kept this information to myself. So I don't think my future plans or current schooling had anything to do with the treatment I recieved. Also just a note- our facility only required checking and documenting the CT status every 4 hours. I know some of you will cringe or not believe this - but I keep a blank set of docs at home (we just got new forms in Nov and I wanted to study them). Not that I should have not been checking but documenting is only every 4 hours.

[bluesky, BSN, RN]

Again, thank you all for your kind replies. I also wanted to note that I never told any of my co-workers about my plans to attend CRNA school or talked about my grades to anyone. I learned through this board that many people have had issues when they told others of their plans and so I kept this information to myself. So I don't think my future plans or current schooling had anything to do with the treatment I recieved. Also just a note- our facility only required checking and documenting the CT status every 4 hours. I know some of you will cringe or not believe this - but I keep a blank set of docs at home (we just got new forms in Nov and I wanted to study them). Not that I should have not been checking but documenting is only every 4 hours.

OK. Well then the unit you were on was a towering inferno of incompetence that will unfortunately be supremely difficult and time consuming to battle. Furthermore, it won't get you any closer to your long term goal of CRNA or bust. As a past union shop steward, I would have encouraged you to fight these lunatics to the end however knowing that bedside nursing is not your final goal, I would suggest putting all your energy into becoming the bestest CRNA ever so that you will be able to return a few years later and really give it to them. I don't know if this helps but not all CRNA schools require extensive SICU experience. One representative at Georgetown, for example, told me that there were a couple of people in her program who were in the ICU for less than a year.