I'm a new MICU RN and not liking it!

dorimar, BSN, RN · Nov 5, 2005

Hey Kitty,

I'm sorry to hear your having such a time. I've been working MS ICU for 17 years, and I have to say, for myself, it doesn't get easier. But I have to say this is well: If it is the intensly ill paiteitnts that upset you, then maybe you are in it for the right reasons. I find that the people who care the most, struggle the most. I've worked with a lot of nurses over the years (more so lately), who are smart and efficient and organized and get the job done with lots of time left over, and nothing seems to faze them. But many times they don't take the time to do the extra things, or to know the whole story or progress of their patients, or to give the families what they really need. I could never read a book, or surf the net if I haven't studied my patient's chart and found out if there CXR is getting worse or better, if the WBC's are trending up or down, what the plan is etc. Also if my patient is sweaty, needs a hair wash or ET tape change or some good oral care or line dressing changes.... I try to get it done. I answer my paiteint's family questions & don't get defensive just because they ask...I would be asking too. some times I don't get lunch, sometimes I don't get to the bathroom enough. After 20 years of nursing, I still cry sometimes at work for my patients. And it doesn't get easier when you routinely take care of someone for 1&1/2 month on the vent only to see them die. Burn out is high, especially for nurses who care a lot. Someone who is in it for the paycheck isn't going to burn out that easy. That being said, it can be very rewarding. Knowing that you've made your patient more comfortable, warded off a potential problem, or really made this whole nightmare easier for the family, makes you feel like you can make a difference sometimes. That is what keeps me in it. I have almost almost left nursing completely a couple of times, but I truly feel it would be a loss to the profession if i did so. So my advice is to hang in there for awhile. The tasks and critical thinking will soon come easier, but if you really care, the job won't. I have come to realize that even though the job takes a lot from me, I take alot from it as well. Good luck!!

Doris

RN34TX · Nov 5, 2005

Tough it out and stick with it for at least a year or two.

You're going to learn a lot, but I know it's hard to see so many people in such bad shape.

Trust me, ICU experience opens doors.

There are areas where I've applied when I was a Med/Surg nurse that hardly gave my application a second glance such as Cath lab, special procedures, or PACU.

But now they all seem quite interested in me now that I've done a couple of years of ICU.

You really need to give MICU a chance to either grow on you, or use it as a stepping stone to get you somewhere else later on.

Kitty-MayRN, BSN, RN · Nov 5, 2005

Thanks for the advice. I plan on trying to stick it out for a year and see what happens. The other factor in this is I am going through mental depression, so I'm worried what the ICU might do to me.

Kitty-MayRN

RN34TX · Nov 5, 2005

Thanks for the advice. I plan on trying to stick it out for a year and see what happens. The other factor in this is I am going through mental depression, so I'm worried what the ICU might do to me.
Kitty-MayRN

Death and depression are everywhere in nursing.

You might as well stay where you will not only learn a lot, but will increase your marketability in years to come.

Even if you leave it later, you won't regret having ICU experience wherever your career takes you.

papawjohn · Nov 6, 2005

Hey Y'all

I think DORIMAR's thoughts are wonderful and complete and I was going to say essentially the same thing but probably not as well. I would add that there is a kind of special joy in doing a crucially important job with skill and compassion. The psychological/emotional payoff I get makes thinking of retiring from this job sometimes seem almost threatening.

Papaw John

dorimar, BSN, RN · Nov 8, 2005

papaw john,

I've said it before & I'll say it again: You can take care of me or mine any time.

Doris

txdude35 · Nov 18, 2005

I just finished a clinical rotation in the MSICU, and it took a lot out of me some days. I've seen more death in the last month and a half than I ever really cared to (especially the kids-those were pretty tough), but I also found inspiration in the ones that didn't seem to have a chance and ended up making it. I loved it, and plan to work there.

organichombre, ADN, BSN, MSN, LPN, RN · Nov 18, 2005

Kitty,

All of these suggestions are right on the money. However, if your depression doesn't resolve, don't stay! It's one thing to grieve for a pt and then move on, but to become physically ill while attending to the critically ill pt who may die, you are doing more harm than good.

Good luck, and we need more compassionate souls who can do this work of the heart. :saint:

EricTAMUCC-BSN, BSN, RN · Nov 18, 2005

The other factor in this is I am going through mental depression

Don't wait, seek professional help for this immediatley! Whether it be a PHD, NP, or MD you need to see a specialist on your next day off if you have not already done so. Best of luck and intelligence!

marissa81579 · Dec 8, 2005

I have a couple of issues with what Doris said (I think she was being very generalized) but more importantly, the ICU is not for everybody and that is OK.

It is not normal to cry at work, no one should be that way. Most of us eventually develop coping mechanisms to deal with the constant death and dying around the MICU. It is much healthier to develop these coping skills and to become more pragmatic about it.

Don't be a martyr for your patients! They need you to be STRONG!

Give it time, you will get used to it. One month is never enough time to know if you likew a job for sure. No matter what happens, even a year in a MICU will give you incredible assessment skills and you will really know all about pathophysiology of all sorts.

I started as a new grad in the MICU in one of the largest and best teaching hospitals in the country - YIKES. It was intense. There is never enough time in the day. But after a year or so, after I had been on my own for about 6 months, I started getting organized. And contrary to what Doris said, just because a nurse is surfing the net or socializing DOES NOT mean his or her work isn't done. Surely I was a workhorse when work needed to be done. But after a year in the ICU - if the patient was semi-stable enough - I could have them settled/stable, all meds given on time, baths done, rooms clean, dressings changed, note done, labs analyzed/electrolytes buffed/blood given if needed/CXR looked at etc etc. and still have time to take decent breaks. That is the key to not getting burnt out. NO ONE at any job works to the bone the entire time. You have to give yourself breathing space, but it takes a long time to get used to ways to organize yourself in the MICU. And some days, some patients - NO one will be organized - we all have those days.

One tip I can tell a new grad - and someone else already said this i am sure. But make lists of what you need to do and order priorities (it will take time but eventually you'll know) and just get stuff done. Don't put off what can be done at that minute. It's hard - these patients are complicated.

The dying part is par for the course. I think the mortality rate in my MICU is 50% or higher - it's expected for the vast majority. However, other ICU specialties have much lower mortality rates and you may eventually prefer that.

Don't give all to your patient - save some for yourself or else you won't have anything left to give in a couple years.