Is this normal orientation for ICU??

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I know someone that is having a really hard time in orientation. She has been crYing constantly.

She is new grad to the ICU and was told the 1st day on the unit she needed to speed up. On her 4th day to the unit, her preceptor gave her one hour to assess 2 patients and to complete her charting. (Started shift at 0730, expected to complete ALL charting, head to toe, lines, wounds etc by 0830) This preceptor got upset because she took longer and told her she is too slow for the unit. The preceptor gave her another time limit of 30 minutes to administer medication. She took longer than 30 minutes (she wanted to look up the meds and triple check before giving). She overheard the preceptor talking bad about her at the nursing station. About 30 minutes later she was called into the office and asked how she was doing, she said everything was going well. The manager said that it's ok to tell the truth and that she has been getting complaints about her time management. At that point she broke down and cried for a good hour saying she feels overwhelmed and pressured to be expected to work at the pace of an expert ICU nurse.

The manager thought that it was inappropriate to give a timed deadline to complete tasks and was not aware that it was only her 4th shift on the unit (new manager).

During a staff meeting, a few nurses said that if she can't handle the pressure, this is not the unit for her. They are also upset that she complained rather than talking to her preceptor. Now there are a few nurses that do not speak to her.

I have also another friend on the same unit that was told she needed to speed it up also on the 1st day and was given 2 patients by the 3rd shift of orientation.

Now I don't understand this, aren't most people slow in the beginning? Is this just an expectation in the ICU??? Or could it be just this facility??? Is this a bad thing or a good thing to be rushed??

I personally do not think that it is safe.

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Specializes in School Nursing.

Hopefully they will move this to a more general nursing forum (or ICU) to get more input. I will say giving a brand new ICU nurse 2 patients seems dangerous... when I did my ICU rotation it was 1:1.. maybe this hospital is different?

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Specializes in Trauma Surgical ICU.

It sounds unreasonable to me being this is his/her's first week. Of course a new grad or a nurse new to the ICU will be slow. It's a lot to take in and to chart at first. I didn't put time limits on my orientees until weeks 4-6 but it was for one pt. Weeks 9-10 they are expected to handle both pts using me as back up or a resource. By week 13 they should be independent with both pts.

Our new grads received 13 weeks orientation.

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Specializes in Nephrology, Cardiology, ER, ICU.

Moved to critical care nursing.

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Specializes in PICU, Pediatrics, Trauma.

No...you are correct. Too.much for anyone let alone a new grad.

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Specializes in PICU, Pediatrics, Trauma.
It sounds unreasonable to me being this is his/her's first week. Of course a new grad or a nurse new to the ICU will be slow. It's a lot to take in and to chart at first. I didn't put time limits on my orientees until weeks 4-6 but it was for one pt. Weeks 9-10 they are expected to handle both pts using me as back up or a resource. By week 13 they should be independent with both pts.

Our new grads received 13 weeks orientation.

Agree this is a more usual and more realistic timeline.

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Specializes in ICU, trauma.

I am currently on orientation in the ICU as a new grad. I never had any time limits...Like obviously if im running late my preceptor may remind me that my 9 meds are due etc. But every facility is different.

I would suggest she first have a conversation with her preceptor. She should tell her preceptor she is struggling and ask:

what can be done?

What are some time management skills you use?

Can you show me how you do your assessment so i can better my own?

Is there any faster way to look up her meds? In our Mar we can hover over a med and get a reference manual for that med.

ICU is very intense. It is overwhelming but it truly does take a special type of mentality. Also all that being said, i agree this is unfair and unsafe. Sounds like a very cliquey and gossipy unit. Can she ask for another preceptor?

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Sounds to me like someone should not be precepting anyone at all! It truly sounds like the experienced nurse in this scenario is actively trying to make the new nurse fail. We have a few like this in my ICU. Because their personal belief is "ICU is no place for a new grad", they make absolutely certain no new grad survives orientation. Sad! And inappropriate.

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Specializes in Pediatrics, Emergency, Trauma.

Sounds like they are used to the "sink or swim" mentality.

Do they have a high turnover in that unit?

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Specializes in ER, Trauma, Med-Surg/Tele, LTC.

I'm always a bit skeptical of these "I have a friend..." stories because not only are there two sides to every story, but "friend" stories are generally less informed re-hashings of only one side. I feel like there's still a lot missing from the story.

For example, while new grads often feel like they are being picked on for being slow, they don't know what it's like from the experienced nurses' perspective. OP's friends aren't the first new grads to come through this unit I'm sure. When new grads are evaluated, they're compared to all the other new grads and all the new grads that have come before them. Maybe OP's friends are slow. Or maybe these nurses are just mean. I don't know, I'm not there. Anecdotally speaking though, I've found that more often than not, new grads feel persecuted more often than they actually are being bullied. While I'm not saying lateral violence doesn't occur, the term gets thrown around willy nilly a lot these days...

Second, the new grad was told on the FIRST day she needed to speed up? Was this the first day off didactic? First day on the floor ever without even getting a tour? Even in the worst places I've worked with the worst nurses not much is ever done on the first day other than, "This is where stuff is. This is how stuff works. Follow me and watch how we do it here." How is OP's friend responsible for so much stuff on the FIRST day that she can already be called slow?

I'm not denying that terrible places exist, but there are too many absurdities in this story for me to conclude that this place is one of those terrible places instead of just ill-informed, skewed perspective by the OP.

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Specializes in PICU, Pediatrics, Trauma.
I am currently on orientation in the ICU as a new grad. I never had any time limits...Like obviously if im running late my preceptor may remind me that my 9 meds are due etc. But every facility is different.

I would suggest she first have a conversation with her preceptor. She should tell her preceptor she is struggling and ask:

what can be done?

What are some time management skills you use?

Can you show me how you do your assessment so i can better my own?

Is there any faster way to look up her meds? In our Mar we can hover over a med and get a reference manual for that med.

ICU is very intense. It is overwhelming but it truly does take a special type of mentality. Also all that being said, i agree this is unfair and unsafe. Sounds like a very cliquey and gossipy unit. Can she ask for another preceptor?

Good advice!

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Thanks for the responses. The unit has a VERY high turnover rate, the preceptor has only been on the unit ONE YEAR!!!!! and the ICU was the preceptors 1st job out of nursing school. I went with my friend to the unit and she has been given a new preceptor. The problem is she has not returned to the unit yet because she feels very uncomfortable. Many of the nurses on the unit do feel that if she can't handle the pressure or ppl talking about her it is not for her, she needs to "toughen up". She loves ICU and it's sad that now she really hates the thought of going into work.

The 1st day on the unit she told the manager she was not shown were any supplies were or even the unit set up. She was assigned a patient the 1st day she literally stepped foot on the unit and had to run around to find supplies and ask for help. Turns out this preceptor was not suppose to do that. It also turns out another new nurse is having issues with being too slow, the manager said this issue will need to be discussed with the nurses on the unit, I don't know if that did happen.

Unfortunately, this preceptor is now precepting someone else.

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