Is it too soon to panic? (Hate my new job)

[NurseLy, BSN, RN]

I transferred from a surgical floor (after 4 years)to a neuro ICU. Two different hospitals but the same health system. I have oriented in the neuro ICU for 6 weeks and I think I have 2 weeks left. I really dislike a lot of things about my new job. 

In no particular order..

 I hate the nursing care on this unit. It doesn’t feel anything like what I expected an ICU to feel like. In 6 weeks there have been only two vented patients, on different drips, who were pretty busy/complex like what I pictured when I envisioned ICU patients. The vast majority are all fairly simple. Neuro assessments done every hour. BP and sodium goals. A LOT of electrolyte replacement and then drawing labs, then more electrolytes, then more labs... We recover patients post cerebral angios, that’s just even more frequent vs and neuro assessments. While I do feel busy, I feel bored  because it feels like the same few tasks on repeat all day every day. So many neuro assessments!

Pretty much every patient goes to CT every day for serial head CTs. We do our own transports by ourselves pushing the patient in the bed down to ct and back. It is so annoying. 

There is very little experienced staff. I have been trained by a nurse with 1 year experience. She is the most senior night shift nurse. Several nights I found I have been a nurse longer than all 5 nurses working, collectively!! And I haven’t been a nurse that long. 

While I have a lot to learn in the ICU realm, I know basic nursing care. These nurses don’t seem phased by basic things I have always been diligent about. ie: capping IV tubing when not in use, scanning medications before giving them, not using the same straight cath a second time if you miss your destination, etc etc. I try to put this in perspective if this is just me not thinking like an ICU nurse so these things are not their priority, but quite honestly we had plenty of time to care and do these things right, it seems the culture is such that the basic nursing care is sloppy… 

No experienced staff also means a lot of staff left in a short amount of time. That’s a bit of a red flag in itself. I asked the staff, they claim it was just bad timing. Some nurses finished school, some left to travel, some went PRN to stay home with kids, etc. 

The high amount of new nurses means the few more experienced nurses are so sick of orienting that I don’t feel like I’m learning as much as I could had they not been so burnt out.. it’s a super unwelcoming feeling every shift.

I swear maybe one other nurse I met is in my stage of life. The other newer nurses are all pretty young. They are still in the bar after work/party every weekend stage. My old floor I had a lot more in common with my coworkers, a lot of good friendships. I miss that. 

No one is designated to watch the tele monitor. On my old floor there was a monitor tech who sat at the desk and would call with any alarms, then I would be able to log in and be the one to decipher if that alarm was a true concern or not. On this floor it is the nurses who watch the monitor because the floor is small. There is no free charge though so it concerns me everyone could be in a room and miss an alarm. Even though I am orienting I saw a situation where the nurse was not alerted to a patient with several vtach alarms because the nurse who saw it determined it was not true vtach. (It was) That situation had me livid just thinking about the risk of having telemetry alarms acknowledged on MY patients but not being informed about it. 

I was hired for day/night but told in the interview it would be just a few nights in a schedule period. I was actually assigned to 50% nights on my schedule I just received. I questioned that and was simply told it’s not set in stone and it is what it is. I’m super dissatisfied with that and the impact it’s has on me and our family routines.

In two months I have not seen my manager or assistant manager in person. I have received info twice by email, and it’s when I emailed first with questions. Neither have checked in on orientation asked how things are going, nothing. We have had no sit down check ins, which was standard the other places I have worked. 

So basically I’m getting ready to start a ton of education. Online modules, in person classes, etc. This is all completed on top of my scheduled 36 hours. I knew about the education and initially I didn’t mind doing it, I actually enjoy learning. I’m hesitant now though to throw so much of my time into a job I hate already. Typically you need to stay 1 year before transfer but I think right now I could transfer back to my old unit as an exception, but if I let them invest more time and money in me I will potentially be stuck for the full year. 

Would it be silly to try to jump ship so soon? I am leaning towards reaching out to my old manager Monday but I don’t want to regret it… I am torn between knowing that if having this one year of ICU experience it can benefit me and my future endeavors and not wanting to spend the year tired and miserable on an unsafe unit.

Has you every felt the writing was on the walls and left a job before even getting off orientation?

[EDNURSE20, BSN]

When I started a new job 1.5 years ago, I instantly regretted it. I told myself to give it time. Nothing changed. I’m still here, I still hate it. I’ve only just started job searching again, because I thought things would get better. Sometimes your first impression is right. 

[JKL33]

3 hours ago, NurseLy said:

Would it be silly to try to jump ship so soon? I am leaning towards reaching out to my old manager Monday but I don’t want to regret it

I would. Of course it all kind of depends on why you switched things up in the first place and what weight those reasons carry in light of the new information you have at your disposal now.

These things happen. If I pretty much had my mind made up I'd go talk to previous manager. Be gracious, kind, professional. "Not a good fit." Etc. I do think that if you are pretty sure about this then it makes sense to do it before money is expended on further training in the area you don't like.

Good luck ~

[LovingLife123]

Not a ton of neuro ICU patients are on a vent.  Unless they have had a very massive stroke that would impede them from protecting their airway, they don’t get a vent.

Neuro ICU is a lot of Post TPA patients, SAH, post thrombectomy, and cranis.  That’s what it is.

What I love about neuro ICU?  These patients can go bad quickly.  Like in the turn of a second.  You are constantly watching for those subtle changes.  A SAH can be completely fine, until it isn’t anymore.  A giant Right MCA infarct is good until they start swelling.  Cerebellar infarcts on one of the ones I worry about the most.  
 

Blood pressure control is extremely important in all these patients.  
 

If you are bored this early in, my guess is you don’t quite know what you are looking for.  And that takes time.  Neuro can be one the most fascinating and frustrating things all rolled into one.

[speedynurse, ADN, BSN, RN, EMT-P]

I actually very much hear what you are saying. In all honesty - if this is the way things are going, they may very well not change. I know I switched from one ER job to another, thinking it would be a good life change. It wasn’t. I was miserable from the first week and miserable less than a year later when I finally transferred out. 
 

However, don’t think this is your one and only chance at ICU. You will get other opportunities. However, if you have concerns now, then sometimes those “red flags” are quite legitimate and won’t change. No harm in transferring back to your old unit if you can.

[NurseLy, BSN, RN]

1 hour ago, LovingLife123 said:

If you are bored this early in, my guess is you don’t quite know what you are looking for.  And that takes time.  Neuro can be one the most fascinating and frustrating things all rolled into one.

Thanks for the insight. I am sure you are right, there is a lot I don’t know and that’s keeping the work feeling very task-y right now. I can certainly understand the importance of the frequent neuro checks and picking up on those subtle changes, it’s just that for me personally, physically doing so many neuro assessments is what is boring. I have learned for my personality I need to be busy doing a variety of tasks to be happiest. 

I do work with some really passionate neuro nurses and that’s great, that really specific skill set is so important to the patients and families serviced. 

[VitaminSea11]

What did you end up doing? I read your post because I am 5 months into my current job and absolutely hate it. I’m trying to transfer. I work in the ICU as well.

[NurseLy, BSN, RN]

I went back to my old job and was welcomed with open arms. I am so glad I did. That job (the people/negative environment and lack of management/organization) made me hate going to work everyday.
 

My advice to anyone who is truly miserable at work is to jump ship. Nursing may be a crap shoot anywhere you go right now but there are better places out there with more supportive coworkers. When you know, you know. Good luck with your transfer.