should i just quit?

Nurses General Nursing

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i'm a new nurse and dread going to work... everytime i'm walking from the parking lot to the unit feels like a death sentence. i don't know when this feeling is going to go away... everyone in the unit seems nice, but everything just seems so unfamiliar and my BSN is completely worthless at this point. i've actually worked as a tech before in a different unit that was bearable and would like to beg for that job again in a heartbeat. i know i should give it time... just don't be so hard on myself...but i feel so incompetent. and the more i'm exposed to this profession... the more i hate it... charting, passing out drugs, carrying out orders, demanding families, being a maid... oh how i just hope that it will get better. but the aforementioned job description is not what i intend on being for most of my work life...i am so lost and i don't know what to do. i feel like i wasted a lot of time, money and effort just to do something that i don't think i want to do. i feel such a failure.

Specializes in Med surg, Critical Care, LTC.

Sweetie: ICU is a tough place to get your feet wet. Usually, there are a lot of strong personalities, not to mention high acuity patients.

I would suggest you transfer to a med surg unit and learn your profession there. School gives you the basics, but you learn at your first job. I would never hire anyone without at least 2 years med surg in ICU.

You have to have become confident in yourself and your skills and assessments and prioritizing - before even thinking of ICU. That my opinion. What is a WBC? What does it indicate? If you had a 78 y/o patient with a WBC count of 3.8, temp 96.8, tachycardic, low BP 78/40 hx of CHF, Pneumonia, GERD recent c/o of "hurts when I pee" What would you think with this information. What would you do whilst waiting for a doctor to get back to you. Play dective - put 1+1 together to equil 2. Pt is currently rousable, pale, clammy, tired. Card 1 Bun and Creat elevated, otherwise WNL. This is what you learn to do before you go to ICU.

This patient is most likely uroseptic, dehydrated. Needs Blood cultures, hydration, antibiotics, I&O's, etc...

That's my 2 cents. I wish you luck, and peace AND confidence

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Specializes in Pediatric Psychiatry, Home Health VNA.
Sweetie: ICU is a tough place to get your feet wet. Usually, there are a lot of strong personalities, not to mention high acuity patients.

I would suggest you transfer to a med surg unit and learn your profession there. School gives you the basics, but you learn at your first job. I would never hire anyone without at least 2 years med surg in ICU.

You have to have become confident in yourself and your skills and assessments and prioritizing - before even thinking of ICU. That my opinion. What is a WBC? What does it indicate? If you had a 78 y/o patient with a WBC count of 3.8, temp 96.8, tachycardic, low BP 78/40 hx of CHF, Pneumonia, GERD recent c/o of "hurts when I pee" What would you think with this information. What would you do whilst waiting for a doctor to get back to you. Play dective - put 1+1 together to equil 2. Pt is currently rousable, pale, clammy, tired. Card 1 Bun and Creat elevated, otherwise WNL. This is what you learn to do before you go to ICU.

This patient is most likely uroseptic, dehydrated. Needs Blood cultures, hydration, antibiotics, I&O's, etc...

That's my 2 cents. I wish you luck, and peace AND confidence

Sorry to hijack OP, but Babs I started trying to figure out what could be wrong with the patient before seeing that you already wrote the answer, and it makes me feel good to know that my answer matched yours! ICU nursing is such a rush!

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I know exactly how you feel. I came off orientation maybe 3 weeks ago, work on a med/surg floor that is CRAZY most of the time (short staffed, slammed w/ admissions) and work the 11p-7a shift which has limited resources.

I feel like I am going to the exectioner most nights. Instead of getting easier in any respect--it is getting harder. The past 3 nights I worked were a nightmare! Last night was really bad--I had a really complicated pt. plus 6 others who were ATC wanting pain meds and one admission that took me forever to get settled. It all depends on the person before you too. I got AWEFUL reports on all my patients and had to figure it all out as I went along. (We record our reports, and the previous nurse was long gone by the time I listened!)

I wish I had some advice for you, but I am in the same boat. I also try to take it day by day. I am not ashamed to be a pain in the butt and ask for help or ask questions. Last night I actually wanted to just LEAVE! Abandon ship! Of course I could/would never do that, but I wanted to! I was sighing loudly all night!

Anyways--I pray that it gets easier. I see that some new grads get this nursing profession better than others. There are new nurses 20 years younger than me who are more confident and not as spazzy as me.

I think it has to do with how our coping mechanisms are and our confidence level.

Good luck....stick w/ it for a while because I feel that it is the same no matter what field of nursing you are in--if you are the type of personality that frets a lot like I do--you need to stay and harden up, that is what I am planning to do.

lulu

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Specializes in Cardiac Telemetry, ED.

Moving from student to professional nurse is a very difficult transition. I think we've all felt incompetent and completely unworthy during that phase.

Once you get your feet on the ground and feel more in control, you will be able to claim your nursing practice. What I mean by that is, once you have a good grasp of all the protocols, policies and procedures, etcetera, you can bring your own self into your practice instead of being someone who is just trying to make it through a shift without killing anyone.

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Thank you Nancy, that was a great reply. It is that thought exactly that keeps me going. Just get through the shift w/out killing someone is where I am at right now. I feel bad that when it is really crazy--I am not really doing full assessments because i don't have the time management down. I make sure i do a focused assessment, but then I am running to the room during online charting to check out a stage 2 pu I wasn't told about in report!!!!

Am I bad for not fully asssessing a pt when things are hectic and I am aware of vitals? How do exp. nurses do their assessments of the whole pt. when time is of the essence and you just do not have time?

I am really interested in an answer to this one because last night I was basically a med passer and it sucked. But I knew by seeing the pt. listening to lung and bs, basic--etc. that they were OK and I had to move on! do not feel comfortable finding out later that a patient has an AV fistula when I did not get it in report. I feel like I shoud have had the pt. head to toe naked!

Help me w/ this!

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to all--thanks so much for all the words of wisdom... i really appreciate it. i mean, it's really making me hang in there and really look at things objectively at this point. so, thank you very very much...right now, i'm thinking of riding it out until my contract expires which is in a yr... as for icu nursing, so far i don't think it's for me, but i'm going to stick to it. i really like learning all the equipment, the drips,etc., but i really miss interacting with my patients. i miss assisting them to walk around the nurses' station, the teaching aspect of nursing i really miss... these things are rare opportunities in the icu setting because the patient population are mostly on bedrest and noncommunicative.

with all that said, do u guys think i should stay in the icu for a yr and learn as much as i can or go ahead and ask for a transfer right now which will be another trial run situation???

hope u guys respond... ur opinions really matter.

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Specializes in Cardiac Telemetry, ED.
How do exp. nurses do their assessments of the whole pt. when time is of the essence and you just do not have time?

When I was first starting out, I received some words of wisdom from an experienced nurse. She told me that I should be able to bank on my assessments. So, I make time.

When things are busy at the start of my shift, I may have to start the shift with a focused assessment, but during the course of the shift, as I go in and out, passing meds, doing treatments, I work in the rest until a head to toe has been done. Maybe not in one fell swoop, maybe it's been piecemeal, but it's done.

I always listen to heart and lungs first thing, and check IVs for s/s of infiltration. I can look at edema, check for pressure ulcers, etc., during the course of the shift. For instance, when the patient is sitting up for dinner, I can pop in and take a look at their feet. When they get up to go to the bathroom, I can peek at their bottom. When I need to give insulin or tinzaparin, I can look at their abdomen. Neuro status is easy to assess simply by walking in and talking to them. Half the time, they don't even realize that I am assessing them.

The ideal is, of course, to do a full head to toe at the beginning of the shift, and when there is time, this is what I do. But on those days where the poop is hitting the fan, I do my focused assessment and pick up the rest along the way.

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Specializes in Cardiac Telemetry, ED.
i really miss interacting with my patients. i miss assisting them to walk around the nurses' station, the teaching aspect of nursing i really miss... these things are rare opportunities in the icu setting because the patient population are mostly on bedrest and noncommunicative.

with all that said, do u guys think i should stay in the icu for a yr and learn as much as i can or go ahead and ask for a transfer right now which will be another trial run situation???

hope u guys respond... ur opinions really matter.

I bet you get a lot of opportunity to interact with their family members and do some teaching there, no? Remember too, that even if they are unresponsive, a lot of the time they can still hear you.

As far as sticking with it or transferring, my biggest question to you would be, how much support do you get from your coworkers and NM? Do you feel like you are in a supportive learning environment? Is the morale on your unit reasonably positive? If so, I'd stay rather than transfer and risk getting onto a unit with poor support and/or crappy morale.

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Specializes in Med surg, Critical Care, LTC.

I would transfer, IMO, to an area of lesser acuity. An area like med surg where you could walk your patients (or at least some of them) around the nurses station, do teaching and have more interaction.

Like another poster stated, always do head to toes, but they can be done throughout the shift. Talking to them about breakfast and how they are feeling can give you whether they are A&O x3, listen to their lungs, ask about pain. Check their edema a little later and PP, check their abdomen and BS while helping them bathe, and check their bottom while helping them get up to the bathroom. That was very good advice, and more to the point, closer the the reality of prioritizing and making the most of your time.

Whatever you choose to do, good luck and keep us posted.

:heartbeat Babs

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Specializes in district nurse, ccu, geriatric.
i'm a new nurse and dread going to work......i am so lost and i don't know what to do. i feel like i wasted a lot of time, money and effort just to do something that i don't think i want to do. i feel such a failure.

I was in exactly the same situation as you 11 years ago, I was going to leave my job and become a teacher, but I am still here and although I still say once a month I am going to leave and become a teacher, it is more as a light hearted vent for me, because no one believes me anymore:chuckle

Please, please give ICU a chance, this was my first job in an acute setting and yes it was horrifying, even the staff said I started at the worst time, it was bedlam. I was taken under many wings in the first year, and gained the experience in ICU that has turned me into the nurse I am today, confident and proud. My time in ICU was the worst and best years of my life.

Just give yourself some time to let these feelings pass and get yourself a few wings to hide under for a little while till you find your feet.

Good luck

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Specializes in ER.

After 6 years of nursing I tried ICU and failed miserably. I can't visualize a new grad being successful, even though I know some are.

That said, I had the same feelings as the OP as a new grad in a pediatric unit. If you struggle through it DOES get better. It might get better faster on another unit, or you may prefer to stay with the supports you've got on your unit. I seriously think that if I was to start all over again I wouldn't make it, and I don't envy you. Stay strong and know you are not alone.

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