Inadequacy and stupidity

markm739 · Jan 8, 2007

Are you still on orientation? Do you have any previous nursing experience, or are you starting fresh in the ICU from nursing school?

I started straight out of school in the ICU 18 months ago. I really didn't start to gain any feelings of competency until I got off orientation and didn't have someone breathing down my neck all the time.

I would say it took about 9 months to a year or so to start feeling significantly more confident. A young nurse on my unit who has been there a few years told me it takes a good 2 years to really feel as if you've got it, so be patient.

Remember this also: people often wind up treating you according to how you carry yourself, which often has nothing to do with how much you know or how well you do your job. My preceptor told me to act as if I knew what I was doing, even if I didn't! I have also noticed that the people who carry themselves with a certain amount of poise are treated as more competent by the others.

Watch out about asking questions, also. It is officially encouraged, and should be, but in practice, can create an appearance of dependency to any mean spirited people on the unit. Try to find out the answer yourself without asking whenever possible, and save the question asking for the stuff you absolutely have to do it for.

I am blessed to have a German lady close to retirement in her 60's who has sort of taken me under her wing; I am completely safe with her, am treated with respect by her, and can go to her with anything.....she watches out for me when we are together, I return the favor when possible, and am learning a lot from her years of experience. I hope you can strike up a relationship with someone such as this lady, but pick carefully, as people can be very 2 faced.

Remember that you are trying to learn a bunch of complex stuff all at once, and are often expected to remember things weeks and months after having only been shown one time!

Remember also that you have chosen to invest your life in something that matters, contrary to many young people your age. If you made it through the hell of nursing school, you can make it through this! I personally found orientation harder than nursing school.

Please email me privately if you have any questions or need to vent, as I have just recently been in the spot in which you find yourself, am still alive, and am actually quite happy with where I find myself now!

SouthernLPN2RN, MSN, RN, APRN, NP · Jan 8, 2007

Thank you very much for your advice. I have been an LPN in med/surg type stuff for 4 years, but I think I have it in my head that I'm not good enough to do this. I just started, and have only worked 3 shifts. I know deep down that I'm probably going to be fine, but I hate feeling like this.

My orientation is going to be 12 weeks.

markm739 · Jan 9, 2007

With 4 years of prior experience, you are going in with a leg up on me! I went in completely cold with only school clinical experiences under my belt.

Does your ICU have a series of orientation classes they will put you through? The one disadvantage you may have is being 4 years from school. Did you have a critical care course in your LPN coursework? If not, I can recommend the book I have from school as an excellent one to have.

If you need some comic relief, I can relate a little of my experience starting out in the ICU.

I went back to school in my forties. I gained a great deal of personal satisfaction from having a 4.0 average, graduating summa cum laude, and winning the annual nursing award for the dept. that year. I spent many late hours at the school library to achieve this, and it sort of left me with the sense that I was not a total idiot (ah, the things we assume in life!)

This all changed when I hit the floor! I had a guy for a preceptor who was really hard on me (verified by whispered comments from other nurses who watched us together.) Here is a sample of my typical inner thought pattern on any given day during my orientation:

"This guy is treating me like I am an idiot. Somehow, I know I am not an idiot. But if that is the case, why am I being treated like this? Maybe it's true!!! Maybe I really am too slow and dense to get all this......maybe I am truly not cut out for this, and all I can do in life is take tests and write care plans. Maybe I should just admit defeat, tuck my tail between my legs and quietly make my exit...."

Two things kept me from folding in those early weeks. One was the conviction, somewhere down in the recesses of my soul, that I actually was NOT an idiot; the other was a life changing day when I visited this board, and read these words:

"NEVER let ANYONE treat you as if you were incompetent!"

I can't remember who posted that, but it struck a chord with me; I said to myself, "That guy will NOT treat me like an idiot!" Something rose up in me that day which was a determination to survive, and I can say today that I am now thriving and am quite content on my unit.

Keep posting, and let us know how it is going. We care, and there are a lot of great folks on this board. If you believe in yourself, you will make it!!!

incublissRN, BSN, RN · Jan 9, 2007

I am new to critical care and I just graduated last May. My orientation is 12 weeks. I am finished after this week. I love it because I am learning so much. When I am at work I jot down procedures or diagnoses I need to research more at home so that I will feel more competent when I see it again.

I have issues with my self confidence as well. I'm sure it is more difficult for you because you are very proficient in med/surg. Give yourself some time, you will grow so much over the next 12 weeks!

cardiacRN2006, ADN, RN · Jan 10, 2007

How long does it take to get over the feelings of inadequacy and stupidity when you start in ICU? I am totally hating this lack of confidence I seem to have developed.

It ebbs and flows. Sometimes you will go home feeling good about the choices and decisions that you made, the errors you prevented, and the care you gave. Sometime you will go home and feel totally stupid and like you want to quit nursing all-together (like me, this last week).

I'm told it takes a good 2 years to feel totally comfortable in the ICU.

malamarn06 · Jan 20, 2007

I agree i have the same issues with inadequacy. i was in an icu previously, i was given 3mos orientation (i have stepdown prior experience) once i got off that orientation i felt completely isolated. most of the staff was unbearable. testing me out and no support. the managers told me yes 1-2 years you will feel competent. Then when i reached out. all i recieved was guilt and a finger wagging at me. I finally left. got away for awhile now im back into the ICU(different hospital). self-confidence at a low point. my nerves are peaked. i love being a nurse and want to be there for my patients. i want to be challenged in different areas. i love the icu. i just feel im going to be looked over as someone who is inadequate to preform the work required of me. when all i am doing is working in and out of work to improve myself.

I understand it takes time to feel competent. i am just worried that i won't ever get the opportunity.:chair:

dgudmestad · Jan 23, 2007

Took me a solid year.

slb0523 · Jan 24, 2007

I know how you feel! I was one of only 3 new grads that was hired into my MICU about 3 1/2 years ago. The other two were student nurses in the unit for a year prior to that, so naturally I felt the LEAST competent. It took me a good year to feel comfortable (no butterflies on the way in to work). I also did my first year on the night shift and i would recommend this to all New Grad Rn's working in an ICU. You have time at night to develop basic nursing skill and become proficient with assessments and so forth, let alone the critical care aspect. The day shift in my unit is CRAZY and there are some days that I still struggle to get a 10 minute lunch. I didn't even know if i would make it in the ICU initially, and now I am often the charge nurse, and a core Preceptor in the unit.

Words of advice: You have to look out for your self, be assertive and whatever you do, don't freak out! Remaining calm amid chaos has proven to be INVALUABLE in my practice!

Good luck to you!

SouthernLPN2RN, MSN, RN, APRN, NP · Jan 24, 2007

Thank you all for your suggestions! Now that I've been in there a few weeks, I'm feeling better. I still have totally inadequate feeling days, but it is looking up. I go to nights in February and I'm hoping I'll feel better then.