New Grad, so frustrated

Specialties MICU

Published

Specializes in ICU, now in Palliative Care Home Health.

Hello everyone...

I just joined the site for the second time--I had been a member while in school, and lurked all over for the past few years, but now that I'm starting my work I feel a need to talk with people.

I started working in a general ICU (we get just about everything: med, surg, minor trauma, neuro, etc) in the beginning of June, and now, 2.5 months into it, I'm desperate for some positive affirmations.

See, here's the thing: I love my job. I knew I wanted to work in ICU since almost the beginning of school, and I was hired into it 6 months before school finished, and they have a lot of confidence in me. But it's not what I expected it to be. For the first two months, I had a preceptor who was...not the greatest. Constantly leaving for meetings, telling me that she'd teach me more advanced things (like why I was doing this or that thing, rather than just how to do it) later, making me feel like I was just filling a space, and leaving me alone for long periods of time. I was sharing her with another new grad, a situation that was absolutely horrible: if his patient crashed, I had no support and no one to go to (along with the fact that they spent an awful lot of time "just chatting" when I could have used her help).

Now, I've got a new preceptor, and I'm the only person working with her, and it's a much better situation. But I still feel so in over my head. I cry just about every other day there. I can't stop beating myself up over minor mistakes--forgetting to unclamp a piggyback med, or getting behind on charting, things like that. I made my first med error the other day--a tiny, minor little thing that had absolutely no effect on the patient, and I cannot stop bashing my head in about it. I can't stop holding myself to these perfectionist, self critical standards, and it's really hurting me.

I know that in time, this will get better. But I don't know how long it will take, and that's part of what bothers me. I could handle this a lot better if someone would say to me, "By the end of your 6 month orientation, you will feel so much more comfortable and competant, and these horrible feeling will go away." But right now, I'm just about to the point where I'm considering quitting my job, I feel like a failure, and I can't stop crying anytime anyone asks me how work is going.

Another problem is that I'm sick: I have chronic daily migraines that I use several medications for, and I leave work everyday with my head throbbing. I also have severe mental disorders: bipolar type 2, currently in a major depressive state, and my psychiatrist told me yesterday that she thinks I have symptoms of OCD. So I'm also in the middle of a medication switch. My fiance and I are moving in two weeks, we're planning an overseas wedding, my sleep is completely out of whack, and...aaaah!

So, when does it get better? What can I do to help it get better? I try to talk to my coworkers, and they help me out a lot, but I wind up crying all of the time. I carry an herbal remedy with my in my pocket and use it as needed(Rescue Remedy, and whether it's the placebo effect or not, it works for me). I work on eating and sleeping enough. I just need some encouragement that yes, this will get better....

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Specializes in Med onc, med, surg, now in ICU!.
Hello everyone...

I just need some encouragement that yes, this will get better....

First off, are you ex-Jen, SN?

Secondly, I haven't graduated yet but I know what it's like to hold yourself to the highest standards. I think it's harder if you have always been a good student/high achiever, because you expect so much from yourself.

It has to get better. In six months, things that worry you now won't worry you. There will still be tons of things you don't know, and that's great - the day you know everything, get out and go home. There are thousands of people who do this, and there is no reason why you can't be one of them. You already have one coping strategy, and you have a preceptor who works well with you now. That is one thing that's already better than when you started.

If the ICU has confidence in you, there is a reason. They don't expect you to be perfect this early on, you're still learning even though you have graduated.

Why don't you think about things that have improved since you started? For example, when I started I didn't know how to.... and now I can .... or, When I started I made this mistake, and I have learned from it and never done it again. I bet that in a year's time, when I'm here begging for support because it all seems too much, you'll be telling me "When I first started, I was overwhelmed, but now, it's great!"

SO hang in there, you know what your capabilities are but you seem to have forgotten that you're human and you're new at this! You will be fine.

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Specializes in ICU, now in Palliative Care Home Health.

Bethem--

Yes, Jen, SN was my old blog. Now writing at http://intotheunit.com , but having some writers block.

Thanks for the encouragement. You're still in school? Heading for ICU?

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IntotheUnit (or Jen):

YES, it will get better, you WILL internalize everything you see and do, and be confident in 6 months in situations you now percieve as terrifying.

But you will ALWAYS carry the knowledge that there is always more to know. That is nursing.

If you have fears around the unknown, then nursing is not your field, because you will be required to act confidently at times when you DON'T have a clue.

You have to be able to comfort an asthmatic who needs intubation, and assure him that "It will be okay", even though you know this will be a difficult intubation.

If your panic cannot be bridled, then you need to think about alternatives.

But I'M betting you won't. I'm QUITE sure you will do just fine.

I'm proud you are a nurse.

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Specializes in Med onc, med, surg, now in ICU!.
Bethem--

Yes, Jen, SN was my old blog. Now writing at http://intotheunit.com , but having some writers block.

Thanks for the encouragement. You're still in school? Heading for ICU?

Yep, I certainly hope so. I am on placement in an ICU at the moment and I just love it, I don't want to leave!

Oh, this is weird, it feels like I've found a celebrity or something! I read your old blog and I have been checking the new one too, but I guess you haven't really been in a writing mood - no wonder you have writer's block!

I know from your old blog that you really are a good student, and you were quite confident and competent as a tech and as an undergrad. I am sure that soon you'll hit your stride, and you'll be rocking the ICU like you did your old job!

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Specializes in Telemetry/Med Surg.

I'm a new grad too working in a telemetry unit. I know the importance of a good preceptor as well. I've been very lucky in that regard with the exception of working for two days with one who should not be allowed to precept. it will take awhile to get up to snuff, probably longer than 6 months so don't beat yourself up for it. and certainly you have a lot on your plate with your move and upcoming wedding so give yourself some breathing space. I'm sure you will do just fine. Best wishes.

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Specializes in ICU, Education.

I'm kind of shoked they have 1 preceptor precepting 2 new grads at the same time. That is not optimal and is kind of crazy. However, I AM impressed with the idea of a 6 month orientation! We don't do that. I think they give new grads 3 months. Yes it will get better. They say it takes at least a year to get comfortable in ICU, and you will still have a lot to learn then as well. You will NEVER know all there is to know. We never do, and those who think they know everything, are kidding themselves. Alot of us nurses are perfectionists and a little OCD traits can be found in many of us. I think it's great that you're concerned about the job you do adn how well you do it. There are many out there who just don't care, and seem to think they know everything. I'd much rather have a nurse like yourself than a nurse like that! Hang in there! None of us were born ICU nurses.

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Specializes in ICU, CVICU.
Bethem--

Yes, Jen, SN was my old blog. Now writing at http://intotheunit.com , but having some writers block.

Thanks for the encouragement. You're still in school? Heading for ICU?

Hey Jen,

I don't have any words for you but I have frequented both your blogs on occasion. I'm sorry to hear that things are not going well for you.

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Specializes in Nephrology, Cardiology, ER, ICU.

Just wanted you to know that it does get easier. Jen - please realize (and cut yourself some slack) you have alot of stuff going on. Being a new grad is enough for anyone, let alone adding in bipolar, getting married, etc. Please let your psychiatrist know what is going on so that he can best help you handle the additional stress. Good luck.

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Specializes in Cardiac.

Jen, I could have written your post. I too beat myself up over stupid little mistakes. Getting behind in charting is very stressful, and especially in the morning when every doctor has got their hands on your chart!

You're still new! Your not expected to know it all, in fact, they expect that you will make mistakes. That's why you are with a preceptor that long. I have been working for a little over 2 months as well...I think we are on the same page. However, I had my destination wedding BEFORE I started work LOL! I think the stress of that is really making things worse, in addition to your preceptor issues. You have so many other issues that are stressful, and they are all coming together at work.

Know that it will get better at work with experience. Look back on your past-was there anything that was so hard to do, but you got through it? How about nursing school, it was once hard, but you survived, passed, and here you are, working in an ICU! (and getting married, moving, having migraines, switching meds, having bad preceptors...)

Have faith in yourself, and learn from each mistake. I forgot to hang propofol with vented tubing on my first week of work; I'll never forget to do that again! And I bet you wont forget your tiny med error either. We are all learning this awesome and amazingly difficult job.

Be gentle with yourself...:icon_hug:

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Specializes in Step-down and Critical Care.

I can completely understand your frustration. I have been a nurse for only little over three years and I have done ICU two of those years...critical care is a challenge and it will not always be easy..that is why some nurses do not like ICU. I learn new things every day and will continue to learn for the rest of my career. No one nurses knows all the answers..you just need to quit beating yourself up because it will take a good year before you feel comfortable with the ICU..you just need to prioritize your tasks and if you need to make cheat sheets to help organize your time so you do not forget things. Trust me it will get better just ask all the questions you can while you are in orientation and then scope out the nurses on the shift that you work that you can go to when orientation is over for support. Just hang in there you have alot going on in your personal life along with the frustration of starting a new job..it will work out in the end.;)

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Specializes in ICU, Research, Corrections.

Hi Jen,

I also am a new grad working in the ICU, (Dec 05 grad). My orientation was for 6 months - but pretty much sucked. My preceptor was out for months with a back injury and when she was there I had a communication problem with her. I had a different preceptor every day - but perhaps that was a good thing.

What worked for me was being very friendly and as helpful as I could be to the other nurses. The key is teamwork - I can ask any nurse I work with any question I want and they are more than delighted to answer all of my questions or provide assistance to me. I know "they got my back", and that does wonders for your confidence.

Do not despair. As others have said you WILL make mistakes during orientation - the key is to remember your mistakes and don't repeat them. Do not agonize over each mistake. Be smart enough to ask questions if you aren't sure of what you are doing and something is over your head.

Best of luck to you.

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