1 month new ICU job. I want to run

mookyjoe, BSN, MSN, APRN, NP · Dec 17, 2015

This is probably going to be the worst advice, but I HATE the hospital except for ER myself and while it does get boring, I like having something I know and something that is not go, go, go for 12 hours. It's my own little hospice at times. I have worked enough specialties in my career now to where I know if I was in your shoes that ICU would not be my next specialty to conquer because of the stress. Just not worth it. I would say to management I gave this a go and it's not for me. I am miserable and find that "catching on" here is not something I have within me so what other area would you like me to go onto? I know some hospitals have rules like you have to stay on a unit for 6 months or whatever with no write-ups before you can transfer, but you and only you wake up every day saying, "I gotta go to work." Is this something you can wake up to and feel good about?

I was the queen of running from bad management and positions I knew I didn't have the heart to put my all into. Realizing and verbalizing some are meant for it while I am not keeps everyone happy in their place in life including mine. Consider what you can wake up to everyday because being burnt out emotional or physically is no way to make a living on a daily basis. Best of luck to you and follow your heart. BTW....you won't ever have a problem finding another job doing anything with ER experience!

tamari07 · Dec 17, 2015

I at one point transferred to the Med-Surg ICU and quickly realized it just wasn't for me. I had 4 years of floor experience and decided to try something new. I found out that it just wasn't for me. Our hospital actually had an excellent orientation program for the ICU and treated each new hire/transfer as a new grad. We had classes in conjunction with time spent in the unit with our preceptor. The educator was wonderful and really knew the ins and outs of critical care nursing. With that being said, even with a great preceptor and orientation process I had big anxieties working in the ICU. I had done my senior year practicuum in the same ICU, so I knew what I was getting into. But once I got in, I realized how much I enjoyed my previous unit. I enjoyed talking and interacting with patients and watching them rehab and get better. Obviously in the unit the majority of your patients are intubated or non-verbal and their goal is stablization, not rehab. I spent almost two months in orientation and decided to transfer back to my previous unit. Fortunately the ICU director was understanding. I told her I didn't want to waste anymore of hospital dollars on my orientation when I knew I wasn't happy there and didn't see myself there long-term. It's okay to realize something may not be your jam. I'd much rather transfer back and be happy then stick it out and just be miserable.

I'd do some soul-searching and see if this is somewhere you see yourself working for several more years. Do you think you'd enjoy it more with a different preceptor or orientation program? Do you think this just may not be your preferrerd specialty?

Avenger1 · Dec 17, 2015

I had almost the EXACT same experience when I switched to SICU from the ED. I was CEN and CCRN before ever stepping foot in the ICU. I was not some new nurse. But riight from the beginning I heard all sorts of moaning and snarky comments about the ED, the exact same sink or swim threats and a preceptor who I did not get along with. I was told "there are lots of tough personalities here and you better have thick skin." Please lady, I'm a former infantry Marine with 2 tours in Iraq where I lead 17 Marines into the worst fighting of the war. Get out of my face.

I was EXTREMELY turned off by the arrogant, snotty attitudes displayed just as I had heard they would be. I wanted to leave and go back to the ED but but I remembered why I wanted to go to a Level I SICU... to learn to take care of some of the sickest patients around. So I stuck it out and it did get better, a lot better. Sure there was still lots to learn but that's what I came there for. And there are still some people I can't stand but I started to meet more and more cool people and great nurses. I won't be arrogant and I say I am the best critical care nurse alive but I learned a tremendous amount and still do. The worst offenders learned not to mess with me and I earned my keep amongst everyone else.

Hang in there. It will be worth it in the end.

Itwasjustadream · Dec 17, 2015

I'm sorry to hear about everything that you have been going through. I'm actually a new grad myself and that has been struggling. I been orienting about 3 months now and I've had several different orientors this whole time. Some of them have been encouraging but most of them have been really tough on me. I think once they start seeing you in a negative light just because you may not know everything they know you're label as dumb. I thought it was a problem new grad struggle with when going into a specialty. I been feeling very alone and discouraged but a part of me refuses to give up. RNMeagz, keep your head up, I hope things get better for you.

sjerseymom · Dec 17, 2015

I can sympathize with you. I worked the med/surg, telemetry floors my whole hospital career. I transferred into a cardiac ICU. While this was not the ultimate place I wanted to be, it was what was required if I wanted to pursue CRNA or even work in the PACU. Orientation did not go well. I think my personality was not what the manager was looking for. I think she wanted a type A & that was just not me. Ultimately she got rid of me which I won in arbitration & could have went back. But in the end the ICU was not for me & did not want to work for that 'banshee' again. Depending on your hospital policy, they may make you stay in that position for the 6 months to 1 yr. From my experience I was allowed at other times to transfer back. I am one who never found my "true calling" in specialty. I am now happy working from home for insurance company in case management. Love the schedule no holidays or weekends & working in my PJs if I choose.

Honestly please don't give up on the ICU. Learn all you can. If you find yourself more anxious, unhappy, no getting what you want, go to management & express your concerns. Ask for a different preceptor. The worst that can happen is they say No. If you have a union you can also go that route. If you ultimate goal is for the experience to pursue other opportunities, try to stick with it. Think of your ultimate goal.

Ultimately this is your career & life. Don't let others dictate your life & making you feel miserable. Explore all your options.

TrishaRNSICU · Dec 18, 2015

Great advice. I just accepted a new job as a sicu nurse at a level 2 magnet hospital. I have worked icu at a level 3, crossed-trained, various shifts, not full time. I use a brain, but i have never thought of having a book to write other information down, let alone scheduling turns etc. Any other advice would be completely welcomed!

APRN., DNP, RN, APRN, NP · Dec 18, 2015

I really need to vent and get some feedback as this is driving me crazy. I have been an ER nurse for 3 years. I realized I was getting bored and decided to move to an ICU position. New hospital, level II trauma center, this ICU gets everything from traumas to neuro to cardiac, etc. I felt like this was the perfect learning opportunity.
Well here I am one month in. My preceptor has become annoyed with me. The other day she snapped at me for not knowing the different doctors (some of whom I have never met). I asked her a question about a med rec for a patient who was going to be transferred and she sighed and rolled her eyes in front of my other coworkers and said "we just went over this!" Granted, working in ER I have never had to do a transfer med rec in my life. I confronted her about her annoyance with me and she stated that I'm just not picking things up fast enough and that she is tried of repeating herself all the time. I was shocked because as my preceptor I felt it very appropriate to ask her all the questions I need to understand something. She's made it very clear the whole time that I only get 2 months of training and then "it's sink
or swim".
I don't know if she mentioned this interaction to our charge nurse (also totally her buddy) because he decided the 3 of us should have a meeting today. He said that on the continuum of experienced nurses who are new to ICU I am falling behind and not catching on quick enough. They had a big problem with my charting not getting done fast enough but I was trying to focus on the pts and do the charting later (it's not like my chatting isn't getting done). The charge RN said that he's just really surprised sometimes with the things I don't know. I asked for an example
and the one he gave was checking residuals on a tube feeding. I've never had a pt on tube feelings in the ER!
I am just extremely overwhelmed and anxious to the point that my days off are spent worrying myself sick. I know I should take action and study but it's like I'm paralyzed with anxiety. I want to quit and go back to my ER job but then I will probably just feel like a big failure who couldn't suck it up and hang. I want to cry constantly. Any advice? Thanks for hearing me out.

I would insist upon a second opinion. Get a different preceptor. A good nurse, does not always, a good preceptor make.

RNMeagz · Dec 19, 2015

Thanks for the advice everyone! Gonna try to study more and hold

my head up high.

Greenclip · Dec 21, 2015

Please hang in there. I also had a hard time with my preceptor, a wonderful nurse who was not cut out for mentoring someone. (Now we are friends and she has my back.) I got lots of sighs, lots of eye rolls, and I felt like I was a total failure. I thought seriously of quitting, I lost weight, I was miserable, I didn't sleep...and all of that made me function worse.

Is there anyone else you can go to? Do you have only one charge nurse? Our educator was worthless so I couldn't go to her, even though she was supervising my orientation. Eventually I spoke to a manager. To my surprise she totally went to bat for me. She said she was tired of preceptors expecting their orientees to act like someone with ten years of experience in the ICU! Her words filled me with confidence. By the time I spoke to her, I was almost at the end of my fourteen week orientation. She told me that I would be fine as soon as I was on my own. And...I was.

I try to chart one assessment in the room and have it done by 9 am. It's a goal, but doesn't always happen. I like to get report, then look at labs and read the H&P or the latest MD note. I think I get a better picture by reading notes. Then I assess my patients and pass meds, starting with the sicker one. I try to have all my Is and Os charted on time, every 2 hours, because the doctors look at that during rounds. If there is something unusual in an assessment, I will chart that part at the bedside and finish the majority of it later. If it's busy, then yes, I am going to complete tasks, pass meds, validate vitals and chart I and O...and worry about charting my assessment later.

RN0429 · Dec 22, 2015

Just accepted a SICU position in a level 2 hosp where I currently work, doing med surg at the moment and have level 1 OR experience. Hope I don't have these experiences, reading all this is making me nervous [emoji189][emoji189][emoji189]

wkndnrse · Dec 23, 2015

Bravo to you for taking it on in the first place! Remember that a comfort zone is a great place to be, but nothing ever grows there. When you feel the burn, you are growing. I've had a student percepting with me in Neuro ICU my last few shifts and I sometimes feel like I've been mean when I talk to her. It's the nature of the job that we all do. Sometimes there is no time for flowery words, or any words, just action. Kudos to you my friend. Rough it out. You'll be glad you did. PS, I still Google stuff sometimes :-)

VANurse2010 · Dec 25, 2015

Thanks so much for your quick reply. In our meeting the charge nurse said he's gonna talk to the ICU director and try to get me an extra month of training. But that upper management just sees a big dollar sign on me and wants me on the floor working independently as soon as possible. The goals they thought I should
focus on were things like having meds passed and an assessment charted by 9am. A huge problem is my preceptor is buddies with the charge nurses and director and what not because she's actually a really good nurse (just not a good preceptor from my standpoint) so anything bad she has to say about me will stick with the leaders of the unit. I'm just really lost at what the best thing for me
to do is. Stick it out or go back to where I am comfortable? I don't know if all this anxiety is worth it, not to mention the huge blows I'm feeling to my overall confidence.

Having all meds and charting done on 2 patients by 9 am in the ICU is bull **** says this experienced ICU nurse.