New beginning...transitioning from adult critical care to NICU

[Nursegraves]

Whew..... This is a long short story. :) I have been in nursing for approx 16 years. I began my career as a nursing assistant, went on for an LPN and ten years later received my RN. I have worked in a variety of nursing positions, most recently in the adult ICU. I worked in the PICU for almost two years and I really enjoyed the job, I felt that at last, I had finally found my career, not just another job.....

Then....our daughter passed after a tragic automobile accident. I attempted to continuing working in the PICU, but every time I would get to work, I would relive her final hours, watching the monitors, the vent, trying to sort something out of the chaos. I eventually realized I just wasn't ready to go back to work. I was cheating myself out of the grieving process, I was cheating my coworkers out of reliable nurse, and my patients, well let's just say experience on both sides of the bed, are good, even fantastic, if you are in control of your emotions....otherwise...it can be heartbreaking for everyone. PICU is hard enough, when your heart isn't broken.

Anyway, I left nursing and stayed at home with my children for the past two years. I tried to go back to work last summer in a very small (6) bed adult ICU. The daytime staff was fabulous, the night nurses didn't acceppt me b/c I lacked adult ICU core, and I had emotional baggage, and I was the youngest nurse on staff. They didn't feel like I had enough knowledge to work in their unit. (RN's eat their young)

So, we tried moving me to days, to do a "RN Internship." It became my responsibility to coordinate my training. Alas....a PICU nurse...trying to become and adult ICU nurse... ha, ha.

I did very well on the day shift assignment, much to my surprise. I really liked my co-workers and I felt like I was coming along well. I had a lot of support from the day staff and I was also seeing our in house counselor to help me work on my grief issues and regain my self confidence. This was a condition of my internship.

My unit manager talked to me about considering taking the full time days position vs the night position. The day nurses involved were all in agreement. (I thought the position was mine....) I had took a two week vacation ( during the middle of my internship, dumb I know) to go home for a family reunion. I hadn't been home in 15 years.

Anyway, when I returned the manager had hired an additional nurse, whom the staff weren't receiving well, either. She and I were to work together to put in place an intern program for new nurses hiring into our department. Our manager gave the daytime position to the new nurse, explaining to me that she came from an adult ICU position, and had more experience, and he really wanted me to become a member of the night crew as we previously agreed.

I agreed with very verbal reservations. I knew in my heart of hearts, that they wouldn't accept me, and I felt like I was being thrown to the wolves. I was scared to death. My mananger assured me, it would be fine, and he would talk to the other nurses and we would all be on the same page what was expected of us.

Then.....the unthinkable happened......my brother in law developed sudden liver failure (40 years old) and was in the hospital with a biliruben of 60. They treated him for two weeks, and couldn't get his levels to come down, he was not a candidate for a transplant, and all they could offer was some experimental drugs...we hoped for the best..

He was admitted to the hospital in the middle of the night, and my husband and I left immediatley, I called the house supervisor, explained my situation, and called the unit. I let everyone know our brother was in the hospital and not expected to make it through the night.

Now when we got to the hospital, I didn't call work for two days, and when our brother passed, I called my boss to let him know what the funeral arrangements would be, and that I would be able to resume my scheduled shifts on the coming Monday.

He was very short with me on the phone. He said he had no recollection of my notifying him my brother was even sick. He then told me not to worry about it, and to call him when I got back.

OF course I did, and he told me to come in to work as scheduled. When I got there, I knew something was "up" by the way the nurses were acting. But our manager never said anything, told me he would have me come over to the office a little later so we could talk. In the meantime, the night nurses stayed over, so we (day) nurses could completer our fire drill training. After the fire drill, when we got back to the unit, my boss called me into his office....and yes...you guessed it.....asked me to resign.

He explained to me, that although he felt like I had made leaps and bounds in my orientation, I just want' ready to be on my own, and he needed somebody who he could depend on, and he didn't want this to hurt me emotinally, he really thought I had acheived a lot in the short time I was working there, but he felt there unit was too small to nurture me, and it would be best if I resigned.

Of course, I was devastated. I told him I was hurt, and I felt like he damaged me by making me come to work, assuming everything was okay, and with everybody in the unit knowing what was coming except me, was not right. He apologized, and basically wished me the best of luck.

That was almost six months ago. It has taken me this long to get over that, to move on, and accept that it was "for the best."

I have recently applied at our local hospital for a position in the NICU. The interview went very well, and I felt at ease. I was worried that the four month position in the adult ICU would hurt me, and this manager is very supporting and has graciously welcomed me to her team. I am currently waiting for my background check to be completed, so I can get my physical, and begin orientation.

To mention, I am scared to death....would be an understatement. I loved the PICU, but these little peanuts scare me too......plus, now I am doing something I haven't done before, charting new territory, and with my past emotional state and job insecurity...I am hoping to find someone who can mentor me along.

I don't want to be someone who sits on the sidelines watching what happens. I feel like God gave me a talent, and I didn't go to school, not to use it. I feel like I am ready to put my best foot forward and begin living again.

I just so happen to be scared to death!!!

Any comments, suggestions, would be appreciated. I really would like to find a NICU mentor, if there is anybody out there, please let me know.

Thanks

Nursegraves

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[Tiny1Nisolet]

First of all, let me say I am sorry for your loss and difficulties. I would also like to welcome you to the WONDERFUL world of NICU. I am a senior nursing student who will graduate in May. I am currently in the NICU doing my precepting. I have a great preceptor. I am sure you will find someone who will help you along. There are great teachers and mentors out there, not all nurses eat their young. Thank goodness.:)

You came to the right place. This forum is a great support network. I have found valuable insight and direction from the posters here. I value their input and try to soak up as much information as I can. There are many old posts that you can learn from. I still go back and read and try to learn from the other nurses here.

One thing you may want to do is purchase the Merenstein and Gardner book, "Handbook of Neonatal Intensive Care" I have found this to be very helpful.

Anyway, I wish you the best in your new career. Take care of yourself!

Tiny

[Mags4711, RN]

First, I am very sorry for the tragic losses in your life, it sounds like you have done all of the right things you needed to in order to move on such as counseling and attempting to trust and work with a manger to be successful in the new position (adult ICU). I am also sorry that that ICU manager was so unsupportive. But from personal experience, they are out there...

I wish you the best of luck in NICU, it is scary for a lot of folks, especially coming from adult ICU. Just remember there is usually a protocol for everything, follow it and you'll be okay. NICU is usually a unit where there is little turnover. For whatever reason nurses stay in it for 30 and 40 years. They are a wonderful group but the transition into the group is usually NOT easy. It takes an average of two years to start being really accepted in *our* unit. Is that right? NO, it is not. And I felt very ostracized by the older staff who were supposed to be my mentors and my rocks on which to lean. But after about 18 months it started getting better. They didn't even realize they were doing it. So I am sure there will be many responses after mine denouncing what I say. That's fine, I am sure my experience isn't the same everywhere, but in talking to our travelers, it is pretty much the norm that they have noticed.

Things do get better in time and once you transition in successfully, the NICU is the MOST wonderful family I have EVER worked with. They take care of each other and support each other to the ends of the earth.

I think you will like it, it becomes a very nurturing environment. My biggest suggestion is to go in quietly, don't try to make too many suggestions for change, and learn learn learn.

Good Luck and welcome to a wonderful new world in nursing.

We must be passionate about it, look at the number of posts in NICU versus all the other ICU groups here.