Hi to all~
I'm new to this forum,so please be patient with me!
I recently started in the PICU unit of the hospital that I work at,technically as a "new grad" RN. I had been employed as an LPN for three years on a med/surg floor at the same hospital before this,so I came to this job familiar with the hospital's policies,methods of charting,etc. I have always wanted to be a pediatric nurse,and it is very difficult to find a job in this area if you don't have experience already,at least at my hospital,and its main competitor in the city. So when a PICU job opened up shortly after I received my degree,I applied,interviewed and shadowed on the unit.Even though it was ICU,I felt like the variety of pts and pace would be similar to the floor that I was leaving,so I figured that it would be a good move. I assumed that i would have a lot to learn in the way of pediatric procedures,ICU equipment,etc,but that I was able to meet the challenge. Boy,was I wrong!
I started on the unit a couple of weeks ago,and my first day with my primary preceptor went fairly smooth. She was patient,answered my questions,and even acknowledged that I wouldn't remember everything right away. However,she left for vacation,and I was placed with another preceptor for the next several days during the interim. This preceptor has been there for many years and is very experienced,and apparently well liked on the unit.
I have to admit,the preceptor has been nothing but polite and nice to me. The first day with this person was ok,although i didnt feel as comfortable as i did with my initial preceptor. I told this person that i wanted to get experience with lines,drips,and vents,since these were all new to me. the next day, the preceptor chose a patient that was very complex,had 7 lines and 9 drips running,was on a vent,had two chest tubes, and was post-op from a complicated surgery. I felt overwhelmed,but figured,I had asked for it,so i might as well jump in and start swimming.
Throughout the day,the preceptor would go over some things,but other questions were waved off. I asked specifics on titrating drips(something I'd never done before) and specifics about vents(ditto). The preceptor just said,"you just know what to look for." I came across a mental block when it came to calculating dosages,and maintenance fluids,and asked for help,but the preceptor was having trouble explaining,or I wasn't catching on ,I dont know. I since seeked help with these from the clinical instructor,and feel better about them.
The next few days,I felt like I was improving,but the preceptor kind of took a backseat and watched me go through the shift completing tasks,from flowsheets to hanging IV meds to speaking with doctors/family members. I'd ask questions,but the preceptor seemed to be getting impatient with me.I'd be in the middle of one task,and the preceptor would jump in and suggest doing something for our other patient.I felt like I wasnt moving fast enough,or that it wasn't prioritizing right,or SOMETHING. I havent received much feedback from this person,other than "you're doing a lot." I asked if I was on track with other orients,and was told,"it's hard to compare-the experiences are different."
Yesterday was the worst-all was going well until we had a procedure at bedside for one of the patients. The preceptor sent me for a medication,and I glanced at the MAR before I got it all,and was certain that I had the right dose. I drew it up,and the doctor stopped me,saying that it looked incorrect. Sure enough,it was. My preceptor gave me a scolding look,and I corrected the mistake,but the rest of the day I kept missing things I had done a thousand times before on my other unit.At report time,again my preceptor sat back and the oncoming nurse kept quizzing me about the exact concentrations of meds and what the vent settings were. I was so flustered,i couldnt recall the exact doses correctly,and the vent settings i had to admit I didnt know because I hadnt gone over them yet-when I asked,the preceptor told me before that I would be learning that when I oriented with respiratory. However,at report,the preceptor gave me another look. Afterwards,the preceptor asked me why I had made the medication error and told me that it was a day for me to learn.
I left work in tears,and confided in my friends who work in other units. They keep reassuring me,saying it takes time,and that Im putting too much pressure on myself. One friend told me to find resources to learn about drips,meds,and other ICU info and teach myself. This is what prompted me to look on the Internet,and I found this site.
So,my questions are these-Do I still have a chance at this unit or am I really in over my head? If not,where do I find books or info to help me learn about pediatric ICU nursing? Neither my LPN nor RN program covered this level,and my textbooks dont even review med calculations,let alone nipride drips.
I've wanted this for so long,I dont want to give up now,but I dont know what to do at this point. I hate coming home and crying every night.
Sorry for the length,but if anyone has any advice,I'd greatly appreciate it.
~Overwhelmed RN
