New grad, do not feel challenged at all. Help?

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Hello all,

I have been a nurse for almost nine months now and work in the NICU. This was my absolute dream job, and I worked so hard to land it. While I was on orientation I felt challenged as I was learning SO many new things. I have been off orientation for a while now and have have been stuck with feeder grower patients for over a month. My unit favors nurses with many many years experience and assigns them the sicker kids, daily. They are never given an intermediate assignment.

I am talking more about the nurses who have less than 2 years experience getting mostly the stable ICU cases and some intermediate patients. We are supposed to be mixed around the unit, with at least 30% ICU exposure. I have also (politely) asked my charge nurse to assign me anything ICU because I need the exposure. Usually I am given an excuse, and the next day I am back with the feeder growers. :( Managment likes me, and there has never been an issue with the care I have provided my patients. I don't understand. I am just about at my wits end with this matter. I did not go to school to be a daycare provider who rarely uses her brain. I understand that an intermediate case can shift quickly, but I need consistant exposure to vents, bcpap, umbilical lines etc to remain competent. :( Ugh!

Advice?

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Hello all,

I have been a nurse for almost nine months now and work in the NICU. This was my absolute dream job, and I worked so hard to land it. While I was on orientation I felt challenged as I was learning SO many new things. I have been off orientation for a while now and have have been stuck with feeder grower patients for over a month. My unit favors nurses with many many years experience and assigns them the sicker kids, daily. They are never given an intermediate assignment.

I am talking more about the nurses who have less than 2 years experience getting mostly the stable ICU cases and some intermediate patients. We are supposed to be mixed around the unit, with at least 30% ICU exposure. I have also (politely) asked my charge nurse to assign me anything ICU because I need the exposure. Usually I am given an excuse, and the next day I am back with the feeder growers. :( Managment likes me, and there has never been an issue with the care I have provided my patients. I don't understand. I am just about at my wits end with this matter. I did not go to school to be a daycare provider who rarely uses her brain. I understand that an intermediate case can shift quickly, but I need consistant exposure to vents, bcpap, umbilical lines etc to remain competent. :( Ugh!

Advice?

They probably care less about what you "need" and more about the safety of the patients. While you patiently wait for your day to come, learn all you can where you're at right now. At nine months in, I doubt you know it all ...even when it comes to the most stable babies.

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Specializes in Thoracic Cardiovasc ICU Med-Surg.

This is also known as 'paying your dues'. In my cardiac surgery ICU, you don't get a VA ECMO patient fresh off orientation, sorry. You start with stable doubles, move on to sickish patients and then once you've proved that you have the chops to handle it, congratulations, you've graduated to cluster **** admission complete with balloon pumps, dissected coronary arteries and exsanguinations.

Don't be in such a hurry, kiddo--you'll get to that point and you'll be grateful you had the time building your skills with the feeder growers.

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They probably care less about what you "need" and more about the safety of the patients. While you patiently wait for your day to come, learn all you can where you're at right now. At nine months in, I doubt you know it all ...even when it comes to the most stable babies.

Sour,

Not sure how you think insulting my capability as nurse is constructive.

I provide excellent patient care, and know exactly what a healthy patient looks like. I have over ten years experience in healthcare, and have four children. I also have a deeper understanding/appreciation on the NICU, something in which few nurses can say they have. Each of my kids were in the NICU, and one of them was a golden hour. So please, save that anti-new grad bulling attitude for a prepubescent new nurse.

Furthermore, it is a new rule that each nurse needs at least 30% exposure to ICU assignments for a couple reasons. The first being that a stable intermediate case has the potential to shift to an ICU case quickly. Secondly, the unit has had days when those "experienced, always in ICU nurses" were not working. Nurses who were only placed in intermediate assignments felt out of sorts in their ICU assignments and complained. How is that what is best for the unit?

Take your bad attitude and anti-progressive nature someplace else Ms. Grump.

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I work in the ER and it is quite the opposite. While in orientation if there is an EMS code coming in bet your ass you're going to be right there on the front line. Stoke that needs TPA and the neurologist on call is a pain in the ass, that's your patient. Hypotensive sepsis with a lactic acid that you have never seen before or a dialysis patient that needs bipap with a potassium of 9--- again you will be pulled in there. New nurses are trained there so that they can handle the ICUs.

I think you're right, it's about exposure. What happens when that veteran nurse of 19 years needs to take a month off for surgery. Would they rather have new nurses that are trained to handle critical patients, and how to find the info they need or would they rather have nurses that are going to crash and burn because they don't know what to do? I am a new nurse, I've worked for less than a year and if a critical patient comes in my crew knows I can handle it and I know how to get others involved if I need help. So why should they not trust their ICU nurse?

I would let my manger know, and frequently why I think that I should have more critical patients. If they object I might think about what other ICUs in the area need some help :)

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Specializes in ICU.

I provide excellent patient care, and know exactly what a healthy patient looks like. I have over ten years experience in healthcare, and have four children. I also have a deeper understanding/appreciation on the NICU, something in which few nurses can say they have. Each of my kids were in the NICU, and one of them was a golden hour. So please, save that anti-new grad bulling attitude for a prepubescent new nurse.

Hooooo boy. :no: I sincerely hope this isn't your attitude in the unit.

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Specializes in Critical care.
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Sour,

Not sure how you think insulting my capability as nurse is constructive.

I provide excellent patient care, and know exactly what a healthy patient looks like. I have over ten years experience in healthcare, and have four children. I also have a deeper understanding/appreciation on the NICU, something in which few nurses can say they have. Each of my kids were in the NICU, and one of them was a golden hour. So please, save that anti-new grad bulling attitude for a prepubescent new nurse.

Furthermore, it is a new rule that each nurse needs at least 30% exposure to ICU assignments for a couple reasons. The first being that a stable intermediate case has the potential to shift to an ICU case quickly. Secondly, the unit has had days when those "experienced, always in ICU nurses" were not working. Nurses who were only placed in intermediate assignments felt out of sorts in their ICU assignments and complained. How is that what is best for the unit?

Take your bad attitude and anti-progressive nature someplace else Ms. Grump.

Your dream job happens to be in a specialty that's know (in my experience) for being the most protective of it's patients as far as acute care goes. I read Sour's post as a call to acknowledge the primary motivators of your unit's leadership vs a personal attack. You'll have to gauge this next bit for yourself, but coming from a long-time ICU charge nurse (me) one thing that often gives me pause in making assignments is dangerous overconfidence. Is this the vibe that you're leadership gets from your novice peers? Perhaps your charges are all anti-progressives, too?

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Specializes in Neuro, Telemetry.

Your non-nursing experience does nothing for you as a new grad to your management. Your attitude sounds terrible and you sound incredibly overconfident. I'm sure the care you have provided in the last year is fine. Sour was not insulting your nursing care. Simply stating a fact that there is no possible way for you to know everything in 9 mos.

you ou might be a fantastic nurse. None of us can tell that. But your very confident statements about all this experience you seem to think you have and deserving more complicated patients purely because you think you are so wonderful is probably playing into your assignments.

I do agree that while in a NICU, you do need to be getting more acute patients and some critical ones sometimes to make sure you are learning. But im sure all those experienced nurses on the unit would be wasting their experience and knowledge on a feeder/grower. They out in their dues and you will need to as well. If you are that unhappy with the assignments, find a new job that is willing to just dump critical babies on you and hope they survive.

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Sour,

Not sure how you think insulting my capability as nurse is constructive.

I provide excellent patient care, and know exactly what a healthy patient looks like. I have over ten years experience in healthcare, and have four children. I also have a deeper understanding/appreciation on the NICU, something in which few nurses can say they have. Each of my kids were in the NICU, and one of them was a golden hour. So please, save that anti-new grad bulling attitude for a prepubescent new nurse.

.

Charming.

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Does 4 kids in the NICU give anyone else pause?

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Specializes in PDN; Burn; Phone triage.

Isn't it kinda dangerous to only give the sick kids to the experienced nurses? New(er) nurses aren't going to learn how to take care of really sick patients by taking care of intermediate/stable patients. I am kinda worried that there are so many people in this thread arguing for nurses who have "paid their dues" to get preferential treatment versus patient safety by ensuring that all team members are competent in caring for all patients.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
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Sour,

Not sure how you think insulting my capability as nurse is constructive.

I provide excellent patient care, and know exactly what a healthy patient looks like. I have over ten years experience in healthcare, and have four children. I also have a deeper understanding/appreciation on the NICU, something in which few nurses can say they have. Each of my kids were in the NICU, and one of them was a golden hour. So please, save that anti-new grad bulling attitude for a prepubescent new nurse.

Furthermore, it is a new rule that each nurse needs at least 30% exposure to ICU assignments for a couple reasons. The first being that a stable intermediate case has the potential to shift to an ICU case quickly. Secondly, the unit has had days when those "experienced, always in ICU nurses" were not working. Nurses who were only placed in intermediate assignments felt out of sorts in their ICU assignments and complained. How is that what is best for the unit?

Take your bad attitude and anti-progressive nature someplace else Ms. Grump.

Hope this is not your attitude and behavior in the unit. This post was un-called for. You can agree to disagree, but not insult members for having an opinion on a post YOU decided to make public.

You are going to get people you disagree with. Let it be at that and take the advice you find useful. Simple as that.

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