New Grad, so frustrated

Specialties MICU

Published

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....

New out of LPN school and hired into the ICU and am hearing alot of the RN's saying (not to me but in general) that if you do not have med surg experience then you don't need to be in the ICU. It has made me doubt myself where as before I felt confident. Just wanted to know what some of you guys think????

Specializes in ICU, Hospice.

To IntotheUnit and LovingIt...and all others,

I graduated in Nov 05 and began working in the ICU immediately. Yes, it is one of the hardest things I have ever done (sooo much to learn) and yes I was a perfectionist. I found a quote by Dr Phil that I have posted over my computer at home and on my locker at work. It is "The truth is there is no perfection. What you need to strive for is excellence".

I always try to do the best I can, and most of the time it is enough, but as you have said I made some mistakes too. Like not calling a doctor at night when the pt was anuric. The pt had me in her room every 10 minutes because she had dirrhirea (sp). I gave her 3 complete baths that night and had two other patients. I knew she wasn't putting out much urine, but didn't really notice she was anuric until the day shift nurse came in and almost had a heart attack. The pt was alright long term, but needed dialysis that day.

My best advice is to do the best you can and then leave it at work. Stop beating yourself up...it does get easier and in 6 or 8 months you will look back and realize that the stuff that is hard now has become routine. However, there is always more to learn in the ICU!!!

Specializes in He who hesitates is probably right....

I graduated in June and started in the SICU in July. It was scary at first, but the rest of the crew is great, and my preceptor is the bomb. I have six more weeks of orientation, but I'm handling busy doubles and the occasional sick single by myself. Hang in there, it gets better.:D

Specializes in Critical Care, Cardiothoracics, VADs.

It sounds like work is stressful, but you are not seeing things clearly due to your depression. Get help to deal with your mood first.

I am a perfectionist, and it's an ongoing battle to be as gentle with my own mistakes as I am with others... you have to accept that you don't know anything. I had probably been in ICU 18 months before I felt truly confident in my skills, although I always received great feedback.

Take the opportunity to learn, learn, learn. When you come across things you don't know, ask, ask, ask. ICU nurses know a lot, and generally love to share their knowledge. Best of luck :)

This sounds all too familiar :-)

First of all you have alot going on. I think once you work on your time management skills, things will get better. As for the OCD part, I personally think alot of nurses have OCD, especially Critical Care nurses. You just have to learn to controll it.

Are you going to be working night shift? I think that when you are off orientation, you should work at night. I don't think that it is any easier at night, but you definitly get to do things in your own time, at your own pace.

I think that you are beating yourself up! This happens to everyone just starting out. In one year from now, you will laugh at yourself for stressing over the little things. You can't even imagine right now, but in one year, things will start falling into place.

One thing I can tell about you is you really care. That is the most important part of nursing, just try to relax a bit!

Everyone makes mistakes, and we learn from them. I bet you will never make that "tiny" med mistake again :-)

Good luck new grad!

Specializes in icu.

I too started as a new grad in ICU, but I had a wonderful preceptor. She really took alot of time making sure I understood not only how to do things, but why I was doing them as well. I am now three weeks out from my orientation and am just beginning to get my bearings. I still have a ways to go, but it gets better every day. I am sorry to hear that your preceptor wasn't top-notch. Hopefully this next one will be much better!!!

Best of luck to you - you will be fine!!!!!!!!!!!!!!!!!!!!!!

Specializes in ICU/CCU/ER/CVICU.

Jen, hang in there!! We need people that care.

I've been a RN for 24 years now...and guess what? I still get unnerved from time to time...and kick myself for forgetting something or missing an indication I feel I should have seen. I'm not perfect and never will be but I'm a dang good nurse and my patients prosper because of me..not in spite of me. What frustrates you now will not matter a year from now. What will ALWAYS frustrate you in nursing are those that no longer care (or didn't to start with) and just want a check....and you can't do a thing to change it! That includes all members of the health team.:banghead: Oh, well. I just keep reminding myself that I don't have to live with them....just with myself.

The wolf

Specializes in Critical Care, Med-Surg- Risk Mgmt.

Dear Jen,

I spent 8 years on the medical floor straight out of school just so I could learn to put on the gowns straight, hang the IV meds and get the most rudimentary understanding of practical applied pathophysiology.

THEN I was ready to layer on the added critical care skills. Even then, it took another 5 years before I wouldn't panic when the you know what hit the fan. Another 2 years before I would tell a doctor when he was way off base.

As a new grad out of school you have chosen a really steep learning curve with a much longer frustration time before you feel mastery over what you do. Heck with mastery, it will probably take you 2 years just to feel like you barely know what to do, much less have a real deep understanding of why you should do it.

Be patient, take care of yourself, go easy, be slow, ask a million questions, take time to eat right, exercise, get massages, meditate or pray and look stuff up after it happens so you will understand what you were seeing. You are doing it the hard way, so you will have to be humble and say, "what the heck is this??" to your friends A LOT.

Good luck from my heart to yours.

Jen, I'm not a nurse, but here is a suggestion...check with your doctor to make sure that your medications are not having any short-term memory side-effects, and ask the PHARMACIST if he knows of any drug interactions that may affect short-term memory as well.

You have alot on your plate, and I had manic-depression for years and finally got it under control, so I know how down you feel...it's a sickening feeling and it affects how you feel about yourself on every conceivable level. I actually loved my manic phases becauses I would tackle massive home projects and my house was always spotless, even the baseboards (tee hee). It was never severe, I just wasn't comfortable with the sudden swings.

The reason I'm mentioning the short-term memory thing is I have chronic migraines as well, and require moderate med adjustments (I'm very med sensitive), but sometimes I have noticed that when I became tired, if you asked me to add 2 + 2, I am not sure if I could do it. But when I am fully rested, it's not a problem

New job, wedding, depressive state..yup, that will affect your memory and your RETENTION level. It would anyone.

On your preceptor...don't tell her everything (ie. personal life) , but I would at least tell her about your previous experience with your training so she will know that you may not know as much at this point as you probably should.

I wish you all the luck and congrats on your wedding!

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