New grad here, just finished first week of icu orientation, and having doubts about myself...

[BabyRN246, BSN, RN]

Hello! So my story is: I got my license a month ago and I got accepted into an ICU a couple weeks ago as a new grad in a small community hospital (that is still a few steps behind in their technology and the nurses in my unit (as well as the tele monitors) are all at most 3 years away from retiring).

The nurses are a little judgey that the management has hired a couple new grads into the icu and they don't seem to be too happy about training (a few still do their best to do it anyways), a couple have told me in passing "how long is your training?...oh 3 months??...oh you're lucky, when I came on to the icu floor they didn't give me that training, I had to figure it out". Sometimes I take it the wrong way but regardless I always put on a smile and do my best to be helpful and nice to even the snarkiest nurses just to win their approval and be part of the team.

My issue: The hospital doesn't have a formal new grad program/system. I feel like the past 3 days I have been doing orientation was just like being in clinicals. The ICU is small (only 8 beds) and they don't have terribly ill pt's usually, so I go around helping nurses turn pt's and explore where everything is, explore their EMR, or do my competencies on the computer, ask to participate in EKG's and other procedures that may happen on or off the floor, and ask questions. At times I don't feel like I am learning much because I am trying to keep up with what the nurse is doing as they quickly explain things to me and move on to do their charting and notes (they don't have scanners so they have paper MARs, so this is something to get used to and learn too since all my clinical sites used scanners and more technology) and they don't use nurse brains/report sheets so I feel kind of slow and dumb when I try to use one I made (in order by systems, meds to give and to do list). I feel unorganized and all over the place with some of the nurses because I am not sure as to what I am supposed to be doing in my role (other than observe/take notes/lend a hand/participate in care to the best of my ability), I feel like I'm not doing enough. It feels like clinicals all over again with a tiny bit more autonomy (e.g. my professor isn't hovering over me as I pass a med). Sometimes I feel like half the stuff just gets blocked out because I feel like it's so much information to retain all at once! Or I make dumb mistake I wouldn't have even made in nursing school but I over think so much and I haven't had practice in months since finishing school and studying for NCLEX I forgot! Sometimes I feel like I learned nothing in school and that I am starting out fresh all over again and that I am going to disappoint my manager at the end of orientation.

I plan on taking a critical care class soon (out of my pocket) and I need to renew ACLS I took during school. I go home and research articles on ICU nursing and essentials to know. I tell myself to take it a day at a time but I dont want my training days to suddenly be over and still be insecure. This hospital is small, majority of staff is tight knit, and they are short in almost all the units so there is great opportunity to cross train and float to ER, OR, Tele, Med Surg, Psych etc. Which I thought would be great for my experience if I decide I want to go to a bigger hospital in the future.

What are your tips to surviving and succeeding in the ICU as a new grad fresh out of school?

Is this normal style of training for small hospitals with no formal new grad programs?

What can I do for/ask of my orientation to improve my training (I have about 7/8 weeks left)?

I really want to be a good nurse and a competent nurse! I'm not scared to work and take courses outside of work to fill in the gaps in knowledge.

[Cowboyardee]

Its not clear from your post - do you have a preceptor? It would be pretty worisome not to have at least that much.

Anyway, if you have a preceptor, bring your concerns to her and develop a plan to get you where you need to be in 8 weeks. Feeling overwhelmed at this point is normal and you can get past it with training and a good plan.

If you don't have a preceptor and they expect you to go from new grad to independent ICU nurse in 3 months just by wandering around and doing errands for whoever is there, you need to have a very serious talk with whoever hired you and get your resume back into circulation.