New Grad PICU Nurse Help

[picunurse217]

I started in the PICU last Summer as a new grad. I went through a 6 month orientation on the unit and have been on my own for the last couple months as a nurse. There are days where I feel like I have it all together and I make all the right moves, report critical assessments to the docs and modify the plan of care appropriately with the help of the rest of the PICU team but there are also days where I feel... stupid. Like just dumb mistakes or things I should have known to pick up on.

For example the other night we had an overflow patient from the acute floor who was being discharged home and I forgot to check for the discharge order from the docs. The resident gave me the okay to do the discharge instructions and said she could leave anytime after X time but I just forgot to check it and sent them home. Even though it was okay to discharge them, I should have known to get the order placed.

Or I had a DKA one night and the sugar was coming down very slowly. I mean very slowly. Like 4 hours after admission it had only gone down by 100 points on an insulin gtt. And I checked the IV site and it flushed fine and it looked okay and I had someone else check it and they flushed it and it looked okay and then when I was passing the patient off to the next nurse who was more experienced than me (I only had the pt for 4 hours because I was in for an overtime shift) the nurse thought maybe the IV was bad and the skin looked more taut at this point and it was cold at the site.. I should have kept a better eye on the IV site and checked it more frequently. And as soon as I questioned the integrity of my site, I should have used another site for the infusion.

I was just wondering if anyone else has felt this type of frustration and made mistakes like these or if it's just me, and if anyone has any advice or words of wisdom for someone who is dealing with this frustration. I started with 2 other new grads but we almost never work the same shifts as me and I don't always feel comfortable sharing this with people because I don't want people to see me as incompetent or like I'm not the right fit for the ICU.

[Mickey9700, RN]

Hey,

I started straight out of school into the PICU myself 12 years ago and it was NOT easy. I wish I had 6 months of orientation. Don't beat yourself up, BUT definitely ask your co-workers about anything you're not sure of or anything you even think for a second might be wrong. At least for now. PICU is a scary place and the last thing you need to have is a bad infiltrate on a kid or make a wrong decision especially if you thought of it and didn't ask. There has to be a more senior nurse who can help ya out a bit. I was lucky to have great girls to help me. I worked nights (which you should consider), and I haven't worked there in years, but we are still great friends. On my off days, I'd study a bit more on PICU specifically as opposed to general Peds since they require more special care.

You'll be fine. Any nursing job takes a long while to get the hang of. PICU is an amazing place to be. Keep going, ask if they have extra learning course if you want. Maybe if some of the nurses don't mind, follow them around and learn everything you can from every patient.

Good Luck! ?❤️

[dzapata]

Hi also started as a new grad in the PICU July 2019! I feel the exact same way as you. Also you made a mistake, everyone does. It's all about learning from them!