New Grad on SICU and unsure if I'm the right fit :(

[NewNervousNurse]

Hi everyone!

I had the honor of being placed on the CCU/SICU unit of my hospital for a externship this past summer, and stayed on as a tech until graduation in Dec. I'm taking the NCLEX this Friday, and am a mix of emotions. I started my new job already, and am wondering if my high level of stress is making me want to run for the hills.

I was fortunate enough to receive 3 job offers following graduation, but this was my first offer, and being a new graduate, jumped on the opportunity with no second thought. I'm really hoping that I don't regret that.

During my externship, I was paired with an amazing, young nurse who built my confidence in nursing skills and assessment. I focused mainly on tasks, with a goal in mind to become more comfortable in the role. I dealt with vents, chest tubes, lines, wires, pacemakers, you name it (brand new open hearts). I eagerly learned from her, but didn't overwhelm myself with everything there is to know about a heart patient (I didn't even think a job offer was a possibilty).

So here is my issue: I'm brand new and freaking out. Sure I have experience for the floor, knowing where things are at, some of the nurses, and who the main doctors are. I am familiar with items I've seen, but obviously don't know all there is to know. They are giving me 6 weeks, yes, 18 days of training. Then I'm on my own with the hopes that I can continue to annoy the nurses with multiple questions. I am also in a casual position, with the promise that upon completion of orientation, I will obtain full time, night shift status (this has changed a few times). Nights, are so difficult for me, I'm exhausted. The nurses on nights are waaaaay different thatn those on days; with only a couple who are accepting and willing to teach me (this is the shift I'm training on). Nurses are leaving this floor left and right, and are constantly complaining about work and low staffing ratios. As a student, I always thought that people complain just to complain, but it's actually becoming very scary. Communication isn't the greatest, and I feel like an unwanted crumb on the bottom of their shoes.

I decided to focus my attention on the NCLEX this week. I have told my preceptor what I want to learn, and occasionally get a few things here and there. I plan to talk with the manger about some of these issues, but don't even know where to start. I made myself a list of exactly what I feel I need to work on and go over, but am not too confident of how receptive the nurses will be. (due to what I have felt and received thus far, including the eye rolling). I'm worried that the environment is not safe, and patient care/safety will be compromised. I don't want to lose my license, that I hope to be getting in a few days. What does everyone think? I'm sure I'll hear stick it out, but I'm really afraid to. I plan to at least hang in there until I have the license in hand. Advice?

[NewNervousNurse]

Anyone? Maybe even words of encouragement or what you would do?

[tswim]

hey there N>

Sorry to hear about your situation.... My advice is that you stay in your position at least through your orientation.

In the mean time, you should talk to your manager about whether extending the orientation period might be possible as most good ICU orientations are 3-4 months. If 6 weeks is typical for that unit, so many people are leaving, and they wont officially offer you a full-time position, then that ICU is probably not the best place begin your career. On the other hand, if they're giving you only 6 weeks because you had a preceptorship there previously, then bringing your concerns to the manager should help you get a lengthier orientation.

At the very least, you should make sure you'll have a 'buddy' after orientation. Get to know who the strong nurses are on nights, and if there's one who's especially helpful, let your manager know that you would like to be paired with him/her for the first few weeks post orientation.

Also, if you aren't already taking time to study critical care concepts when you're not at work, you definitely should. Look through the "Critical Care" forums here for suggestions about which books and websites to use as resources.

If you read through these forums much, you'll know that most new grads have a rough time adjusting their first year; being in ICU with poor resources only compounds these frustrations.

Best

[NewNervousNurse]

Thank you so much for taking the time to respond to me. I'm pleased to say that I passed my boards, and at least have that weight off my shoulders.

Unfortunately, 6 weeks is at the long end for orientation, it seems like. A travel nurse, newly hired was given a half day of orientation. Another Neuro ICU nurse, newly hired, told me she was given 2 weeks. The nurses with experience on other floors of the hospital were given about 3 weeks. I feel a bit short-changed as a new graduate, even with being familiar with the floor. I was actually very suprised when I heard this amount of orientation was normal. Many units in other hospitals are given the 3-4 months, as you said. I don't feel very prepared, and only have a few weeks left; but I do plan to speak with the manager still. Especially since they are hiring many experienced nurses, full time.

I have two binders I took the time to make last month, FULL of CCU notes and information. I'm back to reviewing these bits and pieces of the "life of.." but feel overwhelmed. I wish I listened to some of the nurses when I was told that ICU is a hard start for a new graduate, I just didn't realize how hard (and some were from OB, so I wasn't so sure they knew).

I really love your idea of finding a buddy! I know one whom I've found to be very receptive and helpful. I will ask for shifting with him come March. (it seems as if the new hires are thrown into random shifts to fill the needs) I'm just unsure what I will do when he isn't around, because not many are open to teaching me when I ask for help or suggestions. They just don't care.

Thank you again! I have a four night shift in a row this week, and plan to bring lots of materials and to ask many questions, and see how things go. I hope they improve, if not, I feel I may have to move on for the sake of the patients, and myself. I don't want to come home crying, and dread going to work. Plus, I feel my heart is pulling me elsewhere now; I'm just worried it won't be any better. I hate that some forget what is was like being new.