New grad struggles

NPOaftermidnight, MSN, RN, NP · Oct 11, 2016

I recently started in a sicu at a large teaching hospital and am struggling with time management and prioritization. My anxiety is super high and my confidence has been shot down. I feel like I'm making a ton of mistakes and worry about them outside of work. I don't mesh well with one of my preceptors and she constantly tears my performance apart. I feel like I'm not suited for the icu, but if I move units this experience has made me feel like I won't be able to do well anywhere else.

Have you talked to your manager about this at all? If you aren't meshing well with a particular preceptor, it is perfectly acceptable to let your boss know. This happens pretty frequently where I work and we always do our best to make good matches between preceptors and orientees. It is part of their job to ensure that you have a good orientation that gives you what you need to be successful. They want to see you succeed, so don't be afraid to let them know you're having a tough time.

Also make sure, if you haven't already, to have a talk with your boss and your preceptors about your performance. Most ICUs will not sugar-coat it, if you aren't doing well they will let you know. They should already be doing this. Most importantly - if they tell you that you're doing well, believe them. It's normal (and actually, a good thing) to have some degree of fear and anxiety when you're brand new in the ICU. It's the fearless ones that we worry about!

I don't know you, so I can't give you any really specific advice for your situation, but I will say that what you are describing sounds like the majority of new grads in the ICU at one point or another. I would encourage you to stick with it for a while longer before making any moves out of your unit.

Salter444 · Oct 23, 2016

A good preceptor has the job of teaching, evaluating and preparing you to work more independently. We would always use the ShXt Sandwich. You start with what the orientee does well, then what they need to work on and end on a positive. It is tough walking into a new job/role and too many nurses are just angry bitter people.

If you are working is a large teaching facility you should have an educator for your unit who you should be meeting with along your orientation process. Ask him/her to put you with another preceptor for a bit. I never was one to keep an orientee with just one preceptor - it helps to see how different nurses organize and you can pick and choose what aspects of their routine you would like to adopt for your own.

A billion and a half years ago I was a newbie on a step-down unit and assigned to a nurse who worked in the unit for 30 years. She was nasty, mean and I had to do things exactly as she did or she would throw a tantrum. She would then smile and laugh whenever a physician would come near her only to return to her nasty self when dealing with me. I lasted a week before demanding to be put with another preceptor and things were much better after than. However, I always remembered that nasty lady every time I was asked to precept a new nurse. So, even bad experiences can shape the way you approach your practice.

Good luck!

Pook_girl · Oct 23, 2016

Thanks for both of your comments. I finally came to the conclusion, after being told I wouldn't be getting a new preceptor, that a new unit would be a better fit. In moving to med-surg where I'm sure it will have its own challenges, but where I can continue to learn. I'm not giving up on nursing, just taking a different path. New nurses should be so thankful that there are people like you two in the nursing realm to foster our growth, rather than tear us down. You are right, we can learn both from good and bad situations. I've learned what I need from a preceptor and how to ask for it for my benefit and my patients' benefit. I also know what kind of preceptor I want to be one day.

J3w3lz88 · Feb 8, 2017

I'm going straight from being a new grad to ICU, I hope I don't experience what you went through, that is one of my greatest fears.. Not having the proper support can really tear a person down! I start Orientation on February 20th, but my first day at the hospital on March 3rd.. Wish me luck! Any how I have been on the unit where I'm going to be and have met some nurses from there and let me tell you it can get pretty catty and heated up in that unit, teamwork is not a 100% and they sometimes give each other attitude... I don't know what I was thinking when I got myself in this! :down:

Pook_girl · Feb 9, 2017

Hey there, congrats on graduating and finding a job! I wish you all the best. It didn't work out for me but that doesn't mean it happens to everyone. I know some people who also started out in ICU out of school and are doing well. Just keep your head up, don't be afraid to ask questions, and remember time management and prioritization will come with time. Find the support you need and use your resources. Good luck! Let me know how it goes :)

dt_sicubsnrn · Feb 13, 2017

Don't be so hard on yourself. Youre learning to be a nurse, and doing critical care is very overwhelming. I started as a new grad in ICU but it was very challenging. I felt as if I learned nothing in nursing school and had to start all over. Luckily, I had amazing preceptors who are great with constructive criticism. ICU just isn't the right fit for some people. If you really want it, then work hard, and try again in few years when you're comfortable with nursing. I have been told by many coworkers that going from med/surg to ICU is easier to a certain degree because you have less patients, and you get to know the nitty gritty of what is going on (: