new grad having trouble w/ icu personalities

extraordinary067 · Apr 4, 2007

why not just work in the CCU you loved so much? what you are currently experiencing in your L&D rotation is something i am familiar w also. rotations in nursing school were tough bc you were treated like a burden by many staff nurses...i can see how a grp of nursing students could add to the already stress of being a nurse, not that its justifiable but it is difficult to be around and learn and not take it personally. also, as you can see nurses like this are not only in icu. my advice is not to avoid a specialty area like icu bc of the common generalization of icu nurses bc you can find difficult staff anywhere. i am sure there are icu's where staff work well together and are great (like the ccu you were in). i interviewed in a few icu's and was told by staff flat out "we will eat you alive" if you come here. and that i should get 3-5yrs tele experience before i even consider working in an icu. i turned down those job offers and took one w a unit that that said they liked new grads bc it kept them on thier toes and really added to the unit in a positive way. i have been on the unit for a few mths now and have not avoided the "mean" nurses. these types of people are in every area of nursing and every profession. they will always be there but so will the "great" ones.

greenbean · Apr 4, 2007

Sigh. I don't use this site as much as I should, but when I looked today and caught site of your thread, I had to reply. Where I work, second to understaffing/being overtaxed with work, the hardest part are some of the nurses. Fortunately most of the ones on my unit are okay and I'm so absolutely grateful to a few of them. Still, others, especially ones that float over from another unit which has a reputation, are just plain mean. I wanted to throw a chart at the one I was giving report to last weekend. She was responding like I was an idiot and giving a look that matched. It hurts, especially if you believe that you're in it all together. For me, it's a challenge to my self respect. I do the best job that I can and I work at reminding myself just how good I was at something that night. You will never change those mean nurses and mean nurses are something that is out of one's control. Why they are like that is another subject, but still won't change them. All I can do is take pride in my own work and give it over to my higher power. I've been a nurse for little over 1&1/2 years, and though I've learned a lot medically, probably the biggest challenge and most growth has been from dealing with difficult people. It's been painful, but I do feel stronger, maybe even some wisdom. Hang in there and know that you are far from alone.

sacrdhazel · Apr 4, 2007

why not just work in the CCU you loved so much?

I thought about it, but I wanted to see all of my options. I absolutely LOVE cardiac and it would be my number one choice. But I got an offer to apply to a critical care fellowship once I graduate which would mean CCU/ICU/HSU and so on and so forth. So I wanted to see the whole picture before stepping foot in to that fellowship because I heard it was super intense and taught you alot. My personality is the type that works under high stress but I also like to depend, well, not DEPEND, but like to WORK as a team. And when I feel animosity, it is hard for me to work as a team. And I find it AMAZING that in a setting such as critical care where you NEED to be a team, that such competitiveness and animosity goes on. The CCU I worked in, the nurses have all been together for 12+ years so they all knew each others pros and cons and thats what made them flow well. And they were more than happy to bring in new blood because they were starting to get worn out. And the fellowship is through that health system, so that would be good. But its a hike for me to get out there... which is why I took the externship closer to home.

I dont know.. I just want to take as much as I can from this externship this summer. And I am hoping that because they KNOW I am just a temp for the summer, they know I am there just to learn and that I am an added hand. But I also dont want to be the nurses aide either. I guess I'm just over excited. I meet with my nurse manager tomorrow, so I will know more then and I guess I will feel the "vibe" of the unit after that.

bjr3645 · Apr 12, 2007

That was such a fabulous answer to that post!! I want MICU when I graduate, but it can be so daunting..... Thanks for breaking it down..very intelligent!

phiposurde · Apr 13, 2007

I am a new grad icu
rn
in training and am finding the most challenging part to be interacting with the nurses on my unit. Granted some are nice, friendly, and helpful, but the majority of them are unfriendly, condescending, and outright mean to us. I have heard of nurses eating their young but this is ridiculous. It makes me dread going into work everyday. I have been nothing but friendly and professional and am getting glowing reviews at my evals. I am wondering if anybody else has gone through this and if these nurses are being so nasty bc i am new and on orientation. I hope this passes. I really do like all other aspects of ICU nursing.

%%% It's not because you are new. After 9 years I still have trouble with some of those personality. Some of the experience

RN

in the ER, are nervous to call report sometime cause they know what's waiting them! I did few seminar and dealing with difficult personality. I would like to share with you in hope it help you. The 2 most prominent personality in the critical care are what they call: " the sherman tank" and "the know-it-all". Most litterature on the subject use the same terminology so if you want more info i'm sure you could find it. But here the "recipe" to deal with them:

The sherman tank:

-give them time to run down -don't worry about beeing polite; get your point across any way you can-get their attention by calling them by name, sitting down, or standing up deliberately or abruptly-if possible, get them to sit down and discuss the problem with you-maintain eye contact-state your own opinions and thoughts forcefully and whitout apology -don't argue with what thw other person says-don't try to cut him or her down -be ready to be friendly and receptive to negotiation

The know-it-all:

-be prepared. do your homework,review all pertinent material,have all information you need available-listen carefully and paraphrase the main points of contention-don't resort to dogmatic statements or overgeneralizations-be tentative in any diasagreements, use questions to raise any problems-watch out for your know-it-all responses-askexploratory questions to examine any plans for problem resolution-as a last resort, choose to give in, in order to avoid protracted conflict or static and to build a working relationship for futur encounters( basicly choose your battle).

Hope it help!!! And remember that confidence not so much to have it then fake it!:monkeydance:

Guest193822 · Apr 16, 2007

I am a new grad icu rn in training and am finding the most challenging part to be interacting with the nurses on my unit. Granted some are nice, friendly, and helpful, but the majority of them are unfriendly, condescending, and outright mean to us. I have heard of nurses eating their young but this is ridiculous. It makes me dread going into work everyday. I have been nothing but friendly and professional and am getting glowing reviews at my evals. I am wondering if anybody else has gone through this and if these nurses are being so nasty bc i am new and on orientation. I hope this passes. I really do like all other aspects of ICU nursing.

I would say starting in ICU is difficult, but a good experience just as long as U are aware of your surroundings (certain personalities & situations) & your knowledge of your lack of experience & the willing to learn.

I would say that ICU nurses who are "seasoned" can be a little over protective of their pt's & situations because of the experience they've had. This is wear personality comes to play. We deal with different personalities every day with the multiplidisciple team, we all come from different paths & cultures in life. Personality we all have to deal with them. We like it or not. But I've come to a conclusion.

Don't take it personal, pt is priority, protect your license, learn from those willing to teach & those who don't, but stick up for yourself, be strong & you'll survive the crazy world of ICU. I've been doing for a while & I always learn something from someone even if they don't want to teach. Awareness is the key.

After the struggle of training & finally finding my comfort zone, I was in learning mode. I couldn't care what pts I was caring for. I was soaking it in, when finally I became the charge nurse; I became preceptor & mentor to others. Its all just takes time, patience & the wiliness to go on.

extraordinary067 · Apr 20, 2007

well, its been a little over 1 month since my initial post. it has felt like an eternity. i really feel like i am at my wits end with some of these people. there are some other newbies too that i found out are having similar problems as me and have reported it to management. i was called in also and asked how my experience has been thus far. i had to be honest. it is a very poor, non collaborative work environment. there are nurses who completely ingore you when you have a question and that bad mouth you behind your back, call you stupid, etc. i am very fortunate to not have a temper, bc if i did i would be fired by now. most of the nurses are great but there are a few that make everyone elses day difficut (even some of the seasoned nurses). my preceptor who is amazing and has been an icu nurse for 23 yrs even told management something needs to be done bc they are going to continue to loose good people including herself.

over the past few wks i have really thought if somewhre else would be a better fit for me. i really hate that i want to leave. i told myself i would give it at least a year but i just don't know. my thing is is that i finished the critical care cirriculum and am about 3/4 the way through my preceptorship. i feel like if i look for work elsewhere it will look bad that i am wanting to leave my current job after only 3mths. also, what would i say was my reason for leaving...that wouldn't make me look bad.

cardsRN · Apr 20, 2007

if you really feel that you must leave, you can always use the old "it just wasn't a good fit" or say that you realized that you are not ready for critical care (if the new job is a floor) or that you needed time off for personal reasons or that you found a new job closer to home (if you commute). there are many ways to sugarcoat to avoid burning bridges.

myself, i am going to stick it out. at 8 months in, one of the nurses who was a problem to me is now civil (or what in her reality passes for civil) and the few others who were a problem- we ignore each other. so it may get better for you. maybe when your orientation is over you can switch shifts to avoid people. night weekends works for me and the shift diff is nice too...

medorr · Apr 26, 2007

You know it is really unfortunate that on top of everything else you/we need to concentrate and focus on in our profession, that we need to also put our valuable and limited energy into other folks with personal problems!!!. This really drives me nuts. Arn't we here for the common goal of caring and maintaing these patients.

I really feel your frustration of having to deal with nasty people that arn't accountable for BAD and UNACCEPTABLE behaviors..

Personally I have very little tolerance and patience for it. I generally will give a person the benefit of the doubt and will chalk bad behavior off but only for a limited time. When I feel I have given them enough leway then I will confront the behavior or stick up for my self and let them know in a non-threatening and matter of fact way that I am not their little whatever.

I know this sounds harsh and it doesn't really come out as crude as it sounds here, but I do get my point across that I will not tolerate disrespect and I don't wait for a year to do it. That is waaaay too much stress on you in an environment that already has enough stress..

YOU ARE A NURSE just like them and you are as worthy as they are. Every single nurse started off a NEWGRAD-including the mean ones and the know-it-alls.

I do believe it's good to have some med-surg exp before specializing but the world is changing. I know nurses that went right into specializing and they are fine nurses. It depends on the person and the environment.

And you know there are far far too many positions available to expend your energy in a unit that is not working towards the common goal as you. It is not your responsibility to fix a dysfunctional unit and you are not obligated to get sucked into a bad situation that nobody is addressing.

Also during orientation it usually is a time for both the employee and the employer to determine if it is a good fit. If is not, then so be it and don't feel bad about it. If you do leave don't write it off as some shortcomming of yours and say you could't cut it in the "unit", that is not fair to you. Just be honest. Hope it works out for you with out too much pain and suffering-life is tooo short. Good Luck

ICU_floater · Apr 26, 2007

being new, I think you're unprepared for the dynamics of personalities in any unit, let alone and ICU, so you didn't give enough background to your unit.

Are new grads hired regularly? Is there a critical care program to teach you this transition? What is the mix of new and old nurses?

That info speaks volumes for units. Mine is a turn over unit to anesthesia school, we have an extensive critical care school that trains new grads,12 weeks of didactic and clinical... so they come out fairly comfortable and confident... needing situational and policy questions answered... as well as some help with time management if a patient becomes challenging... We start off , off orientation with the two easiest... while in critical care school with a preceptor they take the sickest.... It's to build confidence, time management and skills.

If your unit is "throw you to the sharks".... you'll get nothing but... she can't swim". This is a loose-loose for everyone. If your 1/2 way inbetween, then you must work your orifice off to gain respect.

suggestions- don't ask what you can find. "what color tube does a bmp go in" daily. (call lab, check the reference book), Utilize staff to say... hey listen to these lungs, I think he needs lasix.... Anything you can find, and the finding gets quicker with practice do it! Ask how to find the info... not for the quick answer. If you have down time... your short cutting. No new grad ever sits for months... it's exhausting, strenuous and makes you want to cry and quit..... NORMAL for one year to `18 months.

Want to know how to organize? Find the smoker on the floor and emulate their organization.... it takes great organization to leave the unit 4 times a shift to smoke.

ON a good day and you really HAVE down time, after meds, charting, turning, oral care... don't dare sit... find any nurse in a room, go in and just help... NEVER sit. By being a team player, you've now gained a bath buddy, now talk about your patient and questions over the bath and ask about the other nurses patient while you bathe them.

3 nurses in a room, prioritize, can you stop what your doing for 15 minutes and go in there? DO IT, something is going down, watch, learn, ask "I want to help, what can I do?", be careful initially not to fall too far behind with your own patients.

for gods sake, if you're over 30 minutes behind and nurses are sitting, ASK for help, while a nurse is helping, ASK for time management suggestions. EVERYONE prioritizes different, you've so much to learn by asking EVERY nurse on their shift how they organize it,,,,, emergencies barred.

Study your ACLS at home, in the car, wherever and know the BIBLE until you can spew it out per vatim, learn the defibrillatior, pacing, shocking and become an expert with it... last practice the code sheet, in a code, grab the clip board, stop hidding and start charting.... you'll learn ACLS faster.... 1-3 minutes for each drug... YOU call out when time is up and the next one is due. You just ran a code with out realizing it.

so in summary..... don't focus on the personalities, only how you can improve your practice independently as well as with help to be a functional and independent ICU nurse..... THIS is what the difference is between those that can acclimate and those that can't. If I have to hand feed you, baby sit you, be expected to give you quick and easy answers in an non emergent situation... tell YOU, YOUR patient looks bad.... then we've issues. IN ICU, YOU have the responsibility to read at home, read at work, get involved and be a capable independent provider...... In a Years time.

If your working at this, the staff will have your back. If not, RUN, run now.

KMBrooks · Apr 28, 2007

I agree with ICU_floater, there are some great tips in her post.

I am a new grad and have gone through many experiences where I felt I was treated horribly by the floor nurses, however, the hospital I ended up taking a job at was one who had a fabulous new grad program, was a teaching hospital and I had met enough people on their TCU/ICU floor to feel like I would be treated well. Oh and the floor manager was extremely nice...you can figure that out real quick if they interview you. How did I manage that? Network, network, network...and go to every job fair and hospital meet and greet you can...the nurse recruiter/manager/whoever does hiring usually has no problem letting you take a tour of the floor if you schedule it in advance and let them know you are interested in possible employment.

Have a good sense of humor, if they know they aren't 'getting to you' then why bother trying. If someone criticizes me, I hear them out and end with a smile and a thank you (even if I think what they are saying is total BS) and a lot of the time I don't have to say anything more than that. If you do then respond with something totally unexpected, most people expect you to defend yourself so they can fire another remark at you and just make you feel that much worse. :roll

Another trick, kill them with kindness. I know who on the floor has an attitude towards me because I'm a new grad and they think "I have no business being in TCU/ICU" and I always make a point to do one nice thing for them each shift, even if it's just a compliment. Don't make it obvious to them, just be casual and think of a way to sneak those nice things in when they're not expecting it. :smiley_ab

Find your own tricks to disarm someone's ill temper towards you in a diplomatic way, there are many that are useful for your coworkers, your patients, and mean people in general =)

Keep smiling (even if you have to MAKE yourself smile) and laugh from time to time, believe it or not I get comments from experienced nurses and even patients who are surprised I look so happy all the time.

Atleast you can end your shift knowing you did one thing right! :lol2:

Some inspirational books: Josefowitz's "Paths to Power" and the always good read: "From Novice to Expert" by Pat Benner. Another book I've just started reading is, "Clinical Wisdom and Interventions in Critical Care" by Pat Benner which is also pretty good.

RNKay31 · May 10, 2007

I am having the same experience too, also there is one of the nurse on my unit who stater 2 months ahead of me and she gives me the chills, she think she is all that