New ICU Nurse Burnt Out

[NursingAbroad19]

I started in the ICU in May as a new grad. I was so excited because I loved the fast pace of the ICU and how much it challenges me. Six months in, three months on my own, I feel emotionally and physically drained. I dread going to work. I have cried more times than I can count. With the recent surge in our hospital, we are completely understaffed and we normally have 3 patients. I have such a hard time taking care of three very critically ill patients. I run around all night, not drinking or going to the bathroom. Then, when it's time to do handoff the experienced nurses tells me everything I didn't get to. I try my best, but it feels like I am getting the crap beaten out of me. Working nights running around with anxiety for your patients all night is getting to me. I've developed plantar fasciitis and am not taking care of myself. I feel dead inside. I tried to transfer out of the ICU, but my manager said she will not allow a transfer until I have been on my own in the unit for 6 months. 

Please don't respond with, "that's just how nursing is right now" or "welcome to the ICU". These are the same responses I have received from management and charge nurses, and it's simply not helpful even though it may be true.

I am wondering, what unit would be best to transfer to? I think I might like the PACU, but I don't know a ton about it. Basically, I do love the critical thinking involved in the ICU, but I dislike staying with the same 2-3 patients for the whole week. Your first day's assignment decides your week's worth of punishment. I also have a very difficult time with CIWA patients. I've been kicked and punched from withdrawal patients, and I feel that my sweetness has been completely drained from me. I don't want to hate my job. Also, I should say that I have a 2-year commitment with HCA. Any thoughts on units that would be a better fit to transfer to once my 6 months are over?

[DavidFR, BSN, MSN, RN]

I think ICU is a mistake for a new grad. As is anything too specialised.

Back in the day your first job was always something within  the realms of general medicine or general surgery to get the feel of a multi-bedded general floor. THEN go and do something more specialised when you've perfected your basic skills.

I may be old fashioned and long in the tooth but I think ICU is not the place for a new grad, ever, even if that's where you want to end up eventually. Go off and do some med/surg, then re-evaluate after a year or so. If you're dreading work and crying, it doesn't take much to work out that you need to take action.

Good luck, I wish you well.

[BeatsPerMinute, BSN, RN]

Look up policies surrounding eligibility to transfer to ensure that you have all the information you need and that you understand everything ... consider having an honest conversation with your manager. Talk about how much you want to stay with the company, however, you do not feel like ICU is a good fit for you at this time. 

I have been a nurse for approx 7 years, with the majority of it being in critical care or in the intra-procedural world. I decided to give PACU a go and I HATED it. I hated every minute of it. I was bad at it. IDK what it was - I just couldnt get the flow of it.

I had a talk with my manager and she helped me internally transfer to a different department. Consider calling EAP services too. They may be able to help guide you thro the emotional side of things and also through the practical stuff: like what steps need to be taken so that you are in a position more suited for you. Ask to shadow different departments to get a better idea. Drill in that you really want to stay with the company and find a good fit for both you and the department. 

I was also a new grad in the ICU. I was given a much longer orientation than you. However we did have very SICK SICK patients - we were the end of the line. We received patients other places could not handle. It took at least a year to get "comfortable" (by that I mean competent and also comfortable with discomfort) ... To get there, it required that I be very intentional about my every day (lots of self care, habit building, and studying on my own).