Hello everyone, I just wanted to get some general feedback and get some opinions on my current issue. I recently graduated from a nursing program in March with my RN license. I was offered a job at a local ICU in a large facility and accepted the position. The original position offered was for a nights, but I would orient on days for a month to see the physician's faces and what not. Anyhow, the other stipulation was that I would have one main preceptor and one backup preceptor. Well, my main preceptor got sick (really sick) and was out for the rest of my dayshift orientation. However, I really didn't have a backup preceptor. Instead, I was passed between 6 other nurses. The problem with that was I never really got the hang of one style of any procedure or route of documentation. I tried to pick up on a little something from everyone, but it was hard. (The last time I even took a class that had more than 2 alternate professors, I had to drop because I wasn't learning anything.) By the end of my dayshift orientation I had not even taken one patient by myself. So, I was already behind when it came to night shift.
When I started nights I had one preceptor. It was much better than days. Slowly, my preceptor started just hanging around the desk and waiting for me to come ask questions. When I would ask questions, I would get a question with a question "well, what do you think is going on?" I put a lot of thought into my questions and tried to figure out the answer before I even asked, but always got the same response. Over the course of the next couple of weeks my preceptor was asked to step up to charge nurse often. Three would be nights at the end of the shift where she would literally tell me I had to evaluate myself because she didn't see me all night. This was becoming an issue for me and management because they said I was not progressing like I needed to be. I agreed with that statement because I felt like I wasn't learning anything from her either. After the first encounter with management, they ended up letting my preceptor take three days of vacation to orient at a different facility for a PRN job. So I ended up switching to a less critical unit for those three days (Where I didn't get any negative feedback from my step-in preceptor). Now I'm in a position where, I am going to either have to transfer units all together, or sign a corrective action plan stating that if I am not able to come off orientation within the next 30 days, then I will be asked to resign. The only problem with transferring units is that there are really no positions within my network of hospitals that are of interest. You go from titrating vasopressors and dealing with vented patients to passing out pain medication before rehab. I am not harping on any rehab nurse because I know they are masters of time management and have a difficult job as well, but I never really had much interest in rehab, and I still don't. I already told management that if I were to try to extend my orientation then I would request a different preceptor. They told me they didn't know if they could do that for me or not because the preceptor pool is so thin.
As of now, I've been off work for a week and supposed to have a sit down meeting with my clinical director, my current preceptor, and my team manager. At this point, if I tell the truth, my preceptor is going to feel like I am throwing her under the bus, and so will my TM because I get criticism from them (which is fine because I'm a new nurse and constructive criticism is how I get better), but I don't get many concrete examples of how to fix the issues they see I have. This is how it feels "Your time management needs work, fix it. cluster care." "You need to think critically." I think that last statement is a bit of a cop out because you need a firm foundation on a particular subject before you can "critically think"
Lastly, my TM's are still using examples of things that affected my nearly a month ago, that have not been an issue since. Example, I had a PICC line that would flush and draw at the beginning and middle of shift. Well, come time for lab draws it won't flush or draw. I try to troubleshoot it by patient positioning etc., but no success. I get an order for cath-flo to see if that would work. No success... So the only alternative would be to stick them. I got the stuff. I gather my stuff and try to stick this person multiple times, but they have poor veins and I couldn't get the stick. I asked my TM to help and 45 minutes later they come in to help. They ended up getting the stick and we got the lab work. My TM told me that they felt that lab draw "threw me off track and derailed me and I couldn't recover from it, and that I should have anticipated that PICC would not draw." (I'm still confused on that one) That was nearly a month ago and hasn't really happened since, but they they still use it as a way to evaluate me.
My question is, so far, I don't feel like I have gotten the support I needed in the ICU (I don't expect to be spoon fed material, but I didn't expect this either), and from everyone's previous experience, is it worth trying to stick it out another 30 days to try to make it work, or just work on transferring units? I ask this because I feel like someone has already made up their mind about me it won't matter how ready I am to come off orientation in 30 days, it won't happen. I just don't understand how upper management can take any information from my preceptor as valid considering she hasn't worked with me in 2 weeks. A patient's condition can change day by day, so does my abilities, and evaluations from 2 weeks ago don't seem like a fair way to assess my ability and progression.
