New RN IN ICU

[MsJheri112, BSN, RN]

Hello everyone, 

So I  recently started at as a new RN in an ICU In my hometown. I started preceptorship in Oct. and on my own Nov. 17. I’m feeling discouraged. Even the simplest of things are hard for me like changing a patient and bed rolls etc. I’m not too sure why. I was an LVN for 5 years prior and I did geriatric care which was totally different. I feel like my bedside manner is great but everything else is just completely new to me. I’m having trouble liking my job. Not to mention, there’s seasoned ICU nurses that are not very helpful and rude. I don’t know if it’s the hospital I’m at or what but I’m not feeling it. I dread going to work. I’m just wondering if this gets better or what !?! 

[Been there,done that, ASN, RN]

Turning and changing patients is a basic skill. Did you not learn that in your LVN role? You should have assistants to do that any way.

You did not receive enough orientation to succeed as an RN in ICU. You would need at least 3 months of well structured orientation. How are you reviews?

Can you handle EKG  interpretation, IV titration, ventilators, and arterial lines? If not... time to request a transfer to med-surg.

 

 Good luck.

[MsJheri112, BSN, RN]

Of course I learned how to turn patients as an LVN. They weren’t dead weight and comatose people with ventilators. Very different. I have passed competencies for skills you mentioned. Thanks for your input.

[JBMmom, MSN, NP]

Okay, so the simple things like patient care are tripping you up. I know that I came from long term care and med-surg and I do far more direct patient care in the unit than I did in those positions. It just takes a while to get the hang of moving patients that are on ventilators. Watch your techs and ask them for assistance, they're experts.

Are the not so simple things giving you trouble as well? How do you feel about your ability to put the big picture together and care for critical patients? It does sound like your orientation was on the shorter side. I'm sorry that the nurses you are with are not the most helpful. Do you have anyone you can turn to for more support? Is there an educator in your unit? 

[MsJheri112, BSN, RN]

Unfortunately in this ICU there are no techs. I used to move patients all the time at the skilled nursing facility but they weren’t comatose dead weight.m with ventilators, lines, etc. I feel like my critical thinking is fair. 

[JBMmom, MSN, NP]

If you feel comfortable with the critical care stuff, the moving patients stuff will come together, just give it time. It's more muscle memory and coordinating everything. You must at least have another nurse there to help with most of the patients, right? When you're the one assisting another nurse just try to make a mental note of the little things. Like always bending the knee of the top leg towards you and then you can hold at the shoulder and the knee to get the best grip to roll. I find it easier to work with the side rails down in order to move patients. However, you do run the risk of having a patient directly against your scrubs, which is not always pleasant. You'll get there, try to focus on the positive aspects of the job. Good luck. 

[Been there,done that, ASN, RN]

20 hours ago, Babynurse111 said:

Of course I learned how to turn patients as an LVN. They weren’t dead weight and comatose people with ventilators. Very different. I have passed competencies for skills you mentioned. Thanks for your input.

'there’s seasoned ICU nurses that are not very helpful and rude." Sensing this could be your REAL problem. It takes awhile to "prove" yourself in ICU.

I would not attempt to change a patient alone. Too much chance to interfere with the vent or the lines. You only need 5 minutes of a colleagues time to work together.. and do it safely.

What have you observed? Do your fellow nurses work together on baths, changes, and transfers?

 

 

[baby.icu.nurse, ADN, RN]

I get it. I was a new grad who went straight into the ICU as well. Coming up on my one year mark in two weeks. I think your success depends largely on the support you have at work.  I had to request a transfer to another location because of how terrible my preceptor was (this preceptor was known for this but was the only available preceptor due to a number of circumstances).  Once I got to my new ICU location, there was a night and day difference.  We are total care as well, but the teamwork is amazing. My new team is so supportive of new nurses and never makes you feel dumb for asking any questions.  Many of them have commented that it's because they "want to build their new nurses up instead of tearing them down."  It's just not the nurses either.  Directors, managers, lab, housekeeping, RTs, literally EVERYONE is welcoming and helpful when you have questions.  Just wanted to let you know that it does get better and not to get discouraged. ❤️