I graduated with my BSN in May and have been working on a Level III NICU since June. I got out of orientation about a month ago and I think I've already burned out. During orientaiton, my preceptor and I ended up with the sickest kids. Sometimes we'd have two babies that 5 min into our shift we would realize they should be 2 one-on-ones. Once orientation was over, our educator told us that while they wouldn't go "easy" on us, they would make an effort not to give us the really sick, really difficult kids to start with.
In my first 6 shifts I got 5 bad admissions and 1 transfer. 5th admission, I got a call on my day off saying we're really sorry things have worked out like this. We don't want to lose you. We've talked about it and we're really going to make an effort not to do that to you again. My next shift, I got yet another admission. When I let the person who called me know, her answer was well I guess you've just been targeted huh.
Even on days since that I have just had a difficult assignment, I can't get any help. I sometimes get lunch at 3p (I work 7a-7:30p) if I"m lucky. I had 3 SCREAMING kids yesterday and people just kept getting mad at me for them crying. I was standing in the middle of the room just wanting to join them and cry too.
I always feel like I'm behind. I always feel like I give a crappy report. I hate leaving things for the next nurse to do. I like my beds to be neat and restocked so the oncomming night RN doesn't have to look for things, but I just don't feel like I'm able to do that.
Is this burnout? I've honestly considering going to like Best Buy or something and applying. I just feel like I can't do this and that I made a huge mistake going into nursing.
Is there anything I can do? Is this just part of my "first year get your feet under you"? I don't know that at this rate I"ll last a year...
When I got off orientation and was "resourcing", I was on admission almost every shift for the first few months, and it really helped me with my admission skills (though I didn't like it at the time!). Now I've been in the NICU almost two years (small unit) and I love to get the sick level III kids, again, it's good experience. I want to know I'll be able to handle anything and the only way to get there is to get the practice doing it.
I'll also say I love my unit and my coworkers really do work as a group during admissions, everybody tries to help with something - especially on a level III admit. With the simple rule out sepsis kids it only takes one extra nurse to help with labs and IV, so it still gets done pretty quickly.
I never felt like I was being picked on or hazed though, and if I did I would have talked to my manager or director.
Us old hens know that you all need more experience and taking a primary locks you into the same assignment everyday and therefore you will miss out on many opportunities....cackle cackle.
To the OP...I'm sorry you are not having an easy time of it. I'd speak to the CNS or nurse educator about what is going on. Do they have a preceptor group at the hospital thru education and training...you can speak to the head of that also. I hope you can work things out.
I don't have any advice to give, primarily because I have no experience, but I will be praying for you.
I also want to thank you for posting because NICU is something I want to do (my entire reason for nursing school) and these REAL examples of how things are in a hospital and seeing how experienced nurses respond, is very valuable to me.
I really don't mind the admisstions and the work. I want to be confident. I guess my struggle is really with not being accepted. I talked to the person who called me and her response to everything was I guess you've just been targeted.
Someone mentioned that they want you to ask for help, this is one thing I cover with my oriente. I try to teach them that they do not have to do everything themself they just have to get everything done. The one I hve now just does not get it, so I keep giving her more and more to where she can't get it all done without help. (I am always there watching, I wont let her hurt the babies), but she just won't ask for help when she does not know what she is doing. I find it scarry when they wont ask. I have had many nurses come back to me later and say that was the best thing anyone tought them. I'll bet there is someone there waiting to help if you ask, and if you don't ask they may assume you have it all under control. Many of the nurses in my unit did not learn that they can ask for help just that they can ask me for help, so I need to work on that more. We sometimes use CNA's to help feed and they will still come to me because they can't ask them. You should never be afraid to ask for help! When I am there I also push them to do more admits as this realy helps with their assessment skills. I make them do the assessment and I do the paperwork even if it is not their admit. Unless I'm orientating a new charge nurse then they do paperwork and I do the assessment. My main statement here is you can't always do it all yourself, and you must get it all done you just don't have to do it all yourself. Ask for help when you need it, we all need help at some time or another. If you watch I'll bet all those old hens in the unit help each other out all the time. Our most senior staff 30+ years is best know in our unit for asking "Can you do me a favor?". Hope this helps.
I always feel like I'm behind. I always feel like I give a crappy report..... I don't know that at this rate I"ll last a year...
Whew! I am exhausted from just reading your post! I am creeping up on completing my first year in a Level III and I feel your pain! I felt very similar to you for MONTHS (and still do) Right out of orientation, they wanted to give me a really sick 24 weeker, I was pulled to another unit, every vented kid I seemed to get needed a septic workup on my shift....I was drowning. I kept telling myself that my first year is a TEST...meaning if I say I really want to do this for the rest of my career - I had better mean it... ya know?
I also had a meeting with management about more appropriate assignments, etc. and then I was admitting a 22 weeker - I wanted to shout "WHAT HAPPENED TO OUR CONVERSATION!?!?!?!" and of course I got the "Don't worry, we'll be here to help you" only to have everyone in the room disappear and leave me with the Docs staring at me. One asked "Have you done this before?" and I had to say No.
Ugh.
And don't even get me started on the crappy politics going on.....
I love my job, but they are making it really hard for us new nurses to love it and want to stay.
I really don't mind the admisstions and the work. I want to be confident. I guess my struggle is really with not being accepted. I talked to the person who called me and her response to everything was I guess you've just been targeted.
The "targeted" comment is what really stands out to me. This sounds like a hostile environment for a new grad.
I have worked in two such units. One was in my first job, in which some of the experienced nurses set up some of the new grads to fail. I eventually "passed" their criteria, mostly when a new batch of grads came in so they had "fresh meat". I have to admit that I did learn a bit on that unit, but I was so tense the entire time and felt that there was really no one to turn to. Thankfully, there were some nurses whom I could approach with legitimate questions and not be laughed at or scorned.
To me, it is imperative that new nurses, including those new to NICU, are adequately mentored. I knew some people in that first job who were scared to ask questions because the "queens" would bite their heads off. Then they learned to not ask questions, and that's when the mistakes started happening.
I stayed in that job for 1.5 years. My skin grew tougher and I was finally accepted. I stayed far too long before finding a job at a wonderful unit in which newer people were mentored and the focus was on care for the infants, not hazing for the new grads.
I would try to talk with a person on the shift whom you respect. Is there an educator, former preceptor, or other experienced nurse who can give you some of the scoop? I would focus on the fact that you can't get others to help you. Come up with some concrete examples. In my first job, even though the "queens" would laugh at many questions, they would help to double check an assessment or start an IV for me if I couldn't get it. Sometimes I had to negotiate this, but it was possible.
I am concerned for your growth as a nurse, but I am more concerned for the patients in your unit. Things can go downhill very quickly in NICU. If you aren't getting backup, there could be a serious problem in the future.
Also, I would suggest looking into working nights. There is less going on there and you would have a friend on the shift. The crappy job that I had eventually had a waiting list for night shift because the night crew was nice and supportive.
Good luck and hang in there. Once you have a year's experience, look for another job. This is not the sort of situation that gets better.
BTW, can you PM me and tell me which hospital this is? I live a distance from St. Louis and have considered commuting in for an occasional NICU shift. I'd like to avoid this place!
Wow! I would expect you to be overwhelmed, and to be getting a lot of admits and sicker kids as it is the only way to get experience, which you need when you are new; I would not expect the older, more experienced nurses to make fun of you, ignore you, or stop talking when you come to a group of them, etc. They should be providing support and assistance in your growth process as an NICU nurse. You will get more efficient and organized, and be able to do things more quickly with time and experience, and tips from those who are more experienced. Even a very experienced NICU nurse takes a few months or more to get comfortable when changing to a new hospital. Do you have a Compliance Officer at the hospital? Isn't this a form of discrimination? I'm not sure what to advise you, but I certainly would consider staying there long enough to get enough time and experience under your belt to get another job at a different facility. Believe me, they are not all like this!! I'm sad to hear of your experience there. We older nurses should be mentoring you young ones, we certainly can't do it all as we get older. I've been in NICU since 1979. I will agree, that day shift does tend to have more personalites with an attitude, and be more interrupted as far as the flow of things goes, than nights. However, it does usually offer more experiences, and it certainly is a whole lot better on the body and psyche than night shift is (having done both of them approximately equal time over my years!!). You are definitely in my thoughts. If your nurse manager is aproachable, I'd certainly talk to her/him!
cathys01
150 Posts
When I got off orientation and was "resourcing", I was on admission almost every shift for the first few months, and it really helped me with my admission skills (though I didn't like it at the time!). Now I've been in the NICU almost two years (small unit) and I love to get the sick level III kids, again, it's good experience. I want to know I'll be able to handle anything and the only way to get there is to get the practice doing it.
I'll also say I love my unit and my coworkers really do work as a group during admissions, everybody tries to help with something - especially on a level III admit. With the simple rule out sepsis kids it only takes one extra nurse to help with labs and IV, so it still gets done pretty quickly.
I never felt like I was being picked on or hazed though, and if I did I would have talked to my manager or director.