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Discussion

On my own after 2 days?!?

I recently relocated to a new area after spending one year in a MICU. I was ready for a little change so I decided to do trauma/surgical ICU in a level 1 trauma hospital. I have worked on the unit for 2 days and on the second day my preceptor basically said "ask me if you have any questions" and I was on my own!!! My pt had an ICP monitor, paralyzed, sedated, on an insulin gtt, skeletal traction on his leg, broken neck, the works! Needless to say I was absolutely NOT ready for all this. She was still very good at helping me and answering questions, I asked her over and over about things and she just kept saying "yeah youre doing it right, youre fine." I asked her to look over my charting, I made sure everything was taken care of, but it just doesn't feel right. I feel like theyre ready to just shove me out on my own! I am trying to do the best I can do, they are telling me I'm doing it right, but after 2 days? I hardly feel I am doing everything I am supposed to do even though they are telling me I am. I don't know how to bring it up and how to get the kind of education I feel I need or who to go to. I am still a relatively new nurse (a smidge over a year). What should I do???

Featured Replies

Hello PiPhi2004:

I don't know you, obviously, but what I take from what you said is:

perhaps your preceptor feels you are capable of being alone, with your own patient, without s/he breathing "down you neck"

You may be a "new nurse" but you do have prior ICU experience

What if you approached the hospital clinical instructors with your concerns?

I wish I could be of more help to you, but I do understand a wee bit of where you are coming from. Was working in an Army MEDCEN ICU for 4 days when boom! Left on my own with two patients and a Recovery.....and the prior ICU that I came from did not have the patient acuity this unit had....

Anyway, attempt to talk to your preceptor, your Chief Nurse/Head Nurse/Nurse Manager, or another more "seasoned" nurse and get their take. Not that any of that will make you feel any more comfortable with the situation...

athena

  • Guides

Did you discuss the transition/orientation period before starting the job? It is just so important when you're new to a critical care area. Even with ICU experience, changing to post-surgical can seem like a whole new ballgame. Go and speak to your manager. Say the magic words that you feel "unsafe" (if you do) and would like to discuss some further orientation or preceptorship.

I agree with ghillbert...trauma is a whole new ballgame! I had worked in gen/med ICU for three years, and then went to work at a level I trauma center. I hadn't had any experience with ortho or TBI patients, and I was on orientation for 8 weeks. I would suggest you speak with your nurse educator or manager and let both of them know how you feel. Good luck!

I dont think its THAT unreasonable. I went from a 6 bed medical ICU where it was mostly pneumonia and sepsis..very low accuity, to a 24 bed mixed med/surg traum ICU where we get EVERYTHING. I had a total of 4 days of orientation. I only had 9 months experience at the other ICU. After the second day, I was doing most everything on my own, with my preceptor there to ask questions. You need to be able to kind of throw yourself in. Its overwhelming because everything is so new, but y ou cant stand back and not be doing all the care at this point. The first day or 2 are just days to get to know they unit/ the system, protocols, ect. There should be no reason not to be at least trying to do everything on you own. If you cant cuz its too much, then you cant, but at least try, and ask for help when you need it. Its different when your orientation as a new grad, but as a person with exp, they expect you to know the basics, and just ask what you dont know.

  • Guides

If you throw a bunch of people off a cliff, some of them won't drown. However it'll be despite the fact, not because of it. Maybe you're a quick learner - most people need at least a little time to get used to it. There is not much room for error in these critical care areas.

  • Author

Thanks for all the replies! I was told that I would be on orientation for 1 month and then we could re-evaluate if I needed more or not. I was doing all the care for my patients and that was fine, I just felt that I would have someone double-checking me to make sure it was correct. I talked to my preceptor about this and now shes better at making sure all my charting is correct, that I know where my protocols are, and those kinds of things and we are doing a lot better and I feel a lot more comfortable knowing that I am doing things correctly instead of just 'hoping' it was.

  • Experts

When I was new I just kept asking questions until I started to feel comfortable with what I was doing. Unfortunately the only nurse who was positive about helping me started to act irritated. I just kept asking away until I got it. I would be very, very persistent if I worked in a critical area. Nobody can afford to have you not get it right. Don't feel bad about seeking guidance.

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