Hey, everyone. This is lengthy, but I have a lot to say.
I'm a new nurse working in a CVICU (open heart recovery). I've been a nurse for three weeks now, but I've worked in the hospital in a different department for four years.
My preceptor left to do payroll the other day instead of staying with me to do orientation stuff. While gone, the charge nurse decided I was ready to start taking patients and gave me a thoracotomy. I stuck it out until the nightshift came in. I would have rather had my preceptor with me to double check things but I handled everything great, didn't miss any meds, and no one died. =)
The nurses proceded to not listen to my report and instead criticized my paperwork for about 10 minutes. I left the department and a few minutes later, they called my house, cell, and another department trying to find me to ask if I gave an antibiotic, which I did and charted. I hadn't even left the hospital yet!
I go home, sleep about 5 hours and get up 5 am the next day to work 12 hours. Here's where things start to get interesting. My preceptor is not there, she has the day off. I was supposed to just "help out". I end up getting the thoracotomy, the same guy I took care of last night. No big deal, I'm familiar with him. I end up with an additional patient because another RN had to take a fresh admission.
So, here I am. Three weeks after just getting my license and I have two patients. They're stable and just waiting for a room on the floors to open up so they can be transfered. They're both sleeping. I go to get some food and the charge nurse says "You picked the wrong place to work if you're expecting to get breaks".
I get both my patients transfered to the floor. Remember the thoractomy patient? Here's a little background. He had an airleak the first time I had him, which the surgeon was informed about. For the first 24 hours after surgery, his tubes were to suction. He was stable the whole time, oxygenation was great, ABGs were great, he had no pain and no complaints.
The first morning post-op, the surgeon personally discontinues the wall suction. There is no bubbling in the waterseal chamber my entire shift, thus no airleak, so I sent him to the floor that afternoon. The floor nurse PAGES the surgeon saying there is an airleak.
The surgeon then proceeds to call my department and yell at my ad-hoc preceptor for the day (who is a traveler with a Master's Degree and works as a NP and educator) about how she is an idiot and not teaching me right. She has a fresh post-op CABG and didn't have time for that.
The surgeon does not ask to talk to me, he just yells at everyone else over the phone over nothing.
The floor nurse calls me to talk to me and says there's an airleak and she paged the doctor. The first thing I say is "Is the patient okay?" She says yes.
I'm thinking his airleak came back after he got to the floor. I was looking at those chest tubes every hour recording the output and checking for an airleak. Another nurse saw them at 11 am and didn't see an airleak.
Nothing bad happened. No patient was harmed. I did not miss a med or treatment. My patients were stable and did great.
My director is on vacation so I left a voicemail for the executive director of surgical services and I'm going to talk to her tomorrow in person.
I feel like I'm being treated like crap because I'm the new guy, people are not helpful or receptive. The department is short staffed and busy. My assigned preceptor is ill and might be gone for a few weeks if she has surgery. I'm being screwed out of a proper orientation and am thinking about changing departments.
I'd like some input on this. What are your thoughts?
Thanks for the update, and I'm sorry about your crappy situation. I'm just starting my own ICU orientation, and my hospital does take new grads into CVICU if there are openings. However, we're ALL on orientation, working with a preceptor, for 16 full weeks in every ICU. We also take a critical care class for the same amount of time. You don't take a single patient by yourself until the 16 wks are over. The educator also mentioned to me that "really intense units, like CVICU" often give their new grads an extra few weeks beyond the 16 with a preceptor. Look for a situation more like mine if you can, definitely at a different hospital, and good luck!
MB37
1,714 Posts
Thanks for the update, and I'm sorry about your crappy situation. I'm just starting my own ICU orientation, and my hospital does take new grads into CVICU if there are openings. However, we're ALL on orientation, working with a preceptor, for 16 full weeks in every ICU. We also take a critical care class for the same amount of time. You don't take a single patient by yourself until the 16 wks are over. The educator also mentioned to me that "really intense units, like CVICU" often give their new grads an extra few weeks beyond the 16 with a preceptor. Look for a situation more like mine if you can, definitely at a different hospital, and good luck!