HansRN

I'm not sure why that's an odd way to do an insulin gtt? although it is the only way I learned on the unit. What do you do? And yes the blood sugars for the previous nurse were high therefore she should have checked blood sugars every hour, instead she only checked every two hours. And yes, the order was for the pts sats to be 88 and above. And I agree to some extent that nursing is about what is happening right now but you do have to factor in what happened on the previous shift! You need to know if something serious happened. And it's not just about the orders. You have to look at your patient and see what the patient is doing, that's why they call it critical thinking. We use those skills to make calls and judgements and notify the Doctor that may change the orders that we currently have.

I'm so sorry you went through that! It really does suck, doesn't it! But I'm doing better than I thought. I actually just talked with a friend who worked the same unit years ago and had similar experience. Makes me realize I'm not the only one this has happened to and it seems to be a trend of theirs. I wish I had the opportunity to stay home but I don't. Good luck to you and your job search!

Thank you! And to respond to your questions. I don't think new grads should go into an ICU. I think they need to develop skills first. Whenever a new grad got pulled to my old tele unit they were overwhelmed and didn't do well with time management. That's one thing I feel like I did well in the unit. Although you will have others say that hiring new grads is good because then they can be easily molded to ICU because that's all they know.

I think you're right. Thinking back I do think maybe a step down unit would have been better to go to first to get some of the skills. I also look back and realize that I should have asked for a different preceptor. Lessons learned! And I agree that some of this is probably happening because of COVID especially in areas where they have to take precautions but aren't getting covid patients which was that hospital. They made MICU a Covid unit but only had 3 patients who had it. So those nurses had to be sent elsewhere in the hospital. They also made PACU an extension of ICU, more like a step down unit and again those nurses had to go to other units as well. It's definitely a strange a difficult time right now for everyone! I'm trying to think of the positive in all of this and just look forward! Thank you for your advice.

Thank you!

I was very willing to learn and fix my mistakes in fact at the end of orientation they said, thank you for "brining it" meaning, thank you for giving us your best. As for the alarms, I was only telling the other nurse if their alarm was going off not taking care of their patient. For the insulin gtts there was protocol for however high or low the blood sugar was. For example if blood sugar was 350 increase gtt by 1cc and recheck in BS in 1 hour. If the BS was only 140, make no changes to gtt and recheck BS in 2 hours. And yes the sats for that put were normal at 88 and above for her med history. And I'm not sure what you mean that I'm not taking responsibility because others are doing it? What are you referring to others doing? If its about the alarms, They expressed to me concern for alarms and I then took responsibility to make sure I was catching the alarms and questioning them.

My preceptor was watching me do everything for CRRT, then if I'd do something wrong she'd tell me and show me the right way. It wasn't really guidance, it was more like, "here figure this out and if you can't do it I'll step in." Not the best way for someone to learn, especially with someone so critically ill. Thinking back I probably should have asked for a different preceptor. I possibly can go back to my old job. My old boss did say that she would be glad to have me back if things didn't work out. But with COVID I don't believe they're hiring right now. I will be calling her though. And I think I'll take some time before I decide to go into an ICU again. It's made me question wether it's really what I want.

They used Cerner and I came from a hospital that used Epic. So that was a big change too.

@ Katie I see what you're saying. It was a very "clicky" unit and I did not feel like I fit in. And I hope you're right about the employers only giving dates and personal verification! Thank you for advice! I hope this all passes soon too. As the days go on things are getting better! It really helps that I can express myself here and that you all understand the nursing world!

@ Hoosier, I didn't think of that. I certainly hope you are right!

My question is did they terminate you with these reason in writing or was it more of a "At will" type termination. It makes a difference because with at will terminations you can put prefer to discus in person and if interviewed simply say something like My employer and I came to the conclusion that it was not a good fit. IF you are stepping back to a med surge position you can even say that you felt a bit over your head in ICU and you are returning to a care environment where you feel more comfortable. While an employer can legally say anything about your work that is truthful most will stick to verifying dates of employment. So keep your head high and don't give up. You will find the right job for you. Hppy I wish it were the latter but it was in writing. Thank you for your advice!

I kind of felt that they had decided early on as you said. I saw other nurses not catch alarms and need prompting. Drips that were ended and needed replaced. I felt like any little thing I did was reported to manager. I was also told from the Nurse educator in that meeting that I needed to have a more aggressive attitude and she literally said, "you need to be more, we'll, I'm not going to say the word but you know what I mean." She was referring to a "***." Um, yeah, that's highly inappropriate and unprofessional! No one ever made me feel very welcome either. I only made one friend the time I was there who was also new to the unit and had the same feelings as me. I'm sorry you had that experience, especially as a student. I'm sure it put a bad taste in your mouth for nursing!

Hello everyone, I really need some advice here as I'm in new territory! I was just fired from the ICU after 5 months and it has really devastated me! I went from a tele/observation unit to a cardiac ICU at a different hospital. I fully admit that it was a big jump from what I was used to but I realty felt that I could do it. I had a pretty rough orientation in that I had very high acuity patients right off the bat. My 2nd or 3rd week in I was dealing with a very sick patient that needed CRRT. Before transferring to the unit, I didn't even know what that was. My preceptor said I wasn't ready for it yet but she then changed her mind and had me run it. It was awful and I had tears in my eyes all night plus a headache. I then realized that maybe I had gotten in over my head but then I thought no, I can do this. As I was meeting with my manager and clinician for the first time they expressed concern to me that I was missing alarms and I had missed titrating an insulin drip and got a written warning for it, not even a verbal at first. That was the first I heard of any of this as my preceptor never came to me and talked to me about it and said hey you really need to work on this or that and see if I improved she just went straight to our manager. And after that meeting I was hyperaware of alarms and was telling the other nurses on the unit about their patients! I also didn't miss a beat with titrating insulin but noticed that a seasoned nurse was only getting 2 hr blood sugars after I got report from her and it was suppressed to be every hour....I should have told my manager but didn't. I know better now, record everything and report everything! I also had an incident after orientation on a post-op patient that was to be receiving fluids but I didn't see the order as the computer system was still new to me. Another where pts sats I was told were low and that I needed prompted to check the patient which was not true. The sats for the pt were 88 and above which was acceptable for her and I noticed at the same time the other nurse noticed when she did actually drop and I went right over to the pt. The pts PaO2 in the morning was 50, I know not good! I was told the pt had altered mental status but she was not like that for me, she answered all questions and was sleeping for at least 4 hours thru the night. I'm really not sure how that happened? These were the main reasons I was let go. They didn't feel it was a good fit yet also said I was good with the patients and their families and that I was a good nurse and person but I wasn't offered to transfer to a med/surg floor? I took a bonus so this really screws me over not to mention now I have to put on my applications that I was fired and give reasons why to who I interview with! This is awful and I'm completely embarassed and devastated. I keep running everything through my head over and over!