3 months ago I transferred from a med-surg tele/step-down unit to the cardiac-surgical ICU (CSICU), which I heard is the most challenging ICU at my hospital. I worked almost 3.5 years on my old unit and it was my first nursing job.
I felt comfortable at my old job, but I felt my career was stagnant. I found myself doing repetitive mundane tasks and I needed growth. I'm in my mid-20's right now and I feel a bit lost with my career goals. Eventually I want to go back to school but I am not sure what specialty I should pursue.
I decided to take a challenge and go for an ICU position. I thought it would be a smoother transition going to the CSICU because my med-surg floor shared the same patient population. Once the post-op cardiac patients were stable, they were transferred to my old unit and monitored until discharge. I was familiar with cardiac surgical patients and cardiac devices, such as LVADs and total artificial hearts. I thought if I sink or swim in the ICU, at least I took the initiative.
I am currently almost off orientation. I have been on days for the majority of my orientation. I had just finished "admit week", which was a week of only admitting patients from the OR and learning about the post-op complications and patient's readiness to extubate. I learned a lot but every night I came home stressed and on the verge of tears.
I feel very overwhelmed and have this dooming anxiety before every shift. My coworkers and preceptors have been supportive and have been telling me that I am doing well and things will get better. I feel very anxious at work because I do not feel confident in my new role. I try to do as much studying as I can but there's such a big knowledge gap between ICU nursing and floor nursing. I am having a hard time seeing the whole clinical picture and prioritizing care. A lot of the days, I get very scattered brain and I freak out and panic, which is not very good because lives are at stake. I am worry I will easily make a big mistake one day and cause harm.
Because I have trouble connecting the dots, I find myself having a hard time keeping track of the interventions I have done for the patient for the whole shift. I try to write things down but a lot of times I get so busy that I do not even have a moment to reorient my thoughts. A lot of the nurses don't write anything down and their memory is flawless. One of my preceptors told me not to write anything down because I am an ICU nurse now and I will learn to memorize. That made me even more anxious because I do not trust my memory. I have a hard time talking to the providers as well and I feel intimidated by everyone.
The worst part is giving report to the oncoming shift. On my old floor, I am so used to writing things down on a report sheet and giving detailed report off my notes. Here, I am forced to know everything and the 89454524626983 interventions I have done without reciting off a script. I get very flustered and nervous in report and I feel stupid. I know some nurses are not kind and will chew me up when I am off orientation.
I don't have a lot of confidence in my work and have a lot of doubts about my skill level. I do not want to go back to my old unit because I left there for a reason, but I also know that not everyone is cut for the ICU. I'm giving another week or two to reevaluate.