HeartRN13

Near syncope... Did you pass out or did you not? Lol

Good luck!

I think you're overthinking it, if you're coming from a nursing perspective. Sorry to answer the question in a way that isn't helpful, but I'm an ICU nurse as well and I wouldn't lose sleep or overthink this!

I mean the environment, coworkers, workplace culture, etc. Things of that sort.

I'm curious to hear from other nurses. If any have worked in other parts of the country and worked in New England/Massachusetts, is it generally a more difficult place to work? Specifically the hospital setting.

If you're looking for icu labs that tend to be important... If a patient is intubated... ABGs are always important especially knowing when the last ones were drawn and when they are going to be drawn again, correlated with vent settings (and if there were recent vent setting changes). Also important to look at would be CMP, to get an idea of the patients electrolyte status, and their kidney function. As a new icu nurse, I noticed how important urine output and kidney function was in these critically sick patients (because often septic patients have poor urine output) and it can be easily overlooked)! Especially if we are dumping huge volumes of fluid into them and it doesn't seem to be coming out! These are basic and my automatic go-to's. Of course with every situation there are others you want to pay attention to, such as cardiac enzymes, lactic acid, hct and hgb, ammonia levels, etc. You'll learn when calls for what!

And an additive, I haven't had any negative interactions with coworkers in quite some time. I have learned in my experience how to assimilate into the "nursing culture" and also how to keep my input to myself unless asked. When I mentioned crucifying people for what they say or do, I was more referring to what I've witnessed coworkers do to each other, not what has been in my recent personal experiences. It was more of post of observation rather than experience.

You are right ruby I have considered these things. I definitely try to lend a hand and be a team player in all facets of the implication, but maybe I'm an idealist. It just seems that there is far too much attitude and lack of kindness, as well as lack of empowerment. One of the posters above did mention the lack of leadership and I am kind of realizing now, that it certainly plays a role. I know I don't stand alone in my feelings, because if you look up the reviews of this particular facility I am referring to, the patient satisfaction and care are not very highly rated. To me, attitude is such a vital part of the inpatient and critical care setting. I guess I am just feeling discouraged because I hold true to the reasons why I became a nurse, and I feel like I'm a hopeful and cheerful, optimistic and driven nurse in an environment that everyone is jaded.

Feeling conflicted about anything in life is stressful enough. Feeling conflicted about choosing nursing as my career is one of the most frustrating things I've had to face in life thus far. I love being a nurse. It's fulfilling and I truly love everything it encompasses related to the patient and care. I do not love the crap that comes along with being a nurse. The politics, the cliques, the gossip, being crucified for everything you say no matter what it is by your coworkers. I strongly dislike the fact that no matter where you go, nurses can't seem to stop themselves from acting like mean girls and just constantly pick one another apart behind each other's backs and sometimes harshly to their faces. No one is trustworthy. No one is a team anymore and if someone helps you in the work setting it comes with a price. If you can't help at that moment you become shunned. I am not a catty or malicious person by nature, so these things make me second guess my career choice every day. Feeling conflicted is not how I imagined I would feel today if you asked me years ago when I chose nursing.

Thank you everyone for the replies. I am doing my best to stay strong and with a smile so I don't get dragged down!

I think that's a great suggestion. I didn't take offense at all, I know I'm not crazy but I for sure have to start thinking about utilizing resources that will help with my coping. ?

It all started months ago when I was the new nurse, coming into an environment that I wasn't used to. I had a difficult time adjusting, but once I got through the adjustment period and assimilated into this new workplace, I became the target of lateral workplace abuse. I know my part and contribution from the beginning, but I've truly changed what I needed to and it didn't matter. It's been a long 4 months of being the target of malicious coworkers. I've stayed strong and shown up to work every day with a smile on my face, and being the coworker that I would want to work alongside of. I help, I'm kind, and I work hard despite what has gone on and how hostile they've been toward me. It's affected me at home. I am so hurt and beat down emotionally that I can't even drag myself out of bed. I cry every day because I am so hurt by the way I've been treated, and the hurdles I've had to overcome and hoops I've had to jump through just to get through my workday unnoticed. I find a corner to hide in when I'm not with my patients, praying I can make it out of the building at the end of my shift without giving anyone a reason to try to get me pushed out the door. I'm having such a hard time moving forward, and I know I have to but I just don't know how. I'm scheduled to work tomorrow and my anxiety is already creeping up at the thought of having to go in tomorrow, and it's 26 hours before I even have to walk out of my house for work. Don't they realize that I'm a person? I put on a smile and try to be brave but the truth is I am so shattered after having to go through this. I hate the word depressed but you could undoubtedly call me that.

In my experience with these situations, the times that things have operated in the smoothest and most efficient way depends on the physician who is running it. One in particular that made me also realize this (because yes you're right, it can be so chaotic that it's not productive), was a doctor that said minutes into it, "There are too many people and too much noise for this. Whoever is not directly relayed to this patients care or is not required to be here needs to step out please, thank you." It was one the most impressive things I've seen. If you run into this in the future, maybe politely and quietly asking the doc in charge to relay this message would help. Better to ask the doc to do it, coming from anyone else, people tend to recant and take it personally.

It's such a tough topic and such a familiar and complicated topic that there will never be agreement, nor an answer to what is right or wrong. This particular scenario comes down to a persons individual values of the aspects in their life. Some people have found their workplace to be the most valuable part of their life because they struggle to find value in things outside of work. It's FAR too easy to value being a nurse and come to feel that way because the gratitude and appreciation you receive from patients and families is so fulfilling that you value feeling valued. On the opposite spectrum, there are people who have such a happy balance and personal life that their values lie in THOSE parts of their life, and they don't feel as though their workplace and job are as important to place that value on. At the end of the day, there will never be a right or wrong way to feel about work. Each and every one of us have our own story and reasons why we are the way that we are, and if someone is able to find happiness through valuing their workplace and the relationships it's allowed them to form, then I am happy for them that they are able to feel the sense of connection and belonging. And in regard to those who are on the opposite side of it and have such wonderful and supportive people in their life that they don't feel that they need to engage in the workplace clique, i admire that and respect that as well. I've been on both sides of it. I have my preference and opinion but if I shared mine it would be contradicting my post. No single workplace is any different no matter where you go and how far you travel. Only you can decide for yourself which role you're going to play and why.

The best reflection of how well a preceptor or educator is performing at their job, is the overall or general outcome/success of their student or students. If more than one person isn't performing to their expected standards, or aren't showing signs of improvement and growth, then in my personal opinion their teachers have not been effective.

My advice to you, especially as a new grad in the icu is have faith in yourself, try and instill some confidence in yourself and take the leap off of orientation. The ICU takes a great deal of time to orient to, if not years. If you have other supportive seasoned nurses to go to while you're working but are able to manage the basic nursing on your own, you will be okay. All you need is some support for the critical care part when you are unsure, and keep building on what you know. The lack of confidence in yourself is what probably is throwing management off.

Yup. These are the sad but inevitable changes of the hospital setting. Mine is going through it too. I'm going to stick it out for brighter days on the horizon when all of these messes clear up. Won't be for years to come but I'm not going anywhere lol

My days are not unlike yours and I'm not a new nurse. That being said I know exactly why my days are like this: because I'm always at the bedside. Taking my time to educate patients on a new diagnosis, explaining new meds, making sure they fully understand is why I'm always chasing my tail. At the end of the day though, I feel like I did my job the right way and I'm okay with it.

6 months, and don't plan on leaving at any point in the foreseeable future. This is my first staff position (struggled making per diem work with full time needs), and I've endured 6 months of difficulty with assimilating. I've made it this far no sense in quitting now!

In this market today, stay at least 2 years before you move on. One year experience isn't enough, over 2 seems like too much. This market is getting picky, and once you are coming up on that 2 year mark I'm pretty confident landing another job will be much easier. One year nowadays just isn't enough to get the job interviews rolling in.

In my experience, a simple "I'm sorry I'm busy right now." Is the best answer. You're damned if you do and damned if you don't, might as well keep it simple for the sake of evading argument lol

I am writing in response to you, as both the person who understands what you mean, but also as the nurse you write about. In my recent experience starting a new job and facing the challenges of adapting, assimilating, and trying to learn the new culture of a workplace, it's challenging on both ends. No one wants to deal with someone who just gives off vibes that make them feel the way you described. No one wants to be that nurse either. I went through a couple of rough months of being that nurse you described, because the stress of learning the dynamics of how things worked and feeling alone made me constantly on edge. What made all of the difference for me, and what was a turning point for me, was one day when someone pulled me aside and kindly told me "I think your intentions are good, but people are taking you wrong." I sat and listened to what this person was saying to me, and took it all in while reflecting on my actions and behavior. After that conversation I was able to see that I really was not communicating effectively or nicely with my coworkers, and it was my defense mechanism for the troubles I was facing. I realized how many more problems I was creating for myself, and from that point on I really made a conscious effort to change the way I was reacting and acting to things. It is still in the process, and I know it's going to take time for damage control. Things are getting better, people are taking me in a little more every day because I've changed the way that I react to things. I think my point here is that it sounds like from your reputation, with a kind approach and the right approach, maybe if you took this person aside and talked to them about this, you may be helping a coworker. I will always be grateful to that person who did it for me, and I know moving forward I can only hope to be a coworker that can be support for someone in need.

Same here. I'm going through it now. I'm learning the dynamics of the new hospital I'm at 2 months in. There are so many issues with patient safety that have left me cleaning up the mess of other people. Critical situations wjth patients. I have stood up for myself and my patients on a few occasions and it has not been received well. My manager said I did the right thing and she hopes that I will continue to do so, in hopes that others will follow by example. As you can probably imagine, my coworkers probably don't like that either. I'm definitely treated as an outsider, and not welcomed into their group, but it's not bullying. As you said, it's immaturity, and poor morale.

I don't spend too much time with any particular patient. If one patient needs something like education I have to split it up and I also have rounding to do in between. All five of my patients are tele, so I can't just stay put. I wasn't implying that's what I do, and I wasn't implying that I NEED to make them feel better like magic. What I meant was I often come in for my shift to find annoyed/angry patients and/or family members because no one even takes the time to update them on the plan of care. I personally always ask the patients and families if they have any questions or is there anything they would like to know that hasn't been answered. Transport is showing up to the rooms for tests and scans and no one even tells the patient that they have been ordered and for what. Doctors will come and see a patient for a consult, and don't tell them what their plan is going to be. It's just communication and taking that extra initiative to help the patient feel better psychologically and physically. It seems that the nurses lately don't even want to do that much. I have seen more and more that they don't really want to spend any time with patients at all. Get in and get out, and make the aides do the rounding.

I've noticed a lot lately my patients have been saying "The nurse didn't have time." It's true, with heavy patient assignments, limited help, and a list of things to chart for your shift, nurses really don't have the time. However, I know I became a nurse because I wanted to help people. As nurses we are taught that treatment is not just curing, but it's the therapeutic component that nurses proved that makes the difference. It seems lately that part is lacking. I never leave work on time. The reason why is because I will make the time for my patients needs. If I can spend 30 minutes of my time educating someone about their condition, the plan of care, and help alleviate any of their stresses, that means more to me than recognition from management. Of course that 30 minutes will never be uninterrupted. I just don't feel like I am a good nurse unless I make my patients feel better in every sense. My thoughts for today.