lesdrn

I was never a "Sedation Nurse", but I've worked in Critical Care for the majority of my 18 year career. I've given sedation to intubated patients and also given conscious sedation when assisting with procedures. I think you would either need experience in a department that uses conscious sedation or work in Critical Care. We had to do annual competencies on many things including conscious sedation. But, to prepare yourself, I would suggest getting familiar with the drugs used for those procedures the same way you did during nursing school. It never hurts to have the knowledge beforehand.

I can feel your pain! I worked nights for almost 3 years after 14 years of day shift. I changed jobs, then went back to bedside nursing after 2+ years and took a night shift position thinking it was my foot in the door! WRONG! Speed forward two years, and I went to the doctor for severe knee and hip pain, only to find my Vitamin D level was 19! Six weeks of high dose replacement and my level was back to normal, but best of all, no more pain! Also, I found out I had hypothyroid, which I guess isn't uncommon for shift workers. Get your TSH and D3 levels checked. Maybe that might help to bridge the gap til you can get the coveted day shift position. I just got on days, part time, but I'll be working full time hours. It's a sacrifice, but one I gladly made!

Have you ever gone to a deposition? I have and my charting saved my a**! Now we have electronic charting and I do chart a little differently than I did on paper, but I do hit the high lights of my assessments. I chart in narrative my lung sounds, my cardiac rhythm and anything that is abnormal at every assessment. This may be something that is in my assessment that is charted every 4 hours, but if I have to sit at a deposition, I want to read my narratives to read what was wrong with the patient and try to jog my memory. In nursing school, I was taught to chart by exception, so if I didn't address it in my note, it was normal. I still believe in that principal. BUT, if you go to a deposition, the plaintiffs attorney will ask you what your charting practice is, and do you ALWAYS chart the same way. So, I guess the moral of the story is, chart to protect yourself, chart defensively. There are classes that you can take to teach you how to do this.

It sounds to me like you got a preceptor who is looking to "weed out" the people she doesn't want. She may have a preconceived notion about you, and your long job search. I don't believe that this necessarily reflects poorly on you, I had the same problem when I graduated almost 18 years ago due to over saturation of the job market. But, not everyone will look at you in the same light. I'm sorry for this. I would go to your manager and tell him/her that you feel much more comfortable with your night shift preceptor and that you feel that you have learned more with him. Then, and this is probably the hardest part, take a good hard look at what you have learned from both people. One thing I will tell you as a senior nurse that I cannot tolerate from anyone, is someone who tries to BS their way thru what they don't know. I don't know it all, I'm not omniscient. That's the beauty of having people who have different experience, everyone has something different to lend. So, if you don't know, you don't know. If you think you may know, it's ok to say, "I think this is the answer." And, then when you are learning the rationale, really learn why you are doing something. It's important to make the connections from a to b to c in critical care. That's how you are going to see the changes in your patient's condition and be able to intervene before things deteriorate. This learning curve takes time and experience. Don't ever be afraid to turn to a coworker and ask their opinion about what to do, that doesn't make you a bad nurse, it means you're using the resources around you. I still ask my coworkers their opinions when I have a difficult patient, and I have been a critical care nurse for almost all of my 18 year career. Buy yourself a CCRN study book, they are great reference guides. Carry it with you to work and use it when you have a question at work. Become resourceful and prove to those around you that you deserve to be in the ICU. Those are my suggestions to you, and those are the things that would impress me if I was precepting a new nurse and I saw her struggling. Always remember that this is your career, not a job. You worked hard to get through nursing school, and you graduated AND passed NCLEX! Give yourself some credit and realize that #1 you can't know everything, #2 it takes time to learn the skills to become a great nurse and #3 you're still new at this, and you CAN do it. I wish you the best, and if for some reason, you make the decision that ICU isn't for you, don't give up on nursing all together.