hyed

Thank you everyone for the input. I think I gain a lot from the orientation. It's just the first time happening to me. I will keep working hard.

The thing worried about me is "do not rehire" label. I was voluntary reassigned. They say I am not a good fit for ICU. But overall I am a good person with good working ethics. But just today the manager's attitude really makes me worried. He is very cruel. I am worried if he put a "do not rehire" on my file which may jeopardize my future nursing career. I don't know. I know he's mad because they have invested on me and it did not work out. I really tried my best and very respectful to everyone at work. I hope this would not prohibit me getting a new nursing job somewhere else. I am worried.

Updates: My manager asked me to either resign or terminate. So I chose to resign. Clear my locker and return the ID badge. He told me that there is no positions on other floor, so no internal transfer for me. The whole time he's very emotionless, kind of cruel. He was not like that when he first hired me. He seemed easy to approach and nice. And now he's treating me like watching a criminal. It's very difficult, because I feel I am also emotionally invested on the hospital. When they let you go, you are totally irrelevant. It made me think deep about career and workplace. Hospital and nurse are just business employment relationship. When you are no longer useful, they don't need to be nice to you. It's a hard lesson for my first big girl job.

Many people did not know how difficult it is to be a RN when English is my second language (my native language is Chinese). I am very fluent in English, and studied in US, passed the NCLEX. But communicating in ICU is a total different issue. When I get nervous, I cannot talk straight even my mind is very clear. When someone misunderstood me, I wanted to explain, but I feel people just won't understand. Like my preceptor would think I cannot tell the difference between oxygen and suction. That's really not true. When people throw an incomplete sentence, it's very hard to perform.

Thank you everyone. I think a lot about the loss of job. It's hard, and makes me doubt myself. I know they have really invested on me, and I tried hard. I woke up at 4:30am for my 7:00am shift, just trying to look up information before the shift report. I am trying to learn, and ask questions, but I still made some silly mistakes that make people doubt my ability. Example: I was helping my preceptor turn a patient with Bipap on. My preceptor took off the patient Bipap and put a nasal canula on. I was busy there just trying to help turn the patient, clean him off. My preceptor told me, "Turn it all the way up." I know she's talking about the oxygen, but at that time, I was hesitated because I have never turned a nasal canula all the way up to 15 that high. I thought it was for low oxygen level like maximum 6L. English is my second language. I looked at the equipment, and think, maybe she means she wanted me to turn the suction all the way up? so I did. She thought I could not tell the difference between oxygen and suction! I just did not know that there is a different type of high flow nasal cannula that the tubing is different. You can turn it all the way up. I doubt myself and the miscommunication led me to make a stupid mistake.

I am very sad and a little frustrated today because my manager just talked to me and wanted to let me go during orientation in ICU. I was lucky that I got an ICU job as a new nurse. I had clinical in ICU before so I feel I know basic critical care nursing, but I guess I am wrong. 1) It's not about the task, it's about communication I am very focused on my task (meds), and I have hard time multitasking (listening to family, overhearing from doctors etc). It is even worse when nurses and doctors use abbreviations and medical jargon that I have never heard of! For example, when I report lactic acid is high to a doctor, he just said, "Do a D-dimer". I have no idea what a D-dimer is and I don't know how to look it up when he expects me to put his verbal order in. I have a preceptor, but a lot of time I feel people just talk to her instead of me. So I missed out a lot of information. Talking to doctors on the phone is also frustrating. I am new to the job and also new to the hospital. When I receive a phone call, they just say things quickly, I did not even get who they are. There is one time I was told by my preceptor to call a doctor, let him know that he's the new consulting physician. So I did look up his name and phone and paged him. I told him specifically that the patient's name, room number that is newly assigned to him. He said, "I don't know what you are talking about. That doesn't help." and hang up on me. Later I found out he's always like that. He doesn't really like when attending assigned him to be consulting physician when he feels there is not much he can do about. 2) I feel I need to be perfect, not making any mistakes. The manager said he let me go because he doesn't want to compromise patient safety. God knows I am always check check check. I am so fearful of making med errors. But I feel a lot of minor mistakes (not med mistakes) are due to my lack of experience. I was never told that or my preceptor showed me briefly before I can try on my own and master my skills. For example, drawing blood from lines. My preceptor showed me two different ways doing that. I was a little bit mixed up from drawing blood from peripheral line and arterial line. So after flushing the picc line, I did not attach the syringe to the line pot, I attached the vacutem to the pot, but of course it doesn't fit. So I was there thinking, my preceptor was yelling "What are you doing? I taught you this before." After the second time, I remembered and able to master the skill. But this becomes a reason for my manager to let me go. It's very frustrating because I feel I know what to do, but very slow. In ICU, people changes orders all the time. I do not have much time sitting on computer, waiting to see there are any new orders. When I am busy with things, and come back to my preceptor, she will say, "ok, there is a new order." I feel bad that I cannot multitask or keep up with the ICU world. Finally, I start to pay close attention to new active orders, like monitoring facebook newfeeds. I saw there is a new order of "Mg draw". so I grab all the supplies and went to my preceptor and told her what I am going to do. She said, it's an add-on. so just call the lab and let them know. They could use the blood sample the night shift has drew" I feel so dumb that I did not see the "add-on" words. 3) I feel so lonely and depressed. I am nice person in general, and trying to "obey the order" get things done quickly. But when patients sense my "not outspoken", they take advantage of it. They would be very rude to me, but very nice to my preceptor, even though I am the one doing the care, she is chatting with them. I feel so little. I feel no one to talk to, because no one would understand this. I even feel a lot of nursing falls into "gray area" that if an experienced nurse made all these minor errors, they would just shrug it off. For example, I failed to insert an IV on a patient. I feel so bad that I lack of the skill. My preceptor tried, but she failed too. But she's able to get over it quickly, like it's nothing to do with her competency. I don't know how to manage the stress and self-doubt.