ICURN5305

Hello! I am writing this for all the new nurses (especially the ones that recently started in an ICU) that feel overwhelmed, incompetent, and like it may never work out. I desperately searched for these posts when I was a new graduate.. hoping to relate to someone who has gone through the same thing. I feel obligated to provide other nurses the comfort I needed years ago. (I will make separate posts for nursing student advice, how to pick your first job, etc.) I was in your exact position when I started a few years ago. I always maintained a great GPA at a (difficult) nursing school, so I assumed my first job in a MICU would be a smooth transition. That could not have been farther from the truth. I could tell you the first 6 months of my nursing career caused me anxiety, depression, and lack of self confidence. I wish I could go back in time and tell myself a few things that I will tell you. 1. Stand up for yourself- relentlessly and without guilt. If you are not getting what you need out of orientation, you need to ask as soon as possible for a change in preceptors. My advice- ensure you have ONLY one or two preceptors during the first two months of your orientation so that you are not "starting from scratch" everyday with a new preceptor. You need someone that knows your strengths and weaknesses so they can help you improve constantly. I had a a new preceptor every 1-5 shifts. I asked ONCE to have a more steady preceptor, but by then, it was too late. I was too behind. I felt it was my fault, not theirs. I didn't want to cause problems. Looking back, I would follow the advice I'm giving you during my first three weeks. 2. You ARE intelligent BUT you will feel you lack common sense for the first few months (especially if you were not a nurses aid first- I wasn't either.. I survived!). Small tasks like quickly making beds, doing baths, untangling masses of cords/wires will make you feel overwhelmed. Especially with a preceptor/other staff watching. This is NORMAL. You will learn with repetition and time when you're on your own. 3. You probably will feel bullied at some point during your new career, especially if you are having a hard time adapting to your new environment. There are nasty nurses out there that love to watch new people fail- probably because they feel they are a part of an exclusive group of people that could do this job. You MUST remember it is NOT JUST YOU. I can guarantee that many other staff (new and old) feel the same way, but never speak up. If possible, ask other staff that you can trust if you have questions or need help. Also important- Try to put yourself in their shoes. They have not been a new Nurse in years! They probably forget what they did and did not know at that point in their career. Remind them that you are asking for help because you are inexperienced and want to ensure the safety of the patients!:) 4. You are NOT a failure if you require a transfer to another unit to get basic experience first. I would have read this advice 3 years ago and scoffed. It's true! There was no way a 4 month ICU orientation was going to prep me for what I didn't know ESPECIALLY with an awful group of preceptors and orientation process. Swallow your pride and seek out a position on a step down unit or telemetry floor. I did the same. I worked on a step down for a year, and I returned to an ICU. I learned basic skills with moderately sick patients. I could not have learned these skills with crashing patients every day. I am now regarded as a respected nurse, and I absolutely love my job in the ICU. It is crazy to think that I almost quit this profession. Hang in there!!! It's rough in the beginning. You can do this! good luck! :)

Hi! I am also at a level one trauma ICU. I actually have not started yet. I will be starting in the coming weeks, so I will keep you updated and I hope you will do the same! Feel free to private message me. :)

Thank you for your input! While I respect that many nurses feel it is not the best decision to start in ICU, I love to hear that many also think it is doable. I'm glad to hear that it is realistic and you know this from your own experience. Is it common for new nurses in the ICU at your hospital to succeed?

Thats great to hear. I hope it can provide a good background for more specific ICUs in the case that I am ever interested.

Cardiac care unit is CCU. Unit ratios on both are 1-2 patients per nurse. I believe the unit hires about the same amount of new graduates each year (it is a HUGE ICU), but that is something to think about. I should have stated that differently: there are many younger nurses- some one or two years of experience and they are absolutely amazing at what they do as in precepting and caring for patients from what I have heard and seen. The reason I would say there are less new grads on CCU is probably the smaller size (less beds), but again, it is quite possible that you are right.

The staff was great on each unit, but I especially liked the larger group of younger staff on ICU balanced with more experienced RNs. I know if they have many new grads, that they must have a lot of experience precepting. I realize that sounds like I answered my own question about which unit to pick. If you are familiar with ICU, do you have any advice for or against/encouragement/tips?

I provided additional info to the comment below. Please let me know what you think! Thank you!

All three are at the hospital for the same pay and about 45 minutes drive (doesn't bother me). ICU orientation is four months, while the others are three. More time is provided if needed. I would be part of a residency program for each. Long term, I have not decided at this point, but from what I have gathered, ICU puts you in a great position to start many different paths. Should have included that in the first post. Let me know what you think and thanks for responding!!!

I am a new graduate nurse deciding on what position would fit me best as a new graduate. My choices are ICU, step down, and CCU. My shadowing experience in both CCU and ICU ensured my interest and passion on both units. My shadowing experience on the step down unit did not interest me. I know there are MANY different opinions on new graduates starting in ICU or step down. I would appreciate any new graduates that started on either unit sharing their experiences, mistakes, thoughts, encouragement, etc. I suppose I am looking for a positive outlook on beginning in the ICU because that is what I am truly passionate about, but negative experiences are welcome also. All opinions are appreciated. P.S. I have only two days to make this decision. Thank you.