Quitting the CVICU

[KyRN, BSN]

I am in a little bit of a dilemma. I've been a nurse for a little over a year now. I started in the CVICU about 6 months ago after leaving my telemetry job once COVID had calmed down. This is a high acuity hospital and unit. I never really get any feed back from management, good or bad, other than apologizing for the assignments I've been given sometimes. They've given me paired devices (IABP, impella, CRRT, LVAD), placed in ECMO rooms pretty consistently when COVID was up. Which lead me to believe that I must be doing okay if they trust me with these patients. However, I just don't feel like I've gotten enough education on these actual devices because the unit has been so crazy.

Our education days on devices are just when the reps come in for a couple hours and that's it. They don't physically show you how to work the devices, just how they work. I'm not sure If I just don't enjoy this area, or if I'm just not competent enough. Feed back from my coworkers are that I am doing well and that I am too hard on myself. I get sick patients. But I just don't feel that I know everything I need to know to care for these patients with these devices. For example, I had a low flow alarm d/t P2 level on an impella and had never seen it before (2nd-3rd time with an impella) and wasn't sure what todo with it. So I had just asked a more experienced nurse what to do with it to make sure I'm doing the right thing. The reaction to me asking her that was unpleasant lets just say that, and that I should have known. Before that, I actually started believing that I was doing well. I started thinking about all the other things I don't know, or don't feel comfortable with. I've just always been okay so far. Even trouble shooting an LVAD I probably would have trouble with, besides changing batteries etc. Honestly only recently I feel 100% comfortable with IABP. 

Im trying to decide if this is worth all the mental anguish this is causing me. I HATE feeling like I may not be doing everything I can for my patients. I think about quitting all the time, I just had always wanted to go back to school but I'm not sure what for so I thought sticking some time out in the ICU would be the smart move. I also really wanted to do travel nursing, but can't do it if I change specialties again for at least another year. Lately I've considered some kind of NP but in an office setting. I think If I felt more competent and had more education I would feel better, I'm just so exhausted. It is difficult to get ahold of our educator or management to ask questions. I've even bought books and watched Youtube. My work environment can be pretty cut throat at times and at this point I don't even want to ask anymore. I also don't really feel like they would care to hear me, they'll just hire someone new. A few other new nurses to the unit have shared similar experiences without me even saying all this. 

In general, I find the CVICU stressful, and so far not as rewarding as I thought it would be for me. I'm proud of the skills I have now but its just a lot, and maybe not enough.  Is it me, an educational problem, the unit? Im trying so hard to be positive on my unit but it is literally impossible some days and I don't want to be the Debbie downer of the unit, especially if its just me that is not the good fit for the unit LOL. 

[Emergent, RN]

It sounds awful. 

[Sheila Gebel]

What you are feeling is real.  Don't apologize for it.  Learning CVICU is hard enough without the additional stress that COVID has created for nurses.  I am not sure where you are located but Abiomed provides in person and on line training for nurses regarding management of Impella - including CEUs.  Here is a link to free on line training: https://www.heartrecovery.com/education/nurses

 

[RNperdiem, RN]

I guess you probably work at Meatgrinder Medical Center. I have worked with former CVICU grads who tell me of the unsupportive management, unreasonable assignments and a lack of respect for nurses. Nurses who survive more than a year or two in those conditions are the exception.

Most nurses will take their hard-won skills to hospitals with better conditions and do so much better. Most are in ICUs, others are in procedural areas like Interventional Radiology. 

There is a lot to learn in your unit, and it looks like you are holding up your end by being proactive about your learning. Does anybody else in your unit feel the same?

[KyRN, BSN]

9 hours ago, RNperdiem said:

I guess you probably work at Meatgrinder Medical Center. I have worked with former CVICU grads who tell me of the unsupportive management, unreasonable assignments and a lack of respect for nurses. Nurses who survive more than a year or two in those conditions are the exception.

Most nurses will take their hard-won skills to hospitals with better conditions and do so much better. Most are in ICUs, others are in procedural areas like Interventional Radiology. 

There is a lot to learn in your unit, and it looks like you are holding up your end by being proactive about your learning. Does anybody else in your unit feel the same?

Yes. A few other nurses have expressed their concern and often say they feel overwhelmed. Because I’ve been there a few months more than them they often ask me questions, which is great but feels very much so like the blind leading the blind. I just wish there was a way for there to be a more well rounded education, and less kind of on the fly surprises. It just doesn’t seem like it should be this way. I’ve also only ever been a nurse during the pandemic so I have no idea if this is normal or not. 

[SkiingRN]

I'm not sure if you have looked at the American Association of Critical Care Nurses, but they might have some resources for you. Is there another hospital in your area you could transfer to? I'm not sure if that would be a better environment, but you could at least stay in CVICU if that is what you want. You could also look into a different ICU in the same hospital. I worked in CVICU for a few years (not during a pandemic though), and I agree that the stress I experienced was not worth the very few and far between rewards. What a bummer that the nurse you used as a resource decided to belittle you instead of support you. We as nurses need to fear the people who don't ask questions, not demean the ones who do.  In the end, you gotta do you. You have to do what makes you happy. The hospital doesn't seem to care if you are happy and satisfied with your job, and you can do just as much good with less stress in another area. Good luck. 

[suzil]

I'm sorry you feel that way.  But these things are what I often see when nurses that are way too new in nursing jump into a field they are too inexperienced to deal with.  Save yourself because the hospital will not save you.  Do not beat yourself up.