I'm orienting in the cardiac ICU and tonight I just cracked. So far I've lost four patients, including one last night. It was awful because it could have been prevented. Despite continuously updating the doctors, they wouldn't put in any new orders for him. Just monitor him,†they said. Mid shift he coded and we lost him.
I'm exhausted tonight.
My patient looks bad: vented/sedated, febrile, lactic/trops/sugars/ WBCs/ BP/HR increasing, poor renal fct, on many drips and not doing well. Something bad is going to happen. While hanging a new gtt I froze in the room, started feeling tightness in my chest, hyperventilating, and crying. I don't know what to do. What if he codes?
My preceptor sent me away to hide for a bit. I've locked myself in the staff bathroom. I feel so pathetic.
I soooo want to be a cardiac ICU nurse. I don't want to give up. As stressful as this is, I love what I do. But many these people are so sick and I feel like I'm going to kill somebody. Though I'm just following orders, it was my hands that killed people. My orientation is ending next week and I feel so overwhelmed.
Does anyone have any advice for pushing through this? Also, please share stories of similar experiences, so that I don't feel so alone right now.
I am so sorry you are feeling so overwhelmed. I will tell you as someone who started in a specialty right out of school, you are either cut out for it from the word "Go" or you need a little better orientation into nursing first. That's why so many suggest going into Med/Surg first. I didn't do it either. I went into OR. I couldn't have felt more overwhelmed, beaten down, and frustrated if I tried to work with no arms. I had techs and doctors that hated me, nurses that ate me, and apathetic management. My training also sucked sincerely.
I went into Med/Surg after 2 years in OR to get back to basics. I'm so glad I did and I wanted to be a Cardiac ICU nurse. I don't know what the next 5 years will bring, but being the best nurse now is what's important to me. I have had to deal with death in both the OR and on my floor. I have only had 1 patient under my care die on my shift. She came up from ER dying (DNR). I haven't had that one patient that has touched me so much that I cry. I am saddened, but I'm not a cold heart. I can at this point divorce my feelings and understand it is the way life plays out. I will have that patient one day. I can't imagine 4 though. I think even that would bother me enough to hole-up in a bathroom and cry.
I understand all to well the Doctors who say "we'll just monitor him" as you see the BP rise, breathing become labored, mottling setting in, and no, the patient isn't DNR. I recently had a patient whose BP went to 172/111, I called the Doctor (I work night shift, so yeah, they just love hearing from me during the night) and he said "We'll just monitor her. She'll calm down." She did, but that's not the point. We've had patients drown in their own fluids because the Doctor didn't think all the crackles, wheezing, and dyspnea was fluid overload and didn't order Lasix that could have saved their life. It is frustrating as hell.
Even in my unit I can have patients that are in the same condition as your patients in ICU, although the worse the heart condition they will be shipped out to a better equipped hospital.
Just remember that you are new. It will be the singularly most difficult and overwhelming year of your life. Nursing school was cake compared to the learning curve of a new grad. If you do think it's too much now, don't be afraid to take a step back and find a job in Med/Surg and get your feet on solid ground, then go back. There is absolutely no shame in doing that. I love what I do, but I went through pure hell for over 2 years before I got to where I am. Many things will just never be easy about nursing, but how you choose to handle them will determine if it is easier.
SouthernizedRN, ASN, RN
10 Posts
I am so sorry you are feeling so overwhelmed. I will tell you as someone who started in a specialty right out of school, you are either cut out for it from the word "Go" or you need a little better orientation into nursing first. That's why so many suggest going into Med/Surg first. I didn't do it either. I went into OR. I couldn't have felt more overwhelmed, beaten down, and frustrated if I tried to work with no arms. I had techs and doctors that hated me, nurses that ate me, and apathetic management. My training also sucked sincerely.
I went into Med/Surg after 2 years in OR to get back to basics. I'm so glad I did and I wanted to be a Cardiac ICU nurse. I don't know what the next 5 years will bring, but being the best nurse now is what's important to me. I have had to deal with death in both the OR and on my floor. I have only had 1 patient under my care die on my shift. She came up from ER dying (DNR). I haven't had that one patient that has touched me so much that I cry. I am saddened, but I'm not a cold heart. I can at this point divorce my feelings and understand it is the way life plays out. I will have that patient one day. I can't imagine 4 though. I think even that would bother me enough to hole-up in a bathroom and cry.
I understand all to well the Doctors who say "we'll just monitor him" as you see the BP rise, breathing become labored, mottling setting in, and no, the patient isn't DNR. I recently had a patient whose BP went to 172/111, I called the Doctor (I work night shift, so yeah, they just love hearing from me during the night) and he said "We'll just monitor her. She'll calm down." She did, but that's not the point. We've had patients drown in their own fluids because the Doctor didn't think all the crackles, wheezing, and dyspnea was fluid overload and didn't order Lasix that could have saved their life. It is frustrating as hell.
Even in my unit I can have patients that are in the same condition as your patients in ICU, although the worse the heart condition they will be shipped out to a better equipped hospital.
Just remember that you are new. It will be the singularly most difficult and overwhelming year of your life. Nursing school was cake compared to the learning curve of a new grad. If you do think it's too much now, don't be afraid to take a step back and find a job in Med/Surg and get your feet on solid ground, then go back. There is absolutely no shame in doing that. I love what I do, but I went through pure hell for over 2 years before I got to where I am. Many things will just never be easy about nursing, but how you choose to handle them will determine if it is easier.
Good luck!