Resign in orientation

[AJ1980]

I just started a new job in a different department/area of nursing than my background. Im in a critical care nursing area. I feel discouraged as I thought I was doing better than what was told to me yesterday at meeting with manager and Charge Nurse. I was upset that I have to find out in a formal meeting later on that I haven't been doing right. I would have thought that would be something one would tell you right away especially when dealing with patient safety. I do feel like my orientation has taken me longer to learn than I thought it would. I have five years experience as OR circulator and Outpatient PACU but critical care nursing is completely new to me. I love learning especially love the critical care nursing but don't know if I need to give things more time or move on. I'm definitely humble I forgot what it's like to feel like starting over again. Right now I'm in Interventional Radiology and have been trying to learn our four different areas and a bunch of procedures, and learning ventilators and drips in short period of time and limited staffing. I was told that I need to be more confident but hard to feel confident in a brand new area of nursing and new hospital and doctors I'm not familiar with. I'm 4.5/5 weeks in orientation and thought I was progressing in right direction but after the meeting I'm now having doubts. I took the job thinking it would help me one day move into the Cath Lab(my dream). Now I'm wondering if I should stay and hope things get better or move on and try ICU and learn more critical care skills.

[nutella, MSN, RN]

From what I know (never worked in interventional radiology though but plenty of contact with that dept is a large teaching hospital) is that the RN can be the only RN in the dept and responsible for a variety of tasks, which also includes critical care elements. Because you do not have much support and things can go south plus you do procedures that require moderate sedation or patients are ventilated and what not - you need solid critical care skills. I do not know how you would do this kind of job without that. Granted, PACU gives you some exposure but not to the same degree that ICU work does. I agree that you need to be confident in your clinical practice but that is hard when you are still learning new skills.

I guess it is important to find out if your knowledge gap or clinical practice gap can be closed easily or if it would require longer orientation. And are they willing to invest more time into you or are they at a point where they feel you can not catch up and/or are not a good fit for that work. Working in an ICU would give you the opportunity to learn the skills in an environment that is more controlled with better support. Would they be willing to transfer you to a critical care area?

Lot to think about - I think they should have pointed out earlier that they feel you are not progressing according to what they had set up.

[Jules A, MSN]

Your post here was insightful and articulate so perhaps bring these questions/concerns to your manager and charge nurse to see what they suggest? If you can work together to come up with a plan that suits everyone it would be ideal. Best wishes.

[AJ1980]

Yeah I didn't like not knowing that I'm messing up until a meeting with Charge and manager. They have had me orienting with different people and one nurse does things one way and charge does things differently. It's hard trying to learn when things and people are inconsistent. Every nurse I've been with which some aren't even regular staff all do things different but then in the meeting being told I'm wrong. Sometimes I want to pull my hair out.

[Dodongo, APRN, NP]

I'm surprised you were hired in IR without ICU experience. You should come into IR/Cath lab feeling comfortable with critical patients. You need to discuss this further with your manager. Maybe you can do a lateral transfer to ICU instead?