Should I give up?

I'm sorry this is happening to you. Im still a student, and so cannnot give you an idea of where you should be. However, I think you are the only one that can determine if YOU are cut out for it or not. The people on this thread dont know what your knowledge and skills are, although it sounds that you are forgeting to do very important things.

I personaly believe that everyone learns at a different pace. How long was your new grad program? I think you should talk to your preceptor and ask for her take on this. Does she feel that its normal for you to forget these things at this point? Maybe you need to make little reminders to yourself. When I did my CTU preceptorship, I had a notecard I took with me. I wrote all the things I had to do and at what time they were due. It helped a lot. You should try it. How come you forgot to suction your patient and titrate BP meds? Where you busy charting? I dont mean to sound harsh, but you need to figure out what is taking up your precious time and time manage accordingly. I have been know to set alarms for things like 24hr urine collection and things of that sort. Whatever it takes, do it.

When you are new at something, its impossible to get everything down. Dont give up on your 4th night, but if your heart says that a step-down unit will be more comfortable and safe for you,, then go for it.

I know a new grad at my hospital that worked as a nurse assistant in the neuro/trauma ICU before graduating, so when she got her license she started working in the unit as an RN. She felt so overwhelmed she ended up stepping down to a neuro/surgical floor. She loved her decision and says that she needed a slower, but intense unit to start withs, and that eventually she will head back for the ICU.

Again sorry for what you are going through, and good luck

I don't have any advice for you. I am a new LPN on a busy cardiac floor, and I am so busy trying to keep my head above water that I hardly have time to look at the telemetry, which is the reason that the patients are there! I'm just doing my best to do my assessments and pass my meds that anything unplanned that pops up, which it always does, puts me so far behind on everything. I'm one of those people that is very calm on the surface, so even if I am overwhelmed, my charge nurse doesn't seem to believe it because I'm so cool and collected. They overestimate me and throw me to the wolves because they seem to have some strange notion that I can handle it! It would be flattering if it weren't so darn scary.

I've been at it for five months.

When in doubt, check it out.

If you like you aren't quite keeping up I would strongly suggest a transfer to a less acute floor. Unless you have very strong support and resources it might be less stressful for you to find a floor that has a little more med-surg or less complex cares.

I am sure with a little more basic practice on a less complex floor you will feel more confident in basic skills, routine assessments on basically stable patients and get more time to learn charts, ask questions, pester mentors and talk with patients who are more alert and oriented to you.

I have learned so many things over my past year of nursing from basic med surg floor to now complex cardiac. I feel more confident of all the little things, which allow me build more acuity on top of that.

Take it a step at a time, but I think jumping into CVICU was prolly a pretty scary leap and there is nothing wrong with taking some time before making that kind of acuity committment!

Best of luck!

Taitter

How are your organziational skills? It sounds like you need a system.

I am completing my first year and I work in a newborn ICU. What I do is put a little card in my pocket with each patients name on it. Under each patients name I write assessment times, procedure times, med times. If there is a lot going on with my patients on the back of the card I write every hour down and put each pts initial and a 'M' for med (I put an asterick next to the M if it is a med that absolutely CANNOT be late), 'A' for big assessment, 'a' for a little assessment (vitals and breath sounds), CBG, 'L' for lab, etc. By looking at this, I can see if I need to flex my time a little bit. If multiple patients need tubing changes, I decide when I am going to work that in by looking at my schedule. When I have a spare minute I go through my card and cross off everything I have completed. Some days are crazy, some days are calm. Organization is the key. If you enjoy the other aspects of your job I suggest trying to figure out a system to organize your work before calling it quits.

I want to add that even if you have a system, issues will occur. Being organized doesn't stop an IV from blowing, a pt from self extubating, etc. By having the card though you can get help from other nurses, you can ask if they can get Pt. A their 1200 med, etc. If you don't work in a unit where you help each other out like that, your 'list' allows you to pick up where you left off before the crisis.

If I had a dollar for everytime quitting crossed my mind this first year I would be able to pay off my student loans.

I'm not on the CICU but on the stepdown unit and often feel overwhelmed on my easier unit. So I can imagine how overwhelmed you must be!

I have an organization sheet similar to WeeBabyRN's. I just made it on word. On the top I have names, room #, diagnoses, activity and diets. I have spots for vitals so I can see changes easily. The rest of the shift is divided into hours and I write the meds due and anything else that I need. There is also a spot for Is and Os and a little spot where I mark off everything I've charted. It feels really good to mark stuff off and it feels even bette to chuck it in the shred bucket at the end of the shift.

It took me about 6 months of asking every nurse I saw about their brain sheets" before I came up with the one that worked for me.

And if the unit is just too hard for you at this time take a little break on an easier unit and go back. They'll be glad to have you back I bet.

I am a third semester nursing student and I can't imagine going to ICU my first year! How scary! All of my instructors have advised that I should start with a med/surg floor. They say that a med/surg nurse can transition more easily into another position. Med/surg will allow you to become comfortable with your basic skills and then you can build on those. Also, you will be exposed to, and learn how to care for, a variety of patients with different illnesses and health problems. That is my plan when I graduate. Don't be so hard on yourself though. I think it takes time to gain confidence. I guess only you know yourself well enough to decide if you can do this or not. I know that there is no way, with my confidence level right now, that I could handle that kind of responsibility. My nervousness would get in the way of being effective.

Good luck with whatever you decide. That is the great thing about being a nurse, you can keep trying new positions until you find your fit!

I've been at my job (first job as an RN) for 5 months now. I oriented to med/surg first...and now I'm doing CCU. THey tried to pullme off orientation once...and I asked for more time. I felt like you. It's difficult as a new grad.

Now...I come in just a little early 15-20 min for every shift. I ask what I have....even before report I can start making lists of what needs to be done so I don't forget things specific to diagnosis. It might seem like poor time management...but it helps me since my critical thinking on the spot might not be where it will be eventually. At the top of every hour I look at my list to see if I should/could have done something.

I still miss some things...but at least I catch it at the end of the hour. GOod luck to you...and I really think you need to give it more than 4 days to assess yourself.

Also...not to get lengthy...but I had a conversation with my NM because I was feeling like you are. She told me I was too much of a perfectionist..and that it's hard as a new nurse knowing where you *should* be compared to the experienced nurses you work with so often. Just ask many questions. The nurses who work with me....I forward then. I tell them.... "I ask alot of questions. Please don't take offense...and if you don't know...don't think I'll look at it as a reflection of your skills. I want to learn as much as I can from you while I'm here"....most of them laugh...and occasionally roll their eyes but in good nature.

*** to specify...I haven't been on orientation for 5 months. I had 6 weeks on med/surg...then worked the floor for a couple of months...then started orientation to the unit. I wanted the couple of months on med/surg to work on pt loads and time management.

Thanks so much to everyone for their replies!!

I'm going to talk to my manager and preceptor on Monday, but I think maybe I'll give this a few more weeks before I give up. I really like the unit, the people are fantastic, and I like the type of patients.

I'm feeling so much better about this right now, I hate the thought that I may overlook something crucial, but I think I CAN get better. :balloons:

I'm going to revise my "brain" sheet this morning.

Hi,

Welcome aboard! I've been a CVSICU nurse for>20 years so I think I qualify as an expert. The main problem I see is that you are focusing on what "tasks" need to get done on your shift not what "process" needs to take place to recover your patient. I go many nights without suctioning my patient more than once,-it is a task. Do they have increasing airway pressures, audible rhonchi, hypoxia, are they coughing? Suctioning for the sake of suctioning is a task in can do more harm than good if not clinicaly indicated. My best suggestion is try to look at your patient and say "what is my priority problem for the next 15min" Learning to set priorities and troubleshoot labile patients takes a while to learn. It may be getting caught up on your charting is the most pressing problem for the moment. Try not to think about what you have to do this shift rather what will improve my patients' status right now. What's most wrong with my patient and what do I need to do about it? Taking step down pateints is a great way of gaining experience. If your unit is anything like mine, the senior staff fight over who gets the fresh open hearts. If you can take the step down patients and help out with the fresh hearts when there is something going on everybody wins. 6mos from now you will be fighting for the fresh post ops.