Should I quit now in orientation?

[lacnola]

I'm currently working at an icu and about week 3 in orientation. The first week was all fine and dandy, it seemed like my preceptor was going to be great and that I was really going to enjoy icu. (fyi- I've been a nurse for about 4 years) After that, I feel like all hell broke loose and ive been thrown to the wolves. I was told that their motto is to let their orientees sink. Am i crazy or is that not the most ridiculous thing to ever say? Honestly, it scares the s**t outta me that they can let a newbie in the icu take full care of critically ill patients and "let them figure it out" when people's lives are on the line. I am new to the hospital also, so this makes me feel like I don't belong in a hospital like that with the care that they are providing.

After the first week, my preceptor has totally cut me loose. She is not available, and anytime I do approach her with a question she asks me why she should tell me how to do something again if she has already showed me once before. Also, anytime I ask her to come in the room with me to just make sure I am doing something right, she refuses and says I need to just figure it out because no one will be there to help when I am out of orientation.

Another thing I found out was that we are often stretched to 3-4 icu patients to 1 nurse when there is not enough staffing. When I asked my preceptor how can they expect nurses to take care of 3 people "circling the drain" when sometimes it is hard to deal with 2, she just laughed and told me to again figure it out.

Sorry for the long rant. Overall, I just feel like this is not the place for me. I am a nervous wreck every shift, not only for my patients but for my license. I feel that no one is "guiding me to be an icu nurse". I have just been thrown in there because their staffing is critically low. I have been battling with myself trying to figure out if its just new person jitters or this is completely all wrong for me. I believe i figured out that I need to quit. My question is, would you advise someone who knows deep down its not right and quit asap, or give it more time because the icu is a whole new level of stress?

[NotReady4PrimeTime, RN]

It sure sounds like a place I wouldn't want to work. New staff members need support and guidance while orienting to a new environment. There does come a point where people have to stand on their own two feet, but 3 weeks isn't it. You should be having regularly scheduled discussions with the nurse educator for the unit where you can explore your progress and also air your concerns about your orientation. If you're not getting this, you should insist on it. Your preceptor may be unfairly punishing you for turnover, frustration with ongoing short-staffing and other factors in the workplace that you have nothing to do with. That's not fair. That nurse:patient ratio you describe and her response suggest that it's a long-standing problem. I don't know that even a great preceptor could help you overcome that. If you truly feel that you can't continue there my advice would be to cut your losses now.

Having said that, I feel a need to point out that once a nurse has completed orientation in an ICU, there should be an expectation that the nurse will be able to handle a normal patient assignment - stable patients - with a resource person available to help out if things change. Not someone to hover over the new nurse providing direction, or to take over when the normal and expected occurs but someone to provide a sounding board and an extra pair of hands.

[delphine22]

Having said that, I feel a need to point out that once a nurse has completed orientation in an ICU, there should be an expectation that the nurse will be able to handle a normal patient assignment - stable patients - with a resource person available to help out if things change. Not someone to hover over the new nurse providing direction, or to take over when the normal and expected occurs but someone to provide a sounding board and an extra pair of hands.

I agree, but not at 3 weeks!

OP, you need to go to your manager now and demand a new preceptor. Yours is basically refusing to precept you. Does she have a full pt load in addition to the pts you have? Or is she basically taking this as her "well deserved time off" and hiding the whole shift? Neither is OK.