This is the most stressed I've ever been in my life... what should I do?

[newgradICUnurse, BSN]

I have gotten on here for the first time in years just to vent my frustrations and hopefully receive some much-needed advice and also to give a long-winded rant, so sorry for that. I am a registered nurse and went straight out of school to ICU and went through a training program. I work in a trauma/medical/neuro ICU (basically we see everything that the CVICU in our hospital doesn't.. and we have been seeing a lot more trauma lately). I have worked 1 year and 3 months on nights and I switched to days 3 months ago thinking maybe my stress level would be better.

I know we have a broken healthcare system, and we haven't exactly risen to a better standard after COVID has died down a bit in my state. I do not feel my unit is very supportive at all. Like everyone else during that time, we were tripled all the time, and now we aren't tripled as much but we only have one PCA for 40 beds, no support from charge nurses, and just not a friendly environment in my opinion.

I slaved away at night until every single person I had started with had gone to travel or to another hospital. I felt like every night I was every new grad's resource when I was still learning myself. I asked for experience as co-charge and charge nurse since I was the most senior of the nurses and I had seen nurses with less experience than me do it. My request was pretty much ignored and now that I am on days someone who had only been on my unit for 6 months became the charge nurse. It is okay, I know I am still considered new amongst a lot of nurses and I do not count myself "worthy" (but I am willing to work for it) but it just hurt that it feels like there is still a high school type favoritism going around- and no real good reason why I am not qualified or why I can't learn. 

I switched to days, I didn't expect too much of a difference and I most definitely knew I wouldn't be a charge nurse at that point because the charge nurses on days are like 25 years, my seniors. However, I didn't expect to feel so overwhelmed and I expected to have more help. I am having the same difficult patients from night time; multiple GSWs, maxed on all pressors, but on top of it micromanaging and they treat you like you are just another number. I had a charge nurse see me with a situation where I had a patient on epi,levo,vaso,neo, bicarb drip, insulin drip, given multiple blood products  before 1 pm and was arguing with me because the night nurse had not called OPO for one of the triggers and because I was also delaying calling even though it was delayed for several hours before my shift started. All the trauma patients, dying patients around me, and just a sense of not being appreciated has been weighing on me. But this day, it was just like the straw that broke the camels back. 

I understand.... it is a charge nurse's job to follow up with paperwork and charting. But how in the world can you not help me with some of it when you see me in that situation? Not even the charge nurses at night are familiar with the brain death testing paperwork and all the things that a medical examiner's case requires....I mean I have a patient that should be 1 to 1. And I have another patient. And you ask me to come to the desk to fill out a paper again cause I put the time in wrong...And not too long after the patient passes you ask me if I'm caught up and can I take another patient? Never mind how I am feeling... that it is only the second time I have put someone in a body bag.

There are a lot more stories I can tell like this....and on top of this, I have an orientee who is more stress than I can bear right now. I am trying to show all the love I can, but she definitely takes more time up and requires attention to detail more than being an asset to me currently.

As for the advice part.... I have an ASN. I will finish with my BSN in August. I will also complete my two-year contract in August. However, I don't know if my mental sanity can take it until then. I am watching young people die all the time, putting all my emotional and mental effort into this place. I got a kidney stone working here, have flared up my Crohn's disease...and feel overall miserable.

 

My original plan was to finish my two years, along with my BSN, and continue working in this ICU until I can get the other prerequisites for CRNA school and start school in May 2023. But I don't know what's right anymore. All my family and friends say to try to stick it out until August, but it's very difficult. I hate going to work every day.

I feel that I will like anesthesia but now I don't know because I know it's stressful as well but I really don't know what other fields ill like. And on another note, if I leave here now, and still decide to go to CRNA school does it look bad (after I get accepted) that I have a year in another practice setting that is not ICU while Im waiting to start? I was thinking of applying to another ICU, but I don't know if they're all this terrible....and if they are.. then maybe I need to try another field and then do anesthesia.  Please... I need guidance... recommendations... anything. I am feeling burnt out and I genuinely care about people and my patients, and I was a nurse with a passion for nursing, I come from a family of nurses. But my battery level is on low... I am running on fumes and feel so underappreciated. Any advice is welcome

[JKL33]

I'm not in your shoes right now so...take it for what it's worth:

I pretty much would have almost zero long-term tolerance for the scenario you describe. Even so, I say do everything in your power to stick it out. You really do have the finish line in sight, so to speak.

Find your peace/center/whatever you want to call it and then survive the next 4 months by steadily putting one foot in front of the other. Prioritize according to the resources that have been provided. Do it pleasantly even if others aren't going to like it. E.g. tell charge nurse, "I can't come to the desk right now." Refuse to be emotionally burdened by all the various things. Just prioritize and move on, prioritize the next thing and move on. At every turn, look neutrally at a situation, see what needs to be done. Wants don't count. Wants are for when people pony up resources.

As far as the orientee, none of us like to hear it because we do want new nurses to have good training and a solid foundation, but the fact is that you MUST prioritize patients. You need to move at your pace and your orientee will need to keep up or else they also have the option of addressing the issue of their training with management. I cringe to say it, but it is not primarily your problem--it is squarely on management's plate. Hospitals said they wanted scads and scads of brand new nurses, they worked **HARD** for this moment, pissing off untold numbers of experienced nurses to get to where they find themselves today. They own this 100%. So put that off your plate.

Wake up tomorrow like a brand new sun has risen and this is the way it is going to be. Don't absorb negative energy, leave it right at its source and just go on about your next thing.

I think you can do it.

[Beausoleil]

2 hours ago, newgradICUnurse said:

And on another note, if I leave here now, and still decide to go to CRNA school does it look bad (after I get accepted) that I have a year in another practice setting that is not ICU while Im waiting to start?

Who cares how it might look to some as-yet unknown entity? If you can make that change, go for it! I’m guessing that’s the advice you’d give to your bff or little sister/brother…or perhaps a patient…if one of them was in your shoes, isn’t it? When your mental and physical health are suffering as yours clearly are, all bets are off when it comes to adhering to societal, familial and/or self-imposed timelines, plans and the like. From what you’ve shared, and how you’ve shared it (I.e., clearly written with very few errors/extraneous details), I can tell that you’re not being hyper-emotional or irrational and you’re approaching this with clarity, which says to me that YOU have the answers! ? 

[kbrn2002, ADN, RN]

Would leaving before August cause you to either break a signed contract and/or require you to pay back any hiring bonus you might have received? If so take the first responders advice and take a deep breath, put one foot in front of the other and try to tough it out until August, that's only a few months away and you have survived this long you can make it a little longer.

If there's no downside to bailing out and finding something different then don't feel guilty about doing so. But as you yourself said, our system is broken. Look before you leap or you might just find yourself going from that proverbial frying pan into the fire. 

[HiddenAngels]

First, yea I was going to say the same as kbrn, see if you can tough it out until August it's only 4 months, 3 12s a week, it will fly by if you just take it day by day.  I found that when I'm in the most uncomfortable, critical situations, I felt EXACTLY how you feel.  I used to hate going to work.  I didn't want anyone else to die on me or have people just expect the person is going to die and we just let the course go as it may.  I get it, (the mental toll).  As far as the prepping for the morgue and stuff that's a whole other animal, I used to have to beg for help. Everyone acted too busy because they didn't want to deal with bodies or phone calls again now that covid has slowed down.  OH and don't get me started on the can you take another patient knowing you're still finishing up with the last (some of the charges don't care).

Second, since you saw people leave and felt the sting of aloneness it is going to seem overwhelming, it coincides with the illusion of choice.  But everyone's situations are different.  If you can focus and stick it out, the days will fly by and when you're just about done, I'm telling you, you're going to feel so good inside because you did this! 

Third, yes, you are going to encounter this at some (not all) other places.  Charge nurses/Facilitators on days are usually rooted in those positions.  I believe ICUs are seeing more trauma type patients.  The other thing is small hospitals versus large hospitals.  Large hospitals usually have more staff thereby you maaayyy have more help.  Smaller ones, forget about it.  They just don't have the staff sometimes.  The nurse assistants usually have one in ICU and the rest are covering 1:1s on the floor or either in the ED.  It's just a little tough right now in nursing.  Me personally, I would stay put and thicken my skin, and stick it out.  When I go in expecting to receive help, I feel let down, frustrated, and disappointed.  When I get out the car knowing oh, you're on your own today, let's do it.  I feel better prepared for the busyness of all.

Hope this helps!! Luck either way!  We're all rooting for you?