Too anxious for SICU? (long)

love-d-OR · Jan 30, 2008

I have no words of wisdom, but I just wanted to say GOOD LUCK!!!

rgroyer1RNBSN, BSN, RN · Jan 30, 2008

I know what your going through, Im a sicu NM, I experience this same problem with alot of older (no offense) nurses, who havent been in nursing that long, now I started in er and trauma so I wasnt so intimidated by SICU when I started there as a charge, but anyways its just because your in a new surrounding unit full of the sickest of the sick, give it some more time, ask supervisors for help when needed, youll get use to it soon, and if you dont you can transfer to a new unit, at least youll have some good experience right? My moms in the same boat, shes an older nurse who just transfferred from ortho and med-surg to my SICU. Everything will be OK. I promise.

K98 · Feb 1, 2008

I started in SICU as a GN. It gets better. It took me a good year to become comfortable. As I approach my second anniversary I'm very comfortable. Confidence in your own abilities is good, but confidence in your co-workers is important too. I work with a very skilled group, and can count on any one of them to support me if I have a problem. I will do the same for them. It's a pleasure working with these folks.

Dinith88 · Feb 1, 2008

I'm having some issues and felt I just needed to "vent" and maybe solicit some guidance from all my worthy colleagues here at AllNurses. I transferred to SICU on November 1st after 3 years in Med/Surg, where I started immediately after graduating nursing school. Becoming an ICU RN was not a burning desire I had; in fact, it was one of the last places I would have thought I'd be working. But late this summer my NM approached me and asked if I'd ever thought of working ICU. I asked her point blank why she was recruiting for SICU when we worked the medical floor. She just smiled vaguely and never really answered. Two weeks later there was a huge manager "shuffle" and she ended up as the SICU mgr. I was flattered that she thought enough of me to ask me to follow her to SICU, and I was ready for a change after 3 yrs. on med/surg anyway, so I agreed to transfer. Two other nurses from our med/surg floor also transferred about 4 weeks after me.
The first six weeks of my 12 week orientation were fine. My preceptor has been there for four years, is a relief team leader, and quite knowledgable, and has been supportive of me. She is very laid back, which is good for me, because I am an anxious person by nature. However, the week before Christmas I had some health issues (I have arthritis and experienced a severe flare up) and eventually ended up in the ED thinking I was either having an MI or throwing a clot. Fortunately, I was just diagnosed with "myalgia" and sent home to rest for a few days with Percoset. When I returned to work the next week, I was a nervous wreck. I felt as if any confidence I might have developed in the previous 6 weeks had evaporated. I don't remember being this anxious except during nursing school clinicals and check-offs. I've been in my NM's office twice in the last two weeks basically "throwing in the towel" and telling her I don't know if this is really the best place for me. She responded by saying she will support whatever decision I make, but she really thinks I need to give myself some time to adjust to the new unit, accept the fact that I DON'T KNOW IT ALL (and probably won't ever!) and give myself a break. During my 2nd breakdown in her office we discussed things going on in my personal life, and she advised me to get some "help".
I'm going to be 52 in April, and find that I am probably 20 years older than most of my coworkers. I am also a relatively "young" nurse with only 3 years med/surg experience. I am going through the typical "middle age life changes": my older son is gettng married March 1st, and my youngest daughter is graduating college at the end of April. I'm also in menopause (a good thing) and experiencing all the usual stuff that goes along it: hot flashes, night sweats, mood swings, etc. I'm not a good candidate for HRT due to controlled hypertension (which started when I started nursing school - imagine that!). I did go to my MD today, told her of my anxiety issues and she's prescribed Effexor XR (37.5 mg at night to start). I was excited about that until I looked up all threads about Effexor and now I'm anxious about all the side effects!
On the plus side, I feel I AM a great nurse; In addition to being a relief team leader on my old unit, I too was in the preceptor role. I oriented both GNs and students, and was always being complimented on how well I did. I know I am intelligent and hard working and can eventually warm to this new position, but right now, I just don't know that I want to work as hard as I feel I have to in order to "master" this new role. I know my clinical skills are sufficient and feel that I have learned A LOT in the time I've been in SICU. I just don't know if I can cope with this anxiety. I have trouble sleeping the night before I have to work, and my guts are literally in an uproar as I leave for work (I know where every bathroom is between home and work that is open at 0600!) The timing of changing jobs was probably not the best, but I'm nearing the end of my orientation (they did give me 3 extra weeks). My first day on my own is Feb. 13.
Thanks for listening. If anyone has any words of wisdom, please let me know!

Give the effexor a try. If your anxiety is sabatoging(sp?) your life in such a big way, maybe it'll (the effexor) help you get through this transition you're experiencing (in life, your job, etc.) Maybe in a few months (or longer) when these transition issues are past you, you'll come off the effexor and find yourself in a new (and better) place...and a hardened ICU nurse to boot :specs: Then...you can develope an ATTITUDE and be mean to your former co-workers and argue with people who post dumb messages at allnurses :devil: (kidding!)

heartrn35 · Feb 3, 2008

ggfifi,

I have to question what you are anxious about? I mean I know that ICU is an anxiety producing experience, but just make sure that your focus is correct. Worry about what your patients need, tasks you need to accomplish, thinking things through before you jump the gun...etc. don't worry about what everyone else thinks is important (unless you ask for their advice).

Just remember your not supposed to know everything at this point, co-workers who give you crap about not knowing whatever are just bitter and thoughtless. If the knowldge necessary to be an ICU nurse was easy ICU wouldn't be stressful...but it is.

Give yourself time to make this adjustment, and don't think less of yourself because you are anxious. Anxiety is just a sign that you care. If you didn't care...that would be a sign that your either; 1) too dumb to know you don't know EVERYTHING, or 2) in the wrong place.

You are going to do fine, just be patient with yourself.

bigmona · Feb 5, 2008

I took a job in ICU after working on a cardiac floor for about a year. I also felt like I hit a "wall" in my orientation...the first month or so was great, then after that, very suddenly, I felt clumsy and dumb and like I couldn't do anything right. The feeling passes... it's hard to start over in a new area... one thing that helped me put things in perspective is to compare my thinking and skills level TODAY to how I was the day I first walked into the unit..and even though I felt like I was learning nothing, that made me realize just how far I'd come. And if your NM singled you out to come with her, that should tell you something about your clinical judgment and skills!

cardiacRN2006, ADN, RN · Feb 5, 2008

ggfifi,
I have to question what you are anxious about? I mean I know that ICU is an anxiety producing experience, but just make sure that your focus is correct.

Some of us are just anxious people by nature. I get anxious when the wind blows too much. I worry about the cactus falling over, the birds being blown out of their nest, the screens coming off the windows....etc, etc.

That's why it is a disorder. It's certainly not pleasent, and the majority of us with anxiety don't choose to be anxious....

All4Seasons · Feb 12, 2008

I have 3 words for you,OP: "Life's too short"

If you were happy with your nursing experience in your previous position,if you were generally relaxed,enjoying life as a whole,then listen to yourself,and do whatever you know will make you happiest.

Sure,you could continue on in a position you didn't seek out because you were flattered that someone else felt you could do it,but at what personal cost? Only you can answer that. But,after years of blindly persevering anxiety in clinical settings that were,ultimately, doing me more harm than good,despite the fact that I was frequently hearing from colleagues and nurse managers about what a great nurse I was - I have gotten to the point where I recognize when it is not in my best interest to stay in a clinical situation, and I now move on if it's not the right 'fit' for whatever reason (as is currently my experience). Sustained interruption of sleep (for me) is a warning sign of an unacceptably high level of stress which I now take seriously.

Good luck with this! :)

ggfifirn05 · Feb 14, 2008

Just want to update and thank everyone that was kind enough to reply to my original post. Yesterday was my 1st day "on my own". I was assigned a POD #2 liver transplant pt. with CVVH running too. I actually had this same pt. on Monday with my preceptor - we were in the OR with him during the surgery running the CVVH, so I'm sure that is why they assigned him to me yesterday. I was VERY anxious when I found out he was my pt. but I pulled it together and made it through a very hectic day. My Team Leader (charge)was a huge help, especially when they trach'd the patient and placed a new HVA at the bedside. Unfortunately the CVVH machine kept malfunctioning but several other nurses came to my rescue to troubleshoot and we all decided it was the filter that was problem. There were many moments during the crazy day that I kept thinking, "I'm ready to give my notice" but by around 1600 I realized my charting was all caught up, the pt. was stable and resting quietly, and I could actually take a little break!

I have started the Effexor XR, but I think its still too soon to see any real change. My husband has been very supportive of me, as have all my coworkers. I really feel I can depend on them, especially after yesterday. I still feel like there is SO MUCH to learn, but I'm just taking it day-by-day. And I'm trying to cut myself a little slack too.

Thank you all again for your advise and best wishes.