Transferred to SICU, horrible orientation...what to do??

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I have been a nurse for 3 years 2 on a med/surg tele unit and 1 on a medical IMC unit so I have a good base background in nursing practice, my interest is in critical care and it is truely what I want to be doing but my orientation so far is making me miserable. I work at a well known level 1 trauma teaching hospital so I am expecting a wonderful orientation..I couldnt be more wrong! My first day my preceptor gave me 2 ICU patients and told me to do my thing with no direction while asking me multiple times if I was ready to cry yet. When I ask her about drips I've never seen and ventilators or anything i need explained to me I get an attitude. I have explained to her that I have never worked in an ICU so this is a whole new world to me. Today I had 2 patients one was a mess and gushing fluid from their abdomen, receiving tons of blood products on an insulin gtt using the portland protocol and having their fluids adjusted according to their abdominal output among other many other things going on. I was running back and forth like a crazy woman while she sat out at the nurses station, I did get everything done for my patients and at the end of the day she told me I need to be faster this is my 5th day working in an ICU. I asked her for suggestions on how to be faster or more effective she said she wouldnt have done anything different I am just not fast enough...I guess I will be slower when I am looking things up all of the time because she will not answer my questions. I dont feel like I am learning anything ,my preceptor is so miserable and unapproachable. Am I being unreasonable wanting a preceptor who can teach me how to organize my time as an ICU nurse as well as guide me through all of the new things I will have to learn to be a safe and effective nurse. How should I handle this, I dont want to make enemies as a new person to the unit but at the same time I need to learn how to do things correctly and have someone who is willing to teach me. Any suggestions on how to handle this would be greatly appreciated.

Specializes in pediatric critical care.

You need to speak to your ICU's educator and get a new preceptor right away. She's setting you up for failure, and if something happens you can bet your life she won't back you up. Why are you getting busy 2 patient assignments on DAY 5 of orientation, even though you have no ICU experience? And why in the hell are you getting a CRRT patient without proper training? I have worked peds ICU for 7 years, and I also precept. I would never let you have a CRRT patient unless we had no other choice, and then I would run CRRT and you would focus on meds and assessments, especially so early in orientation. I feel this is unreasonable for you to have to do all the learning on your own with no one to back you up, it's dangerous for the patient, and something needs to change pronto! Do you feel like you have even learned anything up to this point?

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I work in SICU and am worried about your situation.

CRRT patients are time consuming patients when paired with another patient. It is an assignment generally not given to newer nurses.

A request for another preceptor is in order.

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Specializes in Telemetry, ICU/CCU, Specials, CM/DM.

I would RUN, not walk, to your nurse manager!!! I would not work with that preceptor ever again and especially not accept an assignment with a patient on CRRT with out first being trained. Most CRRT patients that I have ever encountered is 1:1 also. I agree with others, she is looking to see you fail so get away from her ASAP!! You should explain to your nurse manager that this preceptor is not teaching or assisting you with your orientation. Good luck!!!

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"I am a B I T C H and proud of it"

"I made the last person cry and they quit"

"Are you ready to cry yet?"

Based on the above quotes alone, go to your manager and unit educator and ask for a change in preceptors. Forget about stepping on toes, just say her teaching style and your learning style is not compatible and leave it at that.

I had a preceptor when I was in ICU who made it very aware she is known to make people cry and she was damn proud of it. May I mention she was a very unhappy person in her personal life and took it out on me? I left that unit so fast and never looked back.

I don't know where these types of ICU nurses come from. There are some very good ICU nurses who love to teach and don't have that mentality. I think something need to be done about these types that feel it's ok to try to make new nurses cry like they have really accomplished something. Lateral violence at its best.

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Wow, I totally understand how you feel. I am currently being precepted by more than 1 RN due to low census, so basically I'm put with whoever gets to work that day. Well it's not so bad except for this 1 particular RN who is always humiliating me and telling me that everything I'm learning from every other RN other than herself is wrong. I know how you feel, whenever I work with her I cry the whole drive home from work. I don't know what to do, I'm scared to report her because I'm a new RN but I also know it's not right to be abused by her. :(

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You may feel ambiguous about going to your manager for your own sake, thinking you may have to "tough it out" with this preceptor. For your patients' sake - you need to. To expect a nurse with no ICU experience to be taking care of ICU patients without being taught how is archaic and very risky. Any manager who cares about patient care and safety in his/her unit will step in and assign you to someone else, and remove this person from being a preceptor. She may be a very capable nurse, but is unfit to welcome and train new nurses into the unit. Don't tolerate this! Let her know you have some back bone and you take being a patient advocate as your highest calling. It is very distressing that this goes on in our profession. It will continue to until we work together and stop tolerating it. It know it is easy for me to sit here and write this, while you have to go in there and do it. Know there are many of us out here cheering you on, and no doubt others in your unit who (maybe secretly) don't like it either and haven't had the gumption to address it. Good luck.

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Specializes in ED, ICU, PSYCH, PP, CEN.

On my first travel nurse job I had a charge nurse who would brag "I can make a travel nurse cry in 30 minutes or less" I took her into the break room and told her that she was going to be respectful to me, or else. I then went to the director of the unit and told her.

She was demoted from charge duties, forced to go to anger management class, and eventually fired from that hospital.

The house super told me that she had cost the hospital a lot of valuable nurses because she was so scary to work with.

Amazingly enough the 2 of us work together now at another hospital and it is okay.

Some people just have to learn that enough is enough

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Specializes in Oncology.
On my first travel nurse job I had a charge nurse who would brag "I can make a travel nurse cry in 30 minutes or less" I took her into the break room and told her that she was going to be respectful to me, or else. I then went to the director of the unit and told her.

She was demoted from charge duties, forced to go to anger management class, and eventually fired from that hospital.

The house super told me that she had cost the hospital a lot of valuable nurses because she was so scary to work with.

Amazingly enough the 2 of us work together now at another hospital and it is okay.

Some people just have to learn that enough is enough

Bullies rely on the assumption that their victims will not fight back. Thank you for breaking the cycle.

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I would ask her what are her expectations of things she will teach you as a preceptor. Then you may gauge from her response if her teaching style fits your learning style. I'm gonna guess it doesn't but at least it gives you a diplomatic excuse to ask management to switch preceptors.

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Specializes in Medical/Telemetry. Now ICU.

I would mention something to the preceptor. Then go straight up the chain of command. If they don't give you a new preceptor immediately, i would quit. I would never stay with someone like that.

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Specializes in Telemetry/Med-Surg.

Just to give an update....my day was aweful today CRRT patient plus another and got the are you going to cry yet line and not much help....so when I talked to the manager about it I told her to just transfer me back to the IMC unit I came from, I am so disgusted with the preceptor and the management of the unit that I could not stand to stay there...after voicing my concern about having to take inappropriate assignments such as 2 ICU patients and an IMC patient one of which was a fresh liver tx and not getting much help in return I felt my license would be on the line working there....policy is no more that 2 patients if even one is icu status. I am so disappointed because I enjoy challenging patients and learning new things so I dont feel stagnant. Thankfully there are 3 other ICU's in my hospital hopefully one of them will have a supportive preceptor waiting for me one day. Thanks for the kind words and support in your postings, it helps to know not all nurses "eat their young".

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Edited because I just saw your update. Sorry to hear that you're transfering back to your old floor! If management isn't much help it's better to find out now. That is super scary, for you and the patients.

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