Troubles in CVICU

labrador4122, RN · Mar 9, 2008

Hi everyone,
I'm a new grad in a CVICU, been off orientation for almost 4 months, and keep waiting for things to get better, and they're slowly getting worse.
I used to have a good reputation at work a couple months ago, now I can tell it's getting bad, people don't say hi or talk to me like they used to. (I've made more than a few mistakes). I've asked my preceptor and boss about my job performance, they both told me I'm doing fine, but I'm pretty perceptive, and can tell people don't trust me, and that I'm not doing a good job.
I don't like critical care, I get a sick, panicky feeling when patients are critically ill, and can't think clearly. I excelled in nursing school, and loved pathophysiology, but dealing with real life is a different story.
I originally got interested in nursing from a general psychology course, and thought one day I would be a psychiatric nurse. I'm not even sure how I got here.
I'm also pretty sure I'm depressed, my self esteem's plummeted, I dread going to work, all the typical things a first year nurse experiences, I guess.
My question is: Should I "stick it out" and get this invaluable training, or cut my losses now, and start out again on a med-surg floor? I want to get the magical year of med-surg training before I start out in psych. I have about a year left of the contract I signed, but I think I can fulfill it on the med-surg floor if I talked to HR.
Thanks in advance for any suggestions

If you are not happy there, then you should perhaps go to med-surg, get that year experience then go to psych, specially if you talk to HR and they tell you that it is possible.

you don't need people's attitudes when you are at work, you are a new grad and just learning everything new.

I am a new grad too, but I was very lucky that I got an awesome job that I do not want to leave.

Regadless, you went to school to become a nurse, and now not to be treated with compassion and care that is not a good thing.

Nursing school is a lot different than being actually working in the real world.......... and those nurses training you seem to forget that fact.

jmgrn65, RN · Mar 9, 2008

Hi everyone,
I'm a new grad in a CVICU, been off orientation for almost 4 months, and keep waiting for things to get better, and they're slowly getting worse.
I used to have a good reputation at work a couple months ago, now I can tell it's getting bad, people don't say hi or talk to me like they used to. (I've made more than a few mistakes). I've asked my preceptor and boss about my job performance, they both told me I'm doing fine, but I'm pretty perceptive, and can tell people don't trust me, and that I'm not doing a good job.
I don't like critical care, I get a sick, panicky feeling when patients are critically ill, and can't think clearly. I excelled in nursing school, and loved pathophysiology, but dealing with real life is a different story.
I originally got interested in nursing from a general psychology course, and thought one day I would be a psychiatric nurse. I'm not even sure how I got here.
I'm also pretty sure I'm depressed, my self esteem's plummeted, I dread going to work, all the typical things a first year nurse experiences, I guess.
My question is: Should I "stick it out" and get this invaluable training, or cut my losses now, and start out again on a med-surg floor? I want to get the magical year of med-surg training before I start out in psych. I have about a year left of the contract I signed, but I think I can fulfill it on the med-surg floor if I talked to HR.
Thanks in advance for any suggestions

No I don't think you should stick it out, ICU is not for everyone, if you are physically and emotionally sick get out asap. I don't think med-surg is necessary go ahead and find your psych job. Good Luck

RoyalNurse · Mar 9, 2008

Anyone have any experience in this?

Should I raise my concerns again to my boss/preceptor? Or go directly to HR? I don't want to go behind anyone's back, but I also don't want to hear the "you're doing fine, just wait a year" speech again.

My work is swarming with gossip, I'm afraid if I talk this out with someone, (even my boss/preceptor) everyone will know by the end of the day.

Thanks again for your help.

racing-mom4, BSN, RN · Mar 9, 2008

Does your hosptial have a Behavioral health unit? If I were you I would confidently inquire about a job in psych. If they dont have one, look on line for the Med Surge jobs avail~~I am sure they have some.

Then go to your mgr and explain that maybe ICU nursing is not for you, and it is not fair for the ICU staff/mgr to continue to train you if your heart is really not in it. Thank her for all her help she has given you and let her know how much have learned. Tell her you saw the hospital has a job posted in such and such a unit and ask her what her opinion is on working there, then ask her assistance for a referral to another unit.

I think she would respect you for being upfront and honest.

ICU nursing is not for everyone, and you would not be the 1st nurse to work somewhere for awhile and think "hmm this is not for me"

Best of luck, I hope you find your dream job!!!

mpccrn, BSN, RN · Mar 9, 2008

it depends on what kind of mistakes you're making......missing an inconsequential accu-check.....or missing major changes in your patient's condition? if you want to do a better job, perhaps discussing your patients condition at the time with co-workers will help you gear into critical thinking and would show your co-workers you really WANT to learn the trade well. most of us don't mind teaching, but we get tired of doing it FOR you....there's a big difference between showing you, with you there watching, learning and you stepping back and letting me do the work for you. we all had to learn at the beginning. now it's a matter of pride.....do you WANT to be good at this or don't you? if psych is your love, then go there. if you have to stay in critical care for a while longer, then learn, do the best for your patient while you're there, then move on.

deeDawntee, RN · Mar 9, 2008

I would stick it out. What you are experiencing, unfortunately, is not that uncommon. A nursing unit can be brutal to a new grad starting out on the ICU. Soon after I started in the ICU, two new grads started on the ICU and both of them said, without hesitation, that by far the most difficult thing was the attitude of the other nurses. On the other hand, in the ICU especially we REALLY depend on each other when one of our patient is going south. Coworkers want to know they can depend on you and that you will 'have their back' when things get bad.

I would become proactive here. Try to start to develop a 'global awareness', if you can. Make yourself available for turns or linen changes. Try to develop a few allies. Ask others what it was like for them when they were new grads, if they have any advice.... I had 8 years of experience when I started in the ICU and it took about a year before I didn't have an upset stomach when I came to work. It helps if you start seeing the whole hospital as possible resources for you. You are never alone.

What I did to deal with my own insecurity, was I studied for and achieved my CCRN. It was such an empowering experience. You can't sit for the exam until you have about a year of experience, but if you start now, not only will you solidify your knowledge, it will help with your confidence level, I promise.

It takes a very brave and committed new grad to make it in the ICU as your first nursing position. You have already hung in there for 4 months, that is VERY impressive in itself. I hope you can acknowledge the hugeness of your courage and accomplishment. I can't think of anything more difficult for a new grad to face. I always say that it certainly can be done, but it is not for the faint of heart.

Let me say something about starting out in med surg. This area of nursing is not in any means "easier". It can be the most brutal, physically draining area of nursing. You run your buttutti off. I do think the area is perhaps a bit more forgiving with new grads, since it is a more accepted path.

If psych nursing is in your future, you have plenty of time to achieve that goal as well. My sense is, don't give up, hang in there, fight the good fight, come on here for support! Email or pm me if you want, anytime, and I would be more than happy to listen and offer support.

YOU CAN DO IT!!!!! :yeah: :yeah: :yeah:

CrazyPremed, MSN, RN, NP · Mar 9, 2008

The floor that I am on is very conducive to new grads. It is tele and I am learning a great deal, and I think that it strikes the perfect balance between critically ill patients (we have a fair share decompensating and being transferred to the unit) and those that will be discharged home the same day. It's stressful enough to keep me reading everyday, but not so bad that I am sick to work there.

I honestly think that transitioning into the role of a nurse the first year is almost more important than where a person works. A safe, supportive environment on a med-surg floor, for example, means more to me than a stressful, hateful, intense ICU experience. As new nurses, we have specific needs that have to be met if we are to continue being happy, healthy, care providers. I question whether or not this ICU can do that for you.

I think that you have learned a great deal on the floor, but your long term goal is not to be a great ICU nurse. No amount of time will change that. I feel that you will probably learn more working in the environment that you want. I say move on. Not only will you be doing yourself a disservice by staying on that floor, but some psych patients are also missing out on a great psych nurse in the making.

Good luck on your journey.

CrazyPremed

Pediatric Critical Care Columnist · Mar 9, 2008

On the other hand, in the ICU especially we REALLY depend on each other when one of our patient is going south. Coworkers want to know they can depend on you and that you will 'have their back' when things get bad.
I would become proactive here. Try to start to develop a 'global awareness', if you can. Make yourself available for turns or linen changes. Try to develop a few allies. Ask others what it was like for them when they were new grads, if they have any advice....
What I did to deal with my own insecurity, was I studied for and achieved my CCRN. It was such an empowering experience. You can't sit for the exam until you have about a year of experience, but if you start now, not only will you solidify your knowledge, it will help with your confidence level, I promise.

This is excellent advice. One of my chief concerns with new staff is the tunnel vision so many of htem have, with a very basic, task-oriented focus that prevents them from being aware and on top of things. There's nothing worse than running your buttutti (I'm going to steal that one and keep it forever!!) off trying to stabilize a crumping patient while the newish nurse with the sleeping stable patient at the next bed does her nails. And anything that you can do to help you understand what you're doing and why, such as studying for certification, will help you be more aware of what else is happening around you. The crumping patient in the next bed may be far over your head, but there will always be things you can do to help, like running for supplies, mixing drips, checking blood and hanging it, drawing labs and so on. But you need an understanding of the work to know what is needed.

I honestly think that transitioning into the role of a nurse the first year is almost more important than where a person works. A safe, supportive environment on a med-surg floor, for example, means more to me than a stressful, hateful, intense ICU experience. As new nurses, we have specific needs that have to be met if we are to continue being happy, healthy, care providers. I question whether or not this ICU can do that for you.

The first comment hits the nail squarely on the head. In this age of desperate shortages of working nurses, the attention to transitioning is often lost. They want to get you on the floor wnad on your own ASAP so the workload will be lighter, only they don't see that by pushing and rushing and forcing a sink-or-swim response is actually adding to the workload. New nurses need consistency above all, in preceptors, in assignments and in feedback. This is a pet peeve of mine and I will try very hard not to rant, but if we want new nurses to succeed we have to give them the tools to do it. An orientation tailored to their needs, at most 3 preceptors, consistent assignments appropriate to their level of function as it is and not as we want it to be, support and frequent constructive feedback all go a long way toward making a good new nurse into a great experienced nurse who is invested in the unit and wants to be part of it.

RoyalNurse · Mar 9, 2008

I would stick it out. What you are experiencing, unfortunately, is not that uncommon. A nursing unit can be brutal to a new grad starting out on the ICU. Soon after I started in the ICU, two new grads started on the ICU and both of them said, without hesitation, that by far the most difficult thing was the attitude of the other nurses. On the other hand, in the ICU especially we REALLY depend on each other when one of our patient is going south. Coworkers want to know they can depend on you and that you will 'have their back' when things get bad.
I would become proactive here. Try to start to develop a 'global awareness', if you can. Make yourself available for turns or linen changes. Try to develop a few allies. Ask others what it was like for them when they were new grads, if they have any advice.... I had 8 years of experience when I started in the ICU and it took about a year before I didn't have an upset stomach when I came to work. It helps if you start seeing the whole hospital as possible resources for you. You are never alone.
What I did to deal with my own insecurity, was I studied for and achieved my CCRN. It was such an empowering experience. You can't sit for the exam until you have about a year of experience, but if you start now, not only will you solidify your knowledge, it will help with your confidence level, I promise.
It takes a very brave and committed new grad to make it in the ICU as your first nursing position. You have already hung in there for 4 months, that is VERY impressive in itself. I hope you can acknowledge the hugeness of your courage and accomplishment. I can't think of anything more difficult for a new grad to face. I always say that it certainly can be done, but it is not for the faint of heart.
Let me say something about starting out in med surg. This area of nursing is not in any means "easier". It can be the most brutal, physically draining area of nursing. You run your buttutti off. I do think the area is perhaps a bit more forgiving with new grads, since it is a more accepted path.
If psych nursing is in your future, you have plenty of time to achieve that goal as well. My sense is, don't give up, hang in there, fight the good fight, come on here for support! Email or pm me if you want, anytime, and I would be more than happy to listen and offer support.
YOU CAN DO IT!!!!!:yeah:

I KNEW I could count on the nurses here to understand. I try to tell my non-nursing friends what's going on, and they can't see at the heart of the issue, while you guys got right to it.

I can stand this a few more months anyway, then I'll reassess and go from there.

Thanks again for all your help! :redpinkhe

suanna · Mar 10, 2008

Get out now. CVSICU is a love it or hate it job. If you are this miserable this far into the job you need to cut and run. Working in a job that you are uncomfortable at is is a slow death! HEY! THIS IS NO REFLECTION ON YOU AS A NURSE! We CVSICU nurses aren't better than the rest of the world even if we act as if we are. I've worked CVSICU for 20+ years and I live in mortal fear of floating to psyc or E.R (or god forbid L&D). The advantage of nursing is there is always somewhere else you can go if you aren't comfortable where you are now. Find a nitch that feels right to you and then make a career of it.

deeDawntee, RN · Mar 10, 2008

You go girl!! I could sense your spirit. No one starts out in a CVICU who is not courageous and undoubtedly equal to the challenge. Showing your stick-to-itivness will get you respect. It will happen. This is a testing time when your coworkers are waiting to see what kind of nurse you will become. The best thing you can be is as forgiving as possible. Don't let them know they are getting to you.

Please keep using this forum. Yes, you will find many who understand. This website can be a very powerful support system. Keep up the good fight!!

:yeah: :yeah: :yeah:

this will be you in a few months!!! I have no doubt.