VENT.....transferred out of icu 6 weeks into orientation.

[stanquim]

I'm sorry this is so long...

So I'm here to vent. I felt like I had the worst day in my life the last day I was at work, and as I had thought it was going to to be the last day that I had worked on the unit for the time being. I started out working in a MICU as a new grad. I didn't have a doubt in my mind that I could not succeed in there as a new grad.

My preceptor was impatient from the first day, expecting me to know what line I should push drugs given theres about 5 IV lines to choose from, my first day, impatient, and pretty much made me feel lower then low and it shot my confidence and I wasn't myself at work , I hardly talked to people, I had no confidence, and it just continued, she made me very nervous, and made me feel very stupid.

So had a meeting with the manager of the unit, my preceptor, and they were saying that I was doing my job with no pride, and with no emotion and not taking anything seriously, and I admit when I worked I felt like a zombie there because thats just how I ended up feeling from all of the putdowns with no encouragement, no support, no nothing, nothing positive. So I wasn't quite aware how to get out that "zombie" frame of mind, but the meeting helped and my eyes were opened, and the next few weeks at work were a lot better.

So my preceptor caught me about to make 2 drug errors in those weeks and I had a hard time remembering things in there, its like my mind when blank, and I couldn't remember easy things it was horrible, I recorded a wrong number my preceptor caught, and then I hung a wrong fluid it was a potassium chloride 20 meqs ina 1000ml bag, it was just a maintenance fluid bag, I never knew of that fluid , i ddin't know they had that as maintenance fluid , I hung potassium d5/ns instead of just ns, not knowing there were different potassium fluids. I knew that was the last draw and that I was going to be transferred. Also I was leaving the unit about an hour late every shift, my time management, was not coming together. So I have a meeting coming up this week and I know I'm going tobe transferred, I'm very dissapointed I worked so hard, and was sure I could tackle the ICU as a new grad, maybe part my preceptors effect on me still lingered affecting my practice and also maybe I just was not ready for the sensory overload of the ICU as a new grad....I'm sorry it was so long, but I had to vent. I'm sure I will be transferring to floor, hopefully a cardiac step down or something if possible.

[casperx875x]

I am sorry you are having such a tough time. It is possible that being out on the floor or a stepdown floor may be much better for you. I hear all of these horror stories about new grads having awful preceptors. It makes me wonder how they select who precepts and who doesn't. Hang in there. Start fresh. You can do it!

[QueenCityNurse]

I'm sorry that you are having a tough time. I am also a new grad RN so I can imagine the type of stress and pressure that you are under. I work on a Progressive Care Unit and the atmosphere is very stressful almost every single minute. The only advice that I can give to you is to just to continue to do the best you can. Please don't be too hard on yourself. If you are transferred to another fllor, just try to soak up as much as you can and try the MICU again later; I am sure you will be great! When you have a free moment "at home" try to study over the things that you see pop up over and over again.

Good Luck!

[Jules A, MSN]

I'm sorry this didn't go the way you had hoped. Maybe this move will be a better fit for you right now. No way would I have been brave or competent enough to attempt ICU right out of school so hats off for giving it your best and again I hope the new move is a good one.

[R*Star*RN, BSN, RN]

It sounds like the ICU you were working in, was not New Grad friendly. Was it common for new grads to start there, or were you the exception?

I'm a new grad in Surgical. . . With the stress of working on a Surgical floor, I can't imagine how much more stressful starting in an ICU would be! I think you have managed very well so far, you are still an RN and you still WANT to be an RN, and it seems you havn't had a nervous breakdown yet. Maybe what you need is a floor that is a little less intense, and requires a little less skill and knowledge.

I have no double that you can be a great ICU nurse, I just think that when you are first starting out it's better to take a position thats better for the beginner, a little less stress, easier to wrap your mind around before you advance to the next level.

[Up2nogood RN, RN]

It sounds like the ICU you were working in, was not New Grad friendly. Was it common for new grads to start there, or were you the exception?

I'm a new grad in Surgical. . . With the stress of working on a Surgical floor, I can't imagine how much more stressful starting in an ICU would be! I think you have managed very well so far, you are still an RN and you still WANT to be an RN, and it seems you havn't had a nervous breakdown yet. Maybe what you need is a floor that is a little less intense, and requires a little less skill and knowledge.

I have no double that you can be a great ICU nurse, I just think that when you are first starting out it's better to take a position thats better for the beginner, a little less stress, easier to wrap your mind around before you advance to the next level.

I totally agree with all you've said. I too am a new grad on a surgical floor and I think I'd rather pull my hair out than work in ICU. Although the pt to nurse ratio is awfully tempting :wink2:. I think ICU or PACU may be something I aim for after a few yrs under my belt. But I don't think an employer can expect a new grad to be competent and ready to be on their own after only 6 wks in the ICU especially with a preceptor that sounds like she didn't want to teach or mentor.

[JanetCCURN]

6 weeks is not enough to even gather yourself and transition smoothly. Im a new grad, started working in CCU mid sept. Just started taking a full load after three months. At about six weeks I took 1 pt.

So far I have worked with about 6 different seasoned nurses who all work very different. I have to keep in mind that I am still new and will not know everything. Lately I have had feelings of whether or not CCU is right for me or if Nursing is right for me. Although I keep hearing that I am doing just fine, I really feel like I am setting myself up for failure.

Maybe starting at a tele floor may have been the best thing to do so that I can get used to basic nursing practices. All though I feel like I am able to communicate with docs and I help out everyone and try to keep a good rapport with all the nurses because I never know when I may need something, I still feel like I am being setup to fail.

The only thing that keeps my head above water is really gaging my time and time management. We still have paper charting, dinosaur if you ask me. Eventually I am supposed to go to nights but I will not have the level of confidence it seems like we new nurses are yurning for.

You know if you really want to be there at this point I would have a serious regroup session with myself and organize my thoughts, figure out the routines, spend that extra time outside of work and really try hard to grasp what you feel you need. Do it for your self confidence.

I chose ICU because I knew selfishly that I would not be nearly as interested in nursing on the floor as opposed to icu. However, I will say that if I could have this realistic picture I have now, I may have been less selfish and start in a Tele floor prior to icu. I didn't realize how much organization and prioritization outside of critical care learning it would be. you hear the argument saying not to let anyone tell you that you cannot start in the ICU as a new grad...aggghhh we all have to find our own cup of tea even if it is disappointing at first.

So this is either a blessing or a call to rise up to the challenge. We can always be better and no one is perfect.

I really wish you the best!!!!!!!!!!!

[SoundofMusic]

Please don't beat yourself up for it. I also started in an ICU and after the first 3 months asked for the transfer myself!! They wanted me to stay, but I just knew I wasn't ready for it and just craved a place where I could get my basic nursing skills and time management down first because I also just felt like such a newbie and so absolutely unskilled and I hated the way they were treating me.

I transferred to a typical med surg floor where the orientation was well managed, and I have done absolutely fine. In fact, I'm precepting now and moving on to get my ACLS soon. I plan to "do my time" on this floor and then perhaps move to a tele floor or other "next step up" to IcU.

I will always say that I have a "healthy respect" for the ICU. You really need to have your skills down and your head into it, with all the fast moving issues and critical skills and thinking. I just need more time -- and I'm not ashamed of that.

I also felt, at the time, that the ICU nurses were just way more happy with nurses coming in who had time under their belt -- at least years or more -- many with 5+ years of nursing experience, that they could train and deal with. It seemed those nurses just took to it so much easier -- and that's how I plan to be -- just get some more time and you will get back to it someday, as I also plan to do.

I've seen new grads go into it, but they were very smart and also had really GOOD preceptorship programs. They were also unattached w/ no kids, etc -- with all the time in he world to study - something I also didn't have raising 3 kids on my own.

And, as I always say, the pay is the same -- at least starting out!

[Sterren, BSN, RN]

I started in an ICU as a new grad too and started looking for a new job within 2 months of starting there. The ICU is a really hard place to start out as a new grad and I was not happy there, nor did I feel competent, nor did I feel excited enough about the job to push myself to learn everything. I am much, much happier on my new unit and have found my "niche" in nursing. I hope the same thing happens for you. Don't beat yourself up over this, it's a really hard place to start out and I don't doubt that you can be a fantastic ICU nurse after a few months or years have gone by.

[FireStarterRN, BSN, RN]

ICUs can be particularly brutal and unforgiving places, with well established cultures as such. It sounds like an overwhelming experience. I am surprised that you didn't know that KCL is added to different types of IV fluids, that's actually very basic information. A mistake like that would also make me wonder about someone's abilities.

Good luck to you on your next venture!

[SuperSleeper]

I started in CVICU as a new nurse. It was so stressful that I cried on the way IN to work for about a month or so. There are some incredibly strong personalities in the ICU setting. Not that you don't find them elsewhere, but ICU's are generally known for it. It takes a bit for your skin to thicken and others to generally trust you. The big issue is that there are MANY opportunities in the ICU to make a "little" mistake and kill someone.

That being said, the potassium-enriched fluid is an issue. Granted diluted like that, it shouldn't be dramatic, but potassium can kill. Get very familiar with your fluids. LR also has potassium in it (btw, just fyi). In the ICU, fluids are one of your main resources.

I agree that your ICU does not sound new grad friendly. Maybe you would be better off out of that environment until you get your feet under you. I am in no way saying that maybe you can't handle it. From your description, it really sounds like your potential has been squashed there, for the most part. If you stayed there, you wouldn't just have to not make mistakes, you would have to be a superstar to win them over. It is possible and I've seen it happen. Obviously, the choice may not be yours, but, at times, life gives us exactly what we need.

Good luck,

SS - SRNA

[SoundofMusic]

I will never understand why any new grad gets shuffled into ICU's. I feel this is a type of nursing that requires experience that can only come from time in nursing, time around patients, excellent assessment skills, etc -- that can ONLY come from time spent with patients. I just dont' get how new grads do it -- but some manage to do it and do ok.

I just don't feel anyone should feel like a failure if they can't make it there right out of nursing school. There are literally 1000's of things to learn as a nurse -- and assessment is always #1. You can't get better at this until you've had time to see many different patients and time to practice it.

I couldn't even work an IV pump, and yet was having to handle big time issues in the ICU. ICU nurses can be outright disgusted at having to show a new grad something so simple -- and I think I'd be the same way if I were an experienced nurse of that type. I mean -- they SHOULD want to precept -- and new nurses just require more -- so they'll take you -- but they can be BEARS while they're precepting.

If you can handle that without taking it personally -- then great. I just couldn't myself and it made me a nervous wreck on the verge of tears every day after work. Looking back it seemed as if some of them were outright cruel. Whatever -- I don't truly care to work alongside such individuals.

I have LOVED my nice med surg floor where I can sort of get lost in my patient's rooms, without someone breathing fire down my neck, and I can sort of fumble a little while I learn and get these skills down pat. It's been so much better for my own health and sanity. And I want to be a nurse long term -- so this way I'm not burning out early or having major dings to my self esteem. I have met WONDERFUL nurses on these floors -- they are as experienced and knowledgeable as any other nurse, and they have the patience to deal with me -- so it's all for the better.

The moral of the story is -- be proud to be a nurse, of any kind. It's ALL hard work, all requires smarts, and it's all important. If it takes a while to advance to critical care, so be it -- you'll be such a GREAT ICU nurse once you get there, because you will have that time in. Be proud of yourself -- whereever you are -- just be a good nurse at whatever you do. We floor nurses can "kill" also with small mistakes -- ANY nurse in a hospital setting can make a major error -- so it's all very critical.