Want to transition to MICU/SICU

[Guest995304]

Hi and thank you to whoever finds the time to reply to my post. I’m about to complete my first year as a nurse in a busy Med Surge/Telemetry Unit. I currently work nights and it has affected my performance a lot. I’m always tired, feeling foggy and I’m constantly worried I will make a mistake due to this. Im thankful I have the support of my coworkers. Some nights are better than others. I got into nursing with the plan of becoming a CRNA, however, after this first year I have started to doubt my capabilities of even making it to ICU. I look at my peers who are more experience ( 3 years experience and up) and their capability of connecting the dots and knowing all the possible scenarios that could go wrong... while I struggle to remember some basic pathologies. I’ve lost my drive because I’m constantly tired but I’m at the bottom of the totem pole if I wanted to transfer to day shift so that’s not an option. I can definitely hang in there for another few months but I don't know what should be my next move... try to suck it in and give ICU a shot or move to OR which is more of a controlled environment ( although I understand that when things go wrong they go really wrong and you must be ready) 
I’ve had several emergencies where we had to send the patient to ICU and I e been told I managed the situation fine. I usually get the “easy patients” because I’m new. So far no med errors and patients like me. For those in ICU, or CRNA... what were your biggest doubt during your transition? 
thanks!
 

[MaxAttack, BSN, RN]

If you're looking to become a CRNA you need ICU experience, point blank.

To get there, most ICU managers that I've known don't care about your experience. They know that comes with time. It's all about your attitude and willingness to learn.

And the self-doubt is normal. I went straight into ICU from school and was sure I was going to kill someone for the first year. Just always ask questions and never stop learning. Look up what you see and really try to understand the why's. 

Good luck!

[Guest995304]

Thank you very much! 

[acmt27, BSN, RN]

My situation a year ago was almost exactly like yours- a year and a half on a tele unit, working nights. I absolutely hated nights but day nurses on tele were always swamped so I put up with the disruption to my circadian rhythm. I've always wanted to be a CRNA but wasn't able to get a spot in an ICU new grad program, so tele was my closest option. I was fed up with the patients and hated going to work but loved my coworkers, so I felt guilty about making the transition. I, like you, felt like I lost all of my medical knowledge (pharm, pathophys, etc.) due to how busy I was on tele. I barely had time to pass meds and draw labs. I hated giving my patients their meds but not having the time to look up why I was giving them the meds.

I finally decided I had enough and started applying to various ICU units at other level 1 trauma centers in my city (I was interviewed for every position I applied for, most positions I made it to second and third round interviews and but always passed over for someone with previous ICU experience?). I had to eventually tell my manager that I was applying to other places, since I had to get them to fill a recommendation survey. They understood why I wanted to leave; I've always preferred the sicker patients who were acutely ill, and our tele unit had mostly chronic illness and psych patients waiting for placement. My manager also supported by ambition to become a CRNA, so she recommended me for our own hospital's MICU, although I wasn't sure about staying at the hospital.  I was so grateful I talked to her about where I wanted to be, because she's the reason I've now been in my hospital's MICU for almost a year (and day shift- normal life ?).

Since I've been working days on the MICU, my attitude and motivation has improved drastically. I love listening to rounds in the morning on my patients, so I'm finally starting to relearn things I learned in pathophys and pharm. I just got my TNCC (my hospital requires it in ED/ICU) and once I've been here a little longer I'll work to get my CCRN so I can start thinking about CRNA school.

Finally, to answer your question at the end, I was super worried when I made the transition to ICU that I wouldn't know how to respond in critical situations, especially with rapidly deteriorating patients. I feel fortunate to have an awesome team of nurses with me. They understand that everyone has to start somewhere, and they help me when I don't know what to do. I've surprised myself with how I've adapted to learn how to respond in critical moments. In just a few months of being in the ICU, I started to feel more and more competent and I don't freeze up when things go south like I used to. Good luck! I'd be happy to share more of my experience!

[Guest995304]

Thank you very much for taking the time to reply. Much appreciate it. ?