Wanting to get trained in ICU. Have I messed up?

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Okay, I have been an RN for one year total. My year of being an RN has consisted of starting at a LTC facility (where I am still employed PRN) and a brief time on a med surg floor at a local hospital.

I didn’t stay for 4 reasons:

1. I was given the worst preceptor possible. People stood by and watched it happen and told me after the fact that they knew I was set up for failure. Why didn’t someone say something? I don’t know. Along with this, I was pulled out of orientation early to assist with coverage needs, due to overwhelming demand during the Covid spike. Despite me telling my unit manager I wasn’t ready. I even caught COVID from the hospital at one point during my orientation and this was still when the CDC said we had to stay home for 10 days. I was not reimbursed those shifts to train. 

2. 1:7 ratio on a hectic med surg floor. Along with my lack of training, it was hard for me to juggle the patient load. I was running from one room to another, putting out one fire only to run to put out the next one. Sometimes it was the middle of the shift before I could sit down to open charts. I would always have to stay about an hour late to chart in the mornings. 

3. I felt increasingly incompetent and a burden to my coworkers with each shift. I know I worried my charge nurse to death with all my questions, although she was very smart and a kind and patient teacher. 

4. I was consumed with dread before my shifts and consumed with anxiety and panic during my shifts. I was always scared I would either mess up, or my charge nurse would finally reach her point where she would be tired of my questions.

So, I put in 2.5 weeks notice. When my manager found out about this, she asked me why. I made it known I didn’t appreciate getting the *** end of the stick. She was desperate to keep me, even offering to put me back in orientation! Mind you, I had been on the floor for 5 months at this point. Why weren’t my concerns taken seriously before she knew I was leaving? Anyway, I left. 

Now, as I said, I’m still PRN at my LTC job. But I’m really wanting to venture out and get the experience needed to travel. Plus I really feel like my skills and experience hit a ceiling in LTC. I’ve recently become interested in trying out ICU. I feel like I would be much better with the smaller patient load. And although ICU patients are much more critical than med surg, I am detail-oriented so I believe this would better suit me.

What I’m wondering is if a hospital will look at my 5 months of floor experience and think I don’t need as much orientation as a new grad would? Or do they typically look at other things- such as the drastic difference between the two units, etc. I feel like I pissed away my hospital experience and any other job I take in a hospital will be sink or swim. 

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Specializes in Travel, Home Health, Med-Surg.

I think it would just depend on the individual hospital and their needs etc. Either way, 5 months med surg is probably not enough to get you into ICU without extensive training, and is definitely not enough for travel. If ICU is your goal you may need to start (again) in med surg for awhile and then apply to ICU. If you apply to med surg you would still get orientation so I don’t think your previous 5 months was wasted, no matter what you do it is still some experience and will help you. If you really want ICU then go for it, you never know till u try. (Just make sure you are getting a good training program).

good luck!

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Your first year.. is a do over. You are not ready for travel or ICU.

"What I’m wondering is if a hospital will look at my 5 months of floor experience and think I don’t need as much orientation as a new grad would? "  

It would depend on the individual hospital. You should submit  your resume to several hospitals and get that feedback.

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

With the experience you have you're likely to still qualify for "new grad"  positions like residency programs that have extensive orientations. There are some ICU programs that take new grads, or you could apply for any acute care residency position to get your skills and then transition into ICU. Good luck!

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Specializes in ICU.

Gonna say that after reading your post, I think you should wait.  Needing lots of support on a general m/s floor says your organization skills and general nursing skills need work, ICU can be pretty intense, and you have to be fairly strong in those areas.  I don't think they will be willing to help you with foundational nursing tasks.  Perhaps another M/S and talk about your poor preceptor, with better support you should be able to get a solid foundation under you.  

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Specializes in oncology.
On 3/1/2022 at 3:42 PM, ModeratelyObscure said:

. I was given the worst preceptor possible. People stood by and watched it happen and told me after the fact that they knew I was set up for failure.

 1) Can you put into words, actions and professional climate what your preceptor lacked?...not what others said, what id you recognize?  Identification of what your orientation lacked will give you a better voice for what you want. 

On 3/1/2022 at 3:42 PM, ModeratelyObscure said:

I even caught COVID from the hospital at one point during my orientation and this was still when the CDC said we had to stay home for 10 days. I was not reimbursed those shifts to train. 

2) you do not know where you caught covid. I do understand sick days do not kick in (in many places) from day 1. It is what it is. 

On 3/1/2022 at 3:42 PM, ModeratelyObscure said:

. I would always have to stay about an hour late to chart in the mornings. 

3) We have all done this when new.

On 3/1/2022 at 3:42 PM, ModeratelyObscure said:

I felt increasingly incompetent and a burden to my coworkers with each shift. I know I worried my charge nurse to death with all my questions, although she was very smart and a kind and patient teacher. 

4) She was there to help you. 

Quote

I worried my charge nurse to death

That is your interpretation, That is why we have charge nurses....they are there to help new nurses!

On 3/1/2022 at 3:42 PM, ModeratelyObscure said:

What I’m wondering is if a hospital will look at my 5 months of floor experience and think I don’t need as much orientation as a new grad would? 

You need a thorough orientation program for any hospital setting. This is an important question to ask when interviewing. 

On 3/1/2022 at 5:33 PM, Daisy4RN said:

Either way, 5 months med surg is probably not enough to get you into ICU without extensive training, and is definitely not enough for travel. If ICU is your goal you may need to start (again) in med surg for awhile and then apply to ICU.

Very wise advice. 

 

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Specializes in retired LTC.

londonflo - ditto!

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11 hours ago, londonflo said:

I do understand sick days do not kick in (in many places) from day 1. It is what it is. 

The poster isn't talking about sick pay, they are referring to the idea that in addition to the orientation being cut short because the hospital wanted them to take a full assignment due to poor staffing, the training shifts missed for mandatory covid isolation were training shifts that simply became more orientation days the OP had to forgo; they were not added back to the orientation schedule.

Also, yes, people generally don't know 100% where they got covid. But if your life depended upon making a guess and being correct, it seems likely you would want to choose "hospital" as a best guess assuming you have no other known close contacts and your orientation is being cut short so you can help with all the covid cases.

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Specializes in oncology.
On 3/6/2022 at 11:28 PM, JKL33 said:

Also, yes, people generally don't know 100% where they got covid. But if your life depended upon making a guess and being correct, it seems likely you would want to choose "hospital" as a best guess assuming you have no other known close contacts and your orientation is being cut short so you can help with all the covid cases.

The research has shown that Covid is most encountered in a setting with 10- or more people.  For example your chance in encountering with someone with covid is very high in a community setting, did the OP go to the grocery/supermarket/SAMs etc? Oh no, this is left out of the equation. If you are working with covid patients, wear mask. wash hands, etc. Being involved with a known population, is better than taking your chances with any communal group, restaurants, gyms, and stopping "in for a minute" with a hastily applied mask to pick up a child at a group facility, go to the gym, stop at a convenience store.

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