What comes after a bad ICU experience?

[SweetBabyJames]

Hi all.

I'm a new grad nurse 8 months into a 1-year contract at a moderate acuity hospital. When I first applied, I wanted to do L&D but they had no positions. They asked me if I wanted to apply for the CSICU and I thought "hey, I'll give it a shot." I was offered the job 2 hours after my interview, and I took it!

Bad orientation where I was on all nights, with a preceptor I didn't really click with. Was told I couldn't get on more days by my manager who insisted days and nights are the same anyway. Well, not so much on my floor which turns out to be more stepdowny. Come off orientation and have little to no experience with admissions, tests, or daytime-flow. Come to find that the other nurses are writing my manager emails about me without telling me I'm doing anything wrong or educating me. I get written up by my manager and told I should go back on orientation, 3 months after finishing it. I shadow with a few nurses, but no orientation. Work becomes agonizing, and I feel like I can't trust my team. My floor has a ton of young nurses and almost no senior nurses. Very cliquey. I feel isolated.

Two months later, I have 4 months left of my contract and I just want to leave this state and completely forget about the CSICU. But now that I have so much knowledge about rhythms, cardiac (stepdown) patients, and a specialized population of surgical patients, I have no idea what I should do next.

Most job postings seem to want two years of experience. I feel weird going back to L&D now. Maybe ED? And I'm wondering how I would go from monitored patients with a 2-3:1 ratio to a floor where I might have 5-7 patients? I feel so screwed.

If you read this far, thank you.

I just feel lost and a bit hopeless.

(TL,Dr: new grad, bad experience in CSICU, what specialty makes sense next?)

Signed,

NotgettingmyCCRN

[Rose_Queen, BSN, MSN, RN]

Do you enjoy the critical care patients but not the unit? It could be that a different facility would provide an environment with a better fit.

Regardless, I would try to stick it out for the full year if at all possible. You won't have to worry about the penalties of breaking the contract, you won't have to worry about being marked ineligible for rehire when a new facility calls the current employer, and that full year of experience is likely going to open more doors than 8 months of experience.

[SweetBabyJames]

@Rose_Queen Thank you, this is good advice. Yes, I do love the patients and the work! Definitely more interested in SICU/MICU than CVICU but I love the work flow, even though I'm still getting used to prioritization when there's 10 things to do at once. Pressors, sedation, new drips, talking and consoling and educating families. It's so interesting. I think with a little more help and practice, I could be so much better. Maybe this is because I had a good day yesterday. But, I think I want a little more time in critical care before I go anywhere else. And I think it's true that I need to finish my year. I'd have less to explain going forward.