What's a good length for orientation for an IMC?

[Kitty Hawk]

I'm trying not to have my tail between my legs, but I was told today that I didn't cut it for the IMC unit. This, after killing myself to pass all the courses etc...I only had 4 weeks on the unit with an additional week in the ICU b/c after 6mos you could be floated there.

I'm a bit surprised b/c I met with my NM last week to make a plan. She told me she didn't invest all of this money into me and that I"m bright and am picking up well, I just needed to build more confidence in myself. I checked off on all the skills, I was able to get all but 1 ABG, IV starts. But learning the new computer plus orders AND watching monitors etc.... well I was told it's hard for everyone and what I was experiencing was normal.

I had 3 weeks of class time. 1 week was hospital intro stuff for all nurses. The next 2 were a critical care course and a basic arrythmia. So like I said, that's 4 total weeks on the unit that I was supposed to be hired for and then another in ICU.

My NM told me point blank that she felt she let me down with my original preceptor, b/c she focused on all the wrong things therefore I didn't get the best start and she was sort of new herself. She put me with my ICU preceptor who has 20+ years and things were going better, but c'mon 1 week of time? My preceptor even said today that she saw massive improvement in things I picked up on and went to the doctor with.

My NM is saying that I'm going on 9 weeks of orientation! um what? I've had FOUR on the unit. 1 in ICU And even though she told me last week this exact time, she was extended my time by 1 week (which is what everyone else got too 5 weeks on IMC/ plus the 1 on ICU) she just flat out took away that option today.

I think if she was having concerns she should have said something before, we had a long talk about this and she mostly blamed herself for not giving me the right preceptor that could teach well. She said the average yr experience in IMC is 2 years and she's afraid that if I got stuck, I'd have no one to really guide me well!

Well I'm stunned and in shock as the hours are not what I signed on for. It's 5 8's and I thought I was going to be 2 8's and 2 twelves. And it's days/evenings instead of days/nights.

It's on an ortho floor, I have no idea what to expect. I have no choice and I feel completely misled. She said she would hire me back in a heartbeat in 1 year, but right now I need to learn the charting better, and basic things. This may be for the best but right now I can't see it. It's like I've gotten thrown to something that I didn't even sign up for in any way. Like the hospital owns me, which I guess they do...but it sucks. This might get me closer to my goal of pain management, but I really wanted a year or so of the critical, just to have. If I do in the future I think I'd go to a different hospital, I respect honesty not being told you're doing fine and then bam. As much as I liked her, I'd have a hard time trusting her now.

Enough whining for 1 night. Did this ever happen to anyone else, hired for one thing sent off for another? How did you cope?

Oh, and then she says no one on the new unit needs to know why I'm there, in other words I could say I just came from my previous job, or that I chose to resign I guess. I'm grateful for a job, but this just increases the reasons I don't want to be in a hospital. I'm just numb right now.

[opensesame]

I think it means InterMediate Care.

AKA Progressive Care, Stepdown, etc.

[Kitty Hawk, ADN, RN]

What I would do if I were you is stick it out on ortho for a year, or at least give yourself a solid 12 months in the hospital system total before you go somewhere else. Who knows, you might really like ortho, and I bet you don't make any less money, and sometimes you just have to remind yourself of that. I would also ask your current manager (of the ortho department) if you could transfer to days or day/evening or whatever your shift preference is when something comes available...even in this day and age with the job market the way it is, I bet something will change before the year is up.

I'm confused as to whether the manager of this IMC is also the manager of the ICU at this place you are talking about. If that is the case, nah, I wouldn't try to get back in there either. Once bitten, twice shy, as they say. Take this time to think about what you really want for yourself and where you want to go and how your current job can help you get there.

Diane

Yes, ma'am...you got it. She's the manager for both.(there was always 1 mgr for both) Rumor has it some people are not happy about it. I didn't see anything overt pointing to anything bad. I was told from one of my former co-workers that she felt horrible for me, b/c I was blindsided walking in from being at classes and having a new manager. She said that things are still in a state of chaos even now. I tried not to let the few bad statements color my preception, there's good and bad in everything.

The NM that hired me, I would work for her I'd think. She told me flat out you know where you stand at all times with her. Everyone loved her...she has a reputation in the area far and wide. She left to clean up another hospital within the same system...actually closer to me. I'm going to try to stick it out. I'm nervous b/c I'm under the impression ortho would be a lot of heavy lifting...anyone that looks at me knows I'm not great at that. I know it's leverage but I still need help with the ultra hefty people. One door closes and a window opens or something like that. I just hope I don't feel totally humiliated come Monday.

[Kitty Hawk, ADN, RN]

I think it means InterMediate Care.

AKA Progressive Care, Stepdown, etc.

Yes exactly. It's closely knitted with the ICU. I was told the major difference between the two is the titration of the drips. The NM even said in her opinion, IMC was harder b/c you have one more pt with not a huge difference in acuity. ICU has 2 pts and IMC has 3. There's a seperate unit for cardiac step down (one level below IMC) but I was told you're insane to work there as it's 5 patients. You can be floated there too as an IMC nurse.

[shoegalRN, RN]

WOW! I'm stunned at some of the politics. I can relate to a lot of that. I was told that anxiety is normal...but you know the rest! That's interesting you didn't experience that in the ER. So they may hire someone with a year or so of med/surg ortho?

I have that on the backburner of my mind. I'm not sure if you have to be a true adreneline junkie for that too or what. I thought maybe you'd have to graduate to a step down unit or something. But the get-'em-in-get-'em-out appeals to me. As does NICU or PACU...things that don't involve heavily turning q 2 H etc.... I know I'm going there...and that's why I'm not sure how long I'll last being I didn't sign on for that.

I know the one poster said to get used to the backstabbing etc....but no, I'd never work for this NM again. I don't think it's cool to be smiling and telling me we'll talk about my last precepting weeks plans and have my preceptor compliment me for the great job and quick thinking under pressure, obtaining the rush ABG etc...and then this. And if it was all lies and I suck...all the more reason to stay away. Thanks for showing me this happens all over. Maybe I won't feel so crappy soon.

If you want to work PACU, you will need atleast a year of ICU experience. That's what I'm told. I work GI Lab two days during the week and I recover anesthesia patients. I can use this experience if I want to go to PACU in the future, but it's no guarantee.

I like ER because it's fast paced, I like variety of patients, it's more skill focused, and I like trauma. I don't have to worry about turning a patient, most of them are walkie-talkies. It's treat em and street em. I get my rush every weekend I go to work for the simple fact I don't know what's gonna walk through the door and I like that.

Trust me, I was shocked when I left the ICU, I felt like a failure. I couldnt show my face up there for a while, but then I thought at least I am happy where I am. I work with great co-workers, wonderful management, and I have not experienced such backstabbing and gossip like I did in the ICU. My orientation was 10 weeks because I had some ICU experience. It should have been 12 weeks, but I got let off orientation early because I caught on so fast (according to preceptor who's been a nurse for 15+ years).

You never know what God has in store for you, this may be part of His plan, and you may end up being right where you should be.