Will I ever get comfortable in the ICU?

[Socrates12358]

I'm finishing my 11th week of a 12 week orientation, and as the time approaches to be working on my own I find myself in a panic. I've been terrified everyday so far during my orientation. The first 10 weeks were on day shift, and that was awful. I am fine with med passes and basic care, vents, etc. Its the bedside procedures, tests, emergency intubations, chest tubes, central line placements that are bothering me the most. This week I have been on night shift which has been SO much better because we dont really do a lot of the tests and procedures at night, only in emergencies. This was making me feel much better until my manager called me the other day to tell me that after my orientation is over with, I have to do a one time 6 week rotation on day shift on my own. I asked her if this was mandatory because I really prefered night shift and she said that this is something new and they will be making all the new grads do a 6 week rotation on days to get the experience with the procedures and so forth, and to also be able to work next to more experienced nurses since most of the people on nights are new. This is also causing some problems because the experienced day shift nurses feel like they have to "babysit" all of the new people and our patients.

I am in constant fear during my entire 12 hr shifts. I am constantly worrying about something happening and not knowing what to do. I am getting better in recognizing problems and knowing how to treat them, but the stress of everything is almost unbearable. Ive only broke down once crying at work, but I was able to go into the bathroom and sob for about 5 minutes. After that I felt better. Oh, and I am absolutely terrified of getting admissions. I know they say that you should jump into things that you are afraid of during orientation so that you will know what to do on your own. Well in the last 11 weeks i've only done about 2 admissions so I still really dont know what to do. I dislike the admissions because most of them end up with emergency intubation, chest tubes, central lines, and many drips to titrate. I am constantly making notes on what to do for everything so I can refer back to it when I need a reminder. However, my notes dont cover everything and i'm afraid to start bother other nurses with my questions. And for the life of me I am awful with my lab results. I have to constantly refer to my normal range sheet for hmg, hct, platelets, wbc -etc. I dont know why some of these numbers wont stick in my head. I get so nervous that sometimes its like I just go brain dead. I cant think. I know a lot of people have gone through this and things seem to work their way out for a majority of them. I worked in a nursing home for 9 months before this on night shift, and though I didnt enjoy having 40 pts, at least I didnt live in constant fear that I was going to kill someone or make an awful mistake. How much longer is it going to take for me to at least not feel like crying every second of every day? My stomach is always either nausous or upset, and sometimes it feels like my heart is beating out of my chest. I know I'm rambling on here now, but sometimes I just feel like I am so alone and nobody in my family understands the pressure I feel being a new ICU nurse.

[renardeau, BSN, RN]

I'm a new grad, but plenty of my friends have gone into ICU straight out of our program, and they say the learning curve is treacherous. You are most certainly not alone nor any worse than other new grads in your position, and the things you are feeling are, well, I don't want to say "normal" to be stressed out 24/7, but it's not uncommon for just starting out. The thing is, they offered you the job---that means they believed you could do it! It's good to have some doubt, as it makes us question things and be more careful, but I can understand how stressed you must be. At least you are wary that there are things you should be worried about, and not on the other end of spectrum (I've heard horror stories too about really cocky new nurses). Before I digress too much, I hope there are other orienting nurses you can share some solidarity with? Or that your floor is really supportive. As I said, they hired you, so they thought you were up to the job. You're wary, you're taking notes, and you're learning. I really think you can do it! Keep your head above water and keep swimming :)