Will ICU nursing get better for me?

midnitej · Jun 7, 2014

Hello Apple71286,

I am experiencing the same thing and also posted a similar post in hopes of getting some advice. The difference between you and I is that I have 4 yrs of nursing experience working 2 yrs in the ED (not a level I or II facility) and 2 yrs in PCU (level 1 facility). In the ED I have stabilized pt's but since it was not a high acuity ED I did not have really sick pt's and in the PCU there were some sick pt's but not what I have experienced in the SICU. I am wondering the same if things will get better. I think you are in a better place then I am b/c you only have 2 yrs whereas I have 4 yrs and think my skills are subpar and the expectation are higher for me. I am just hoping my unit does not give up on me because SICU has been my dream job since I started nursing school. I hope things get better for you. All I can say is to keep giving it your best and don't give up.

I hope this helps although not sure how much since I am in a similar situation as you. Hopefully we will get some good advice from some of the seasoned ICU RN's.

:)

VANurse2010 · Jun 7, 2014

I am not a seasoned ICU nurse, but I did work the floor and I think a lot of what you're experiencing depends on the unit culture. Many, many ICU nurses have MAJOR attitude problems - especially in very high acuity units. I am VERY fortunate to work an ICU with sane, supportive staff, but I feel like that's not the norm.

At the same time, if you're not comfortable with some essential skills such as EKGs, could you perhaps approach your unit educator and see if you can develop a plan?

L.W. · Jun 7, 2014

Believe me I've had the same experience as you do coming out of ICU orientation. I must say that it will get better, much better. Your just lacking confidence in your role there. How to get there is what you do from this point on. After orientation and your on your own, that's when your ICU education really starts. You will have to take the initiative to learn on your own. Whatever topic you are unsure of or feel less confident in your MUST go to your ICU educator on your unit to arrange a refresh of the things learned. Also look into what hospital education classes that are available for ekg interpretation and hemodynamics. If your shy about approaching your fellow colleagues, look at websites that focus on ICU Nursing such as the AACN website. There is a wealth of information regarding various topics in ICU that are extremely helpful. Also the equipment used on your unit being the EV1000, Swans, Scvo2 catheters, etc.. go to the manufactures website. They have videos and charts available for you to understand how to use the equipment and case studies on how to critically think regarding your patients condition. Do you look at YouTube? Use it! Search for a topic you need to know more information on for example interpreting ABG's. You will see a massive amount of RN's, RT's, MD's with a wealth of knowledge giving you a full lecture on it for free. I've done this many times and it has helped me a great deal. The more you educate yourself, the more confident you will become, the better your experience in ICU will be. Stick with it!

Biffbradford · Jun 8, 2014

You'll get it. It takes time for everyone. I started CVICU right out of school and didn't know jack. I took it step by step and made it over 12 years. If you haven't killed anyone by now, I don't think you ever will. If you have questions, ask. Need a second opinion? "Should I be worried about xyz?", ask. Don't go down with the ship alone, call the charge nurse for assistance. Hang in there! :eek:

iluvgusgus · Jun 9, 2014

I asked this to a nurse who was a med surg nurse and charge nurse on M/S unit for 10 years. She said she was in icu 6 months and still didnt feel comfortable and considered quitting, said she had discussions with her husband about it and how she didnt feel confident, didnt feel comfortable, wanted to go back to M/S. Shes been there 2 years now and feels a lot better about it but it will take time. I was in M/S and I felt that I was confident in what I was doing, and that I knew my resources if I didnt know something. I think that as long as you know what you dont know and you know your resources, you will be ok, just give it time.

GatezRN · Jun 9, 2014

Hang in there! After 10 years as a med-surg nurse, I made the transition to ICU one year ago. For several months I felt like a fish out of water and second guessed my decision to go to ICU. Thankfully, I work with an amazing group of very seasoned critical care nurses that are willing to teach and support us newbies. It's a very humbling experience going from feeling completely confident back to feeling like a novice. After a year, I'm more confident but still ask tons of questions. I too struggle with the EKG interpretations (never had any tele experience), but the team I work with is great and I often ask for a second opinion. Just remember, you are never alone. Your confidence will build again. I'm still learning and doing new things every time I work. Heck... I just did chest compressions for the very first time two weeks ago. Hope it helps to know that what you're feeling is common. Take care!

Sugarcoma, RN · Jun 9, 2014

What you are feeling is normal. I personally would be fearful of anyone just off orientation in the ICU who didn't feel this way, no matter how much experience they had (unless ICU). You are starting over. I felt like a brand new grad when I went to ICU from med-surg. My self confidence took a huge beating as like you I was considered a competent med-surg RN. I also felt horrible guilt because I relied on my coworkers so much in the beginning. Especially when I knew they had a busy assignment themselves. You need to give yourself at least six months and ideally one year on your own before you start considering moving.

My advice to you would be to identify the nurses on your unit you can count on. Ask questions, no matter how silly you may think they are. Better to ask than pretend you know when you do not! Use your resources! Coworkers, Pharmacy, RT, your docs. Even if they yell or make you feel stupid. There is absolutely nothing wrong with calling a doctor and telling them hey I'm not real sure what to do here.

I am also a universal RN, my unit does medical, surgical, neuro, trauma, cardiac and ct surgery. It was extremely daunting in the beginning but I promise over time you will become more comfortable with each type of patient. I would recommend in the beginning that you focus on general things common to many different types of ICU patients. Example, you need to be able to interpret lab values, troubleshoot a ventilator, know how to handle a patient in respiratory distress regardless of cause, how to titrate pressors, etc. Start there. Get yourself some good reference books. EKG's take time and lots of practice. I can still sometimes hear my preceptor in my head saying "March it out, march it out, march it out." Practice interpretation with your patient's and others on the unit if you have time. Especially if there is one with a block, junctional rhythm etc.