Womp, womp, womp...

[TheBlackDogWaits]

So, I'm not really sure what my dilemma is. But I'm going to try to give y'all a crack at it the best I can describe....

I've been wanting to be a CRNA since before school. My entire direction has been focused on this idea. There are many reasons why, and they aren't really pertinent so I'll jump ahead. Got hired into an 18-month residency program before I even graduated, and got hired into an ICU before that was over. So This is where I am right now....

There are a few dynamics at play here. The first being that I honestly don't feel like my residency prepared me AT ALL for my current position. I currently work for a large magnet corporation/teaching hospital. I am very excited about this just because I feel like as a new nurse, teaching hospitals are the best way to go for a comfortable learning environment. Having said that, I often find that there are also a lot of new doctors drawn to this system as well, and more often than not they are expecting me to give them suggestions for orders, or just outright expecting me to put in the orders. HUH??? So, there's that.

I've been in orientation for a bit of time, and my first preceptor was not a good teacher by any stretch. You know, generally I have shadowed a preceptor for a couple days and then start taking my own patients, prior to now. I've rotated through a few different units in my previous position, and learned a lot. This time, though, I felt like I was shadowing this preceptor for an entire month. Control issues. She didn't know how to articulate what she was seeing, looking for, how she came to conclusions about care, etc.... so I didn't have a lot of direction. She was super friendly but I had to eventually address that I felt I needed another preceptor, and she turned into a different person. She started talking to me about how she didn't think I'd make it in this unit, and I'm not getting this or that, and she feels like I am always just waiting for her to do everything. I really was laughing to myself, because I feel like for the most part my development is a direct reflection of her. Needless to say, I am with another preceptor who is pretty great, and I've really started feeling less panicky about my learning opportunities. She actually let's me do my job, which I am beyond thankful for. I learn better and I learn more this way.

I don't know that I like this job though. It's completely different than I thought it would be. And I've read so many posts about this feeling, and for some reason, I never felt like it would apply to me. I have zero passion for this unit or even for this job. Most of my patients are nursing home complications, whose families refuse to DNR them. Most of them are contact precaution for the sheer fact that they're from community living, and I spend day in and day out eyeballing their lytes and cardiac function. Even though they are clearly at the end of the line.

On the one hand, it's tough because I'm still trying to connect all the dots and figure out the big picture, but on the other hand I almost feel like I am not learning about all the million things I should be learning, that I could be learning if I were t a different hospital. I'm stuck between feeling like I am not good enough (because of my experience with my previous preceptor) and also like I could be so much better if I were in a different environment.

I don't know at which point I should be owning my experience here. I hear a lot of people saying, "Stay the year..." but am I wasting my time and my boss' time? Am I wasting my preceptor's time?

I feel like I want to stay and take advantage of this opportunity, because if I were a student reading this or a nurse without a lot of opportunity reading this I'd be green with envy and/or bitter about a possible lack of appreciation or insight on my part, but I also feel like all I'm doing by staying is being a nuisance to the unit because I am moving through preceptors and haven't been picking up info at the expected rate. At the same time.... I'm learning that I don't like acute care. I don't like trying to figure out the big picture. I like teaching, and I like patients who can talk to me in their right mind. I like chill environments. I like patients who are engaged in their care. Most of these patients are poor historians, with no family to advocate for them - and there are a lot of nurses who enjoy taking on that role, but I don't believe I am one of them.

I'd like to make a decision that benefits everyone here. I don't really know what to do. There must be a few of you who have weathered similar events and made it through with a lot of regrets - or no regrets at all.

Care to share your thoughts?

[MYSTICOOKIEBEAR]

First and foremost congratulations on getting a job on one of the Units fresh from school, that is no small feat! Secondly, I am very sorry to hear that your preceptor/s take offense to you not being able to learn as well from them. Nurses need to realize that not everyone will get along with each other and that there is no teaching style that is one size fits all. Some preceptors can adapt to the needs of their orientee, but other preceptors can't. It sounds like your preceptor was one of those people who were unable to do so.

I don't mean to sound demeaning, as that is not my intention, but it sounds like you are experiencing the fairly normal first year "angst" on The Units. I know because I was there, and thought about quitting no less that 87 times! Just kidding, it was more like 5-6 . The ICUs are a completely different world and is such a different beast compared to almost every other area of nursing. That being said, it is not for everybody, but it seems that you are still very new to it. As for me, I am very happy that I stayed.

It seems that you need a preceptor who can teach in the way you learn best and that is very hard to pinpoint, but it is important for you to express your sentiments to your manager. If they never know how you feel or your concerns, they will not take any corrective action to help facilitate your learning. They hired you for a reason and I am willing to bet that they would work pretty hard to keep you.

It sounds like you work on a MICU and that may not be the best place for you especially if you want patients with more positive outcomes and patients who also interact with you. My advice to you is to talk to your manager, try to work it out, and tough it out for at least one year. It does get better, you just have to roll with the punches and tread water long enough until you learn how to swim

[MYSTICOOKIEBEAR]

It sounds as though you have a bias against older patients - listen up, Gero is where it's at. And where it's going to stay for the next 35-40 years.

Whether your patients are nursing home residents "whose families refuse to DNR them", or you feel inconvenienced by reviewing lab results for patients who are at "the end of the line", these individuals deserve the very best nursing care you can deliver.

Your dismissive attitude is distressing. Imagine how dismayed you will feel if your Grandma or Grampa, or one of your parents, and one day, your spouse, are treated as though they are less important or less deserving of aggressive care.

It's not clear where your attitude comes from, whether you picked it up from co-workers or arrived at this age bias on your own, but an effort toward adjustment will benefit both your patients/families and your own heart.

One of the best attributes a nurse can bring to his/her practice environment is humility. It's not all about you and what makes you happy at every moment; it's about using your nursing talents - if you have them - to respond to patients' unmet needs. Nursing is a gift. It's a privilege to participate in others' lives and to move with them through difficult moments.

If you find a patient care setting that is chill, please let the rest of us know.

Please correct me if I am wrong, but it seems that you are offended that the OP was sharing their concern and seem to be extremely defensive and very rude. You seem to have a chip on your shoulder and will berate and belittle anyone who doesn't have the same mindset or sentiments as you.

This is a case of a new nurse not getting the greatest orientation because he/she has a preceptor that is not doing a very good job at teaching him/her. I didn't at all take it as an attack on a certain patient population or unit. I feel like it is sentiments like yours that do not help new nurses into the field and is very off putting. So please do not lecture the OP for voicing very valid concerns.