Would I be ready to leave to another floor after 6 months?

Scrubs_n_sirens, MSN, RN · Jun 14, 2016

I usually recommend you get at least a year before you move. If only to develop as a nurse. It's not abnormal for new nurses to feel like you do. It's actually sometimes expected.

But don't sacrifice your own well being for your resume. If you truly are miserable get out now before you burn out early. Not everyone likes their first job and there's no shame in it. We tend to glorify our first jobs. You can't know what you'll truly get into until you're in the sh**.

I will warn you though. ED isn't easy either. You'll be the first person those trauma patients will see. You'll still get drug addicts, homeless, drunks, inmates, the violent psychotic patients, and generally awful people. You'll have a lot to do and be expected to do it fast because "look here comes your next ambulance." Every unit will have its pitfalls. Every unit will be challenging to you especially as a new nurse. But you need to be able to go home, leave work at work, and live your life.

calivianya, BSN, RN · Jun 14, 2016

Definitely leave - that's horrible!

I think you should try ICU somewhere else before giving up on it altogether. The hitting/punching/kicking is personally why I would never work ER. If you work a high enough acuity ICU, 99% of your patients are going to be intubated, sedated, and restrained. I have never had anyone hit me (though a couple have tried).

Go somewhere higher acuity. A good keyword to look for is regional referral center. Or, of course, level 1 trauma center. Places like that will have the high acuity patients you are looking for with fewer that are able to hit you.

Staffing is awful at my job, too - but I actually don't mind 3 ICU patients as long as they are all vented with no family in the room. The last night I worked, I was lucky enough to have two semi-comatose on no sedation vent patients whose families had gone home after dinnertime, and my third patient was extreme AMS who was also a ward of the state and didn't wake up all night. Couldn't have had an easier night if I tried.

NURSEJSS · Jun 14, 2016

Definitely leave - that's horrible!
I think you should try ICU somewhere else before giving up on it altogether. The hitting/punching/kicking is personally why I would never work ER. If you work a high enough acuity ICU, 99% of your patients are going to be intubated, sedated, and restrained. I have never had anyone hit me (though a couple have tried).
Go somewhere higher acuity. A good keyword to look for is regional referral center. Or, of course, level 1 trauma center. Places like that will have the high acuity patients you are looking for with fewer that are able to hit you.
Staffing is awful at my job, too - but I actually don't mind 3 ICU patients as long as they are all vented with no family in the room. The last night I worked, I was lucky enough to have two semi-comatose on no sedation vent patients whose families had gone home after dinnertime, and my third patient was extreme AMS who was also a ward of the state and didn't wake up all night. Couldn't have had an easier night if I tried.

Thanks for understanding! The acuity at my hospital it pretty high. It's not level 1 trauma but most of my patients are intubated, sedated, or restrained. However that is not ALWAYS the case. Some pts are in ICU for other reasons that don't require them go be intubated or sedated. A lot of our doctors donut like sedating our patients (lol) so I still deal w a lot of hitting. The violence comes from mainly the population of people my hospital serves. I do also mind having 3 ICU patients. Although they don't move or talk they areusuallu the sickest and the ones you need to keep an eye on or those whose health is crashing. I do not feel safe working with 3 intubated patients that are unstable. Just one ICU patient keeps you on your feet all day. I don't want to deal w 2 others! The night we all had 3 patients my third admit I admitted coded. I needed so much help so I had a lot of the nurses helping me one nurse was forced to take care of FOR ICU patients during that code all which were not stable.

NotAllWhoWandeRN, ASN, RN · Jun 15, 2016

I think it's perfectly reasonable to leave a job that's impacting your mental health.

If you do go looking, make sure not to badmouth your current employer. Finesse your reasons for leaving. For example if you apply for a med-surg unit you can say you want to get your feet under you with more medical experience before the constant high-pressure instability of ICU.

Sun0408, ASN, RN · Jun 15, 2016

I would rethink leaving the hospital. Short staffing chronically is usually hospital wide. Also, those violent pts you talk about go through the ED first and then the floor after they leave the ICU. You will still be dealing with the same sh$t by either having a higher pt load or more frequent admits into the ED. As a new grad with less than 1 year experience , it would be difficult to manager 3 ICU pts.

I left my first ICU job because of that but guess what, the grass isn't always greener.. After 2 years , I went back to the same hospital and unit I left. Just keep it all in mind.

BC_ICU · Jun 17, 2016

What did you decide to do? I'm on the same boat and in need of some advice!! Thanks in advance.

NURSEJSS · Jun 17, 2016

I decided to start applying to various places and in the meantime continue working until I got a better job somewhere else. At least that way I can continue to work on my experience meanwhile I look for something else. I plan to definitely leave after 1 year.

HouTx, BSN, MSN, EdD · Jun 20, 2016

I am so sorry that you find yourself in this situation. But the first thing I would advise you is to STOP taking on more shifts than you have to. STOP answering that phone! Don't feel guilty. The staffing problem is not yours to own. If you have more down time when you're off, those challenging shifts will easier to cope with.

You said you had been employed as a NA in the same unit prior to becoming an RN.. did your facility eliminate the nurse assistant positions all together? That's kind of a red flag which may signal some serious financial instability for the organization. It's not really that unusual for ICU ratios to exceed 1:2 if you have a qualified nurse assistant to help you.

I'd also advise you to talk to your manager about your concerns about patient safety & the level of burnout you are experiencing. S/he can't read your mind - you need to ask for help when you need it. If you're ignored, you have the option of escalating your patient safety concerns via the organization's normal processes. They have to have an 'integrity' line (CMS requirements) & you can always use that.

Best of luck to you - hope it gets better soon.