Eaten in the ICU

Image: Hemera | Thinkstock

It’s been a very long first week of summer. School started and we’ve been thrown head first into the ICU. It’s exciting, and horrifying all at the same time. The way my school’s program is set up, we have our first year dedicated to fundamentals and med-surg, and then we break out for the second year into OB, peds, and psych, finishing up this 9 month non-med-surg run with a super intensive ICU (or SI-ICU, super intensive for us, ICU for the patients) rotation. So, now that we can’t remember the last time we hung and IVPB and haven’t had to go pick a patient (and do the subsequent 5 million hours of paperwork the night before) we are not only expected to hit the ground running, but we have to pick up where we left off last summer. Thanks nursing school.

But hey – it’s the ICU! I’ve been looking forward to this, although, now that it’s started, I really can’t remember why…. Oh yes! It’s because I really enjoyed working in the PICU, and so I thought this would be sort of like that. But somehow, the stress of it all has sort of diminished any happy thoughts I ever had of picturing myself as a PICU nurse. Despite this, I tried to stay optimistic on the floor last Thursday when we went to do our “scavenger hunt” of the floors, figuring out where supplies are, how to find what we’ll need when we’re actually working next week.  So here we are, the professional looking students, donning our unflattering white uniforms (yes, I had to throw that in there again), and we’re looking around the floor. As a student nurse, I always try to ask questions politely, I don’t like disturbing other nurses, because I know they’re busy. I’m used to getting short answers and not taking it personally. That’s sort of how it goes. But it didn’t really take long before we started to really get the feeling like we weren’t welcome on the floor.

With the exception of ONE nurse (and we talked to, or tried to talk to, quite a few), we were greeted, so to speak, with blank stares and monosyllabic, albeit borderline rude, responses to questions. A friend of mine literally had to ask 3 nurses (all sitting in the nurses station) how to print a 6 second strip before another nurse sighed loudly and said, “Just push the record button!,” without taking her eyes off the screen in front of her. I mean, seriously, I know you’re all busy, I get it – I really do. But I felt like saying, “You were where I am now not that long ago, don’t you remember that?!” I just don’t get it. There’s that horrible saying, “Nurses eat their young,” but I always sort of thought that was an old saying, that it didn’t apply to how nurses act today – WRONG!  I just don’t understand, especially since I feel like, as students, we’re there to help. If we can get along and have an amicable, working relationship with our nurses, we can make a pretty awesome team, and give some seriously awesome care to our patients. But with this wall up between us and them, and with the stress of the day piled up on top, it just feels like a recipe for disaster.

I really want this quarter to be great. And while I am nervous about the expectations being placed on us, I really feel like I am finally at a point where I am ready to tackle it. Sadly, the one thing I am most worried about, is the team dynamic on the floor. I can deal with the pressure I put on myself, and I can work with the pressure from my instructor. But if I am getting negative vibes sent my way from the nurses too, I don’t know how I am going to deal with that. I just hope it was a bad first impression, otherwise it’s going to be a long quarter.

Nurses out there reading this: How do you feel about working with students? Any advice for the students reading (and me!) about what you like to see from us?  Students: Have you clashed with the staff? How did you deal?  And on another note, does anyone have any advice on how to deal/organize/prepare for ICU clinical?

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Ani Burr, RN

I'm a brand new, full-fledged, fresh-out-of-school RN! And better yet, I landed the job of my dreams working with children. I love what I do, and while everyday on the job is a new (and sometimes scary) experience, I'm taking it all in - absorbing everything I can about this amazing profession we all fell in love with.

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12 Responses to Eaten in the ICU

  1. Annie

    Ani. LOVE this blog <3 ICU is so intimidating!

  2. Lyn

    I graduated 6 years ago. I spent a year on med/surg, 4 years in ICU/CCU (two locations), and last year started my dream job in NICU. I DO remember, vividly, what you are talking about. From what I have seen since graduation, the nurses who treat students that way either hate their jobs, or (and?) lack confidence in their own performance. It’s hard to teach when you don’t feel that you know what you are doing, or would rather not be doing it! I promised myself that I would not behave that way, and I don’t. Having students keeps me at the top of my game. After a while, I think everyone is able to perform certain aspects of their job without thinking about it. When I have a student watching everything I do, I explain as I go and it makes me pay more attention. Kill them with kindness, as the saying goes. In particular, be most cheerful and verbally appreciative to the rudest nurses (Oh, THANK you so much for your help, Nurse Frownyface! You’ve been WONDERFUL!) It will probably make them ashamed of their behavior. Even if it has no effect, you haven’t lost anything. One word of advice: It makes me CRAZY when a student automatically jumps up to follow me every time I walk across the room. There is nothing to be learned from a trip to the copy machine. Ask the nurse you are following for the day to let you know if you should come with her, because you don’t want to crowd her. Explain that you heard this from ‘a friend’, so she doesn’t think you are being lazy. This will save you embarrassing in-tandem trips to the bathroom! Good luck!

  3. Sean Dent Scrubs Blogger

    I think it’s a crap shoot, you’re going to get nurses who love students, and the nurses who despise them (sorry).
    I loved working with them.
    I can tell you that the one thing that is difficult for us nurses is ‘slowing down’ to the students pace (sorry if that offends someone). We have to find a way to slow down and stop our normal pace to let you have the opportunity and time to learn a new skill and absorb a new concept.
    That is tough on an ICU nurse who is all about time management and working at a lightening fast pace.
    Communication is the key in any arrangement with a nurse and nursing student. Get it all out in the open and be sure to leave your emotions and personal feelings at the door.
    In the end it IS about you (the student) and your learning. Take advantage of every learning opportunity and be aggressive enough to know when someone or something is impeding on that.
    Stay strong!

  4. Trish Hoge

    I love working with the Students. However, there are times when the hospital your are at, has understaffed, and under-supported RN’s to help Students. I work in a Magnet Hospital, and we actually get points and education on how to help Students.

    Just remember your experience and promise you will not become those negative RN’s that should be brave enough to find a new career.

  5. Liz

    I personally haven’t had a bad experience on clinicals, but I have a lot of friends from uni that have. I thought I’d just write about my latest experience. I just finished 4 weeks of clinical placement in an Emergency Department of a busy metropolitan hospital, and I can’t believe how fantastic all the staff were. Everyone, from new grads to very experienced nurses, was so supportive and interested. They all gave us every opportunity possible to build our skills, ask questions, and even just watch what they were doing. It’s given me a new perspective on this issue: if all of these nurses (who were just about run off their feet the entire time!) can be such fantastic preceptors, why should it be acceptable for nurses in less busy and less acute areas to treat students poorly? It’s not just a part of being a student that should be “a given” or accepted. Sometimes it is outright bullying, and it would not be acceptable from a fellow colleague. Anyway, I hope when I’m registered I can be just as good as these ED nurses were.

  6. kayce

    I love to teach and wish I had more opportunity to do so, but in my job it is a real hindrance. With 20 patients there isn’t enough time to complete my own work to my satisfaction. Whether it is clinical students or orienting new nurses they have to be ready to learn (literally) on the run. My advice to students in that environment is this…feel free to ask all of the questions you can because we may not think to explain every little detail. When we do take the time to explain something do NOT cop the attitude that it’s something you already know. And please don’t interfere with what we need to accomplish in your rush to complete your own assignment. We know full well how important it is to you, but you must remember that this is our job & license on the line, these are real patients, these are OUR patients, not a simulation.
    Most of all, remember that one day you will be doing the same thing as we do, you WILL get there! And hey, if you have a bad preceptor…at least you’ll know what NOT to do.

  7. Roxane

    I know how you all feel. As a nurse that has been graduated for almost 20 years, I promised myself that I would NEVER take on the attitude of ” eating my young”. I enjoy teaching students, and do agree that it can be difficult on times to step back, slow down, and take the time students need and deserve to teach them. I find myself continually reminding otheres, that everyone of us were a stundent/ new graduate. There is NO such thing as a stipid question, only those that are not asked. The only thing I can say is, be availabel, willing to learn, and dig in: seek out someone who can be a mentor. I find what I give, I get SO much back!!!! But, if it is a really busy time, stand back,and observe, ask your questions later, the nurses will then know your are absorbing something and are interested!…. hope this helps a little…

  8. Nicole Lehr Scrubs Blogger

    I agree with Sean, sometimes it’s hard for nurses to slow down to the pace of the nursing student who is trying to soak up knowledge like a sponge in the short amount of time they are in that location. You will find this once you are out in your first real job too. Don’t get discouraged, there are plenty of nurses who love having students and who thrive off of sharing their wealth of knowledge with said sponges. You just have to weed through the not-so-pleasant ones until you find that nurse :) You’ll be fine. Thumbs up for choosing a difficult ICU, I did my practicum in a Level 1 trauma ICU and to this day say it was the best experience I ever had. Good luck!

  9. Kelli

    Sorry you had a bad experience. It says more about the quality of the nurses you worked with than it does about you.
    I had the best time with the nursing students, even in a busy level 1 regional trauma hospital ICU. We were always super busy but it’s still a thrill to teach someone to doppler a pulse or read a SWAN. Fun times…
    The Devil doesn’t always wear Prada… sometimes she wears scrubs.

  10. Jeanyis

    The attitude of the nurses in ICU/Stepdown clinicals turned me off from ICU nursing. I’ve never seen a more aggressive, competitive, cliquey, unhappy acting group – and this was not unique to the facility I was at. I had been a ward clerk previously at another facility in another city. Although I find the subject matter interesting and wish I could practice in this field, I don’t seem to be a good fit personality-wise with the majority of the nurses in this particular type of nursing. The headaches and stress it would cause would not be worth it.

    The flip side of the coin – the ICU nurses that took the time to explain to me what was going on with the machines that go ‘ping’ and why they did what when they did it when I was a mere ward clerk helped spark my interest in nursing. Without them, two in particular (Nancy and Allan, thank you, wherever you are today!), I would not be an RN now.

  11. i love having students! It keeps me fresh and on my toes. It gives me the oppertunity to talk through things and educate patients in a way that they gain confidence in my care. Having a student makes me a much better nurse! As a student I often felt I was a burden to the nurses and I have always tried to make an effort to show students what I love about my job, be honest about what I dislike and give words of wisdom of what I feel is the most difficult aspect of nursing “social drama”.
    To so many nursing has become just a job. It is a burden of need rather than a labor of love. I feel that inspiring student nurses is a way that I can possitivel impact as many lives as possible. Who knows when that student may use that bit of knowledge you lended them to save a life, comfort a family member, or provide someone with the respect and dignity that every human being deserves. Remember that student could take care of you one day. I want a motivated and eager nurse to care for me. Do unto others because someone at some point is surely going to do unto you.

  12. wendi taylor

    I have yet to be eaten by a nurse, I was eaten and spit out by an instructor. She was rude, condescending and just plain mean. I became so stressed that I couldn’t even function around her. i ended up quitting for a year. I recently returned to school and finished my first year. Any advice on how to handle an instructor that isn’t an educator but a bully?