What are the skills and qualities of a great critical care nurse?

zambezi, BSN, RN · Oct 24, 2003

Hey Caroline...I posted this for another thread, but this is what I do on a regular basis as a CCU nurse... It is a great job IMHO, the technology, autonomy, and teamwork is great. Caring for patients and their families at such a time in their lives is rewarding and fascinating. The human body and mind never ceases to amaze me.

I work in a CCU. Though CC nurses usually have 1-2 patients, Critical Care Nurses have many functions. Critical thinking is a big one.We look at the entire picture and how everything relates to plan for the best outcome for the patient. We look and intrepret labs and determine whether the dr needs to be called for abnormal values and we take steps to correct the values. If a patients condition is deteiorating we look at the big picture to figure out what is going on and support the patient until problem can be solved. We can order ABGs, CXRs, Labs, etc to try and pinpoint problems based on what we see. Often there are standing orders that we have that can be used based on clinical intrepretation to guide our care (ie: to start vasoactive meds, for pain control, to give blood products, potassium replacement, for codes, for extubation procedures, etc). We use technology to assist us in our care (vents, CRRT, IABPs, swans, icps, and many other things), We titirate medications that are very potent to manage clinical symptoms and "numbers" obtained from our technology. If the patient is actively trying to die, we take measures to save them the best that we can. We also are a part of the code team in the hospital, so we run to codes on other floors and follow acls protocols to stabilize and transport the patient. If a fresh post op heart is crashing we stabilize or maintain the patient best as we can, alert the surgeon, assist the surgeon in packing the patient up to go to the OR or assist in reopening the chest in the unit (though the surgeons usually get them to the OR as fast as they can, preferabley before we have to do this in the unit)...We have a close working relationship with our docs and and are trusted to use our clinical judgement and critical thinking skills to solve problems.

On top of all that, we do basic care for the patient, keep them as comfortable as we can, take care of their emotional and spiritual needs and we support the family (which can be a big job in itself, LOL). We are the patient's advocate. We are the ones talking to the families to find out the needs of the patient (if the patient is unable to speak for themselves). We coordinate the patient/family wishes with the plan of care and to the doctor. Many ICUs do not have CNAs, if your patient is vomiting or has frequent BMs, is "crazy" etc, it us up to you to do the cleaning, turning, skin care, baths, feeding, etc. It is a great job, both technical/mechanical but the "basics" are just as important to remember! I am sure that others will have more answers as to what an ICU RN does.

zambezi, BSN, RN · Oct 24, 2003

Didn't read your entire question...as far as skills and qualities go, i would say the ability to think quickly, use critical thinking skills, being able to look at the entire clinical picture IE: the numbers, patient history, labs, current issues and most of all the patient and use your skills to support the patient and intervene when necessary. Being able to work in a team and independently. I think that teaching is also an important skill to have. Being able to learn from situations and take that knowledge and use it next time. Trusting your skills and knowledge. Being able to take constructive critisism to better your practice. There are many other important skills as well. Pros of working in this area are independence/autonomy, the chance to work in critical situations, seeing and using advancing technology, helping patients and families through difficult times and teaching them about their situation, plus many others.

CV CNS CCRN · Nov 6, 2003

As someone who has hired WAY over a hundred critical care nurses over the last twenty years, I can tell you that one of the characteristics I value mose in an ICU nurse is FLEXIBILITY!!! Things change in a heartbeat (no pun intended) in ICU's, and it is ESSENTIAL to be able to "go with the flow", change assignments, do whatever is needed to support our patients. I would much rather have a nurse as an employee and team member who is a little bet less expert in her skills, but way more flexible.

wv_nurse 2003 · Nov 6, 2003

In addition to critical thinking skills and flexibility, I think strong assessment skills are a must. I tell new critical care nurses that even if they can't "diagnose"--if they can give the physician (usually by phone) an accurate assessment, it is invaluable.