ICU nursing in USA ?

  1. I am curious how nursing in ICU is in the USA. I am a RN nurse -since '93- in th Netherlands and now in training for ICU. We only have one kind of degree of nurses working in hospitals. A nurse has to be at least one year RN if he wanted to start for example ICU. It is not possible to work on ICU without training or being in training. In the Netherlands we believe that we are a modern country and that we have a high level of healthcare.
    The schooling of basic nurse takes five year, than you are allowed to work in a general hospital, mental (= psychiatric?) hospital, institution for mentally handicaped, and district nursing.
    ICU training takes one year and a half, and recently, training is not including CCU anymore.
    On ICU we do ventilation. I read about respiratory therapist, I think we dont have that in the netherlands. The doctor and nurse determine the breathing mode (like ASB, CPPV, BIPAP, PCV, and SIMV)......

    I would like to have contact with american (IC)nurses to talk about the differences between nursing in our countries.
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  2. 6 Comments

  3. by   Carl P
    Beste Paul,

    Cant tell you much about nursing in the usa, Id rather stay in the Netherlands.
    Im a cardiac care nurse in Apeldoorn, a small town in The Netherlands ( 175.000 inhab.) with a hospital of 450 beds. To my knowledge theres a Ventilation Practitioner working in a of the 2 locations, maybe similar to the respiratory therapist.

    Greatings, Carl
    Last edit by Carl P on Mar 11, '05
  4. by   Elenaster
    Greetings Paul!

    Here in the USA, you can come right out of nursing school and work in the ICU, with a training period that varies from 3 to 6 months. ICU here is highly specialized and units are generally broken down by specialty like neurosurgery, cardiothoracic surgery, general medicine/pulmonary, trauma, etc.

    We do utilize respiratory therapists, and they typically manage your vents, extubate patients that have successfully weaned, maintain O2 flow rates, and draw ABGs.

    ICU nursing in the US is very stressful, largely because more and more patients are moved into the ICU to die, therefore we often care for extremely sick people with little to no chance of survival (often referred to as futile care).
  5. by   Heartman
    Dear Paul,

    I would have to agree with the previous poster, that ICU nursing is quit variable through out the United States.

    I can tell you a little about my experiences.

    I graduated from a 4 year bachelors program in 1981. I have worked in the ICU environment in different units since that time.

    Almost all of my hospital career has been with the Veterans Administration System. This is the system that our country has set up for the care of all verterans of US military service. So keep in mind that our pt. population is mostly male and all adult, many elderly.

    I started out in a medical ICU for about ten years.
    General medical pts. requiring ICU level of care. Lots of pulmonary and cardiac cases often with multiple system involvment like liver and renal failure. Many end stage pts. with end of life issues to be delt with. No trauma pts. May pts. intubated with eventual tracheostomies on vents. Frequent heodynamic monitoring and occasional insertion of temporary pacing wires at the bedside. Some overdoses and some senile dementia.

    About ten years ago our hospital downsized and combined the medical and surgical ICUs. This brought a different kind of pt. In addition to the medical pts now we had to deal with all types of general surgery pts. Excluding neuro and open heart surgery. Ventilated pts are managed by resp therapists.

    At the beginning of this year I transfered to a surgical ICU closer to Boston. This unit deals with all general surgical pts. but primarily open heart surgury. The nurses take a more autonomous role in weaning the pts from the ventilator and extubating them. When their PA catheter is no longer needed it may be DC'd by the RN. Pts. are moved along quickly from their cardiac surgery. Usually extubated within hours of their procedure, OOB to chair and maybe ambulating on post-op day 1 and transfered to the general floor on post op day 2.

    Well thats a brief synopsis of what I do. If you have any more specific questions please let me know, and I will try to answer them for you.

    Looking forward to hearing from you soon,

    Walt
  6. by   sockov
    I would like to have contact with american (IC)nurses to talk about the differences between nursing in our countries.[/QUOTE]

    hi
    the hospital I work at has a program where nurses from the different ICU's go to amsterdam to be with their ICU nurses for a week, and shadow and learn how they do things.
    then the amsterdam ICU nurses come here to the USA to do the same. The nurses each house each other.
    It is very succesfull and we get great ideas both ways. plus make new friends.
    PM me if you want more info.
  7. by   angelique777
    Quote from sockov
    I would like to have contact with american (IC)nurses to talk about the differences between nursing in our countries.
    hi
    the hospital I work at has a program where nurses from the different ICU's go to amsterdam to be with their ICU nurses for a week, and shadow and learn how they do things.
    then the amsterdam ICU nurses come here to the USA to do the same. The nurses each house each other.
    It is very succesfull and we get great ideas both ways. plus make new friends.
    PM me if you want more info.[/QUOTE]
    Can you tell me more about the exchange program thanks so much
    Angela
    ladyarwenofriven@aol.com
  8. by   wmsvandyrn
    I've been an ICU nurse for almost six years now working in a variety of different types of ICUs. I don't think I could ever work on a general med/surg floor again, but I never say never. It is extremely intense in any ICU, as I am sure you are aware.
    As for our education, in order to become an RN over here you can either obtain a four year Bachelor's degree or a two year Associate's degree. In the past, many ICUs required at least one year of nursing experience before hiring, but, with the nursing shortage over here, they will hire new graduate nurses.
    As for vents, most of our patients are mechanically ventaliated, but the respiratory therapists handle most of them. The nurses just trouble shoots any problems and monitors them. As for vent modes, the MD and respiratory therapists determine that based on ABGs. Nurses give their input, but with some MDs that doesn't count for much.
    It seems that there are many differences between your country and mine. It's interesting to hear about those differences. Please feel free to contact me if I can be of any help. Wendy

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