Redeployed to ITU and hating it

[MVH119]

The specialist Plastics ward I had worked on for the last 7 years was recently shut down by the NHS Trust I work for (I'm in the UK) and the only alternative post I was offered was in critical care which I know nothing about.

After 2 weeks on the Unit I find I absolutely detest the place and I really dread going to work. My surgical and wound-care skills are now useless and I'm overwhelmed with a whole lot of new information.

The UK job market is currently in a very difficult state. Most London hospitals have a recruitment freeze due to lack of funds so securing a post elsewhere is nearly impossible.

Please someone tell me how to survive in Critical Care, a job I neither chose nor want until I can get the hell out of there!

[MVH119]

I chose surgery for a reason. Because I enjoyed it and because it had a positive outceme.

Most of all I enjoyed my positive relationships with my surgical patients. That was fun and to my mind PROPER nursing.I cannot form a therapeutic relationship with an inert body in a bed

[nursern20]

At any rate count me out of the miserable technologies that extend a life that has come to a natural conclusion to the torture of a ventilator and inatropes.

Go into that gently.

i love what u said. i completely agree!

[nursern20]

I chose surgery for a reason. Because I enjoyed it and because it had a positive outceme.

Most of all I enjoyed my positive relationships with my surgical patients. That was fun and to my mind PROPER nursing.I cannot form a therapeutic relationship with an inert body in a bed

I feel like this too. Anybody have any thoughts on this??

[gradcare, LPN]

I chose surgery for a reason. Because I enjoyed it and because it had a positive outceme.

Most of all I enjoyed my positive relationships with my surgical patients. That was fun and to my mind PROPER nursing.I cannot form a therapeutic relationship with an inert body in a bed

Well than it seems like you will never like ICU what about private practice ? clinics etc?

Otherwise try remembering that you are not only treating the patient but also the family. Sometimes they need someone to bring some reality to the situation. On the other hand are you sure of your assesment (regarding some of your preveous posts) in cases that are not going to have a successful outcome? I have seen several so called hopless cases come through but have also had some patients who you would have thought should have survived die.

Either way I do feel for you being forced into a high pressure environment did they not as for choice of redeployment (eg med - surg) as opposed to critical care?

[Celia M, ASN, RN]

MVH119,

This is really tough time for you, you are grieving for the loss of your great job and angry becuase you are being forced into one you did not choose. Moving to a new area of nursing such as critical care is difficult and stressfull even if ypu choose to do it, being forced to do it makes it doubly worse. i worked in the NHS over 18 years ago and so have liitle memory of it, but the job freeze situation sounds terrible! I have been forced to move from 2 great jobs over here due to restructuring, it was tough at the time but has in each case worked out for the better. Please try to see your patients as other than an inert body in the bed, as an esperienced ICU nurse I can tell you that you can still have a relationship with them, they can hear and often respond non verbally. You can also forge a bond via the family members by finding out about your patient through them and having a relationship with them. Unfortunately there is a higher mortality rate in Critical Care, outr patients are so sick, and I have definately seen cases where we should have stopped trying to stop death a long time ago, these cases are difficult to deal with, but there are also those miraculous occassions where apatient pulls through against the odds or the team and family pulls togehter and a patient dies a peaceful death. If ICU is truly not for you, what about a wound care clinic or community nursing so you can use your wound care skills.

I am so sorry that you are going through this. I will keep you in my thoughts.

Celia

[MVH119]

A hundred people may apply for my post but they will not get it because of the new-staff freeze.

ITU costs roughly about £3000 a day. In many cases this is a criminal waste of resources if you work for the NHS as I do.

Example...my particular ITU recently maintained a brainstem-dead patient for 15 days. That is 36,000.

A criminal waste of money. This is the UK. We have proper healthcare here, not the ludicrous US system of private insurance.

The UK cannot afford this "Save lives at any cost" policy and it is also ethically unsound.

Compare your replies to my identical posts in UK nursing

[Celia M, ASN, RN]

MVH119, You are obviously very upset and angry at this time and so I will forgive you for your comments about the US healthcare system. It is not perfect and many people do fall between the cracks and due to the threat of lawsuits we do se the overuse or abuse of healthcare resources. However there seems to be no perfect healthcare system, the NHS has it's problems as you are experiencing yourself along with incredibly long waits for non emergent procedures, empty wards and no nursing jobs due to lack of funds. My father was diagnosed with BPH in Feb 06, his bladder had 6 l of urine in it, luckily he only had to wait 3 weeks for an outpatient ultrasound after seeing his GP! It took 3 months for them to do a TURP, all of that time he had a foley that was changed once, they did the TURP, took out the catheter and sent him home, and were surprised when he was still retaining urine, no bladder training at all. That was May, after being recathed, taught bladder training, , attempting self cathing, and failing they found he also had a stricture, requiring dilatation, after another failed self cathing attempt they have just put in a supra pubic cath. Had he had been in the US as he is over 65 he would be insured by the federal government through Medicare and in my hospital he would have had the TURP and all the subsequent tests etc and suprapubic cath with 1 month. No system is perfect and there are always those cases that leave us shaking our heads and wondering about the use of strained healthcare resources and it is not limited to ICU.

[MVH119]

I've already asked to be moved. I think ICU is one of those specialities you either love or hate. And I hate it with a passion.

Luckily the Unit manager was very sympathetic. She was quick to say that Intensive Care does not suit everyone and that no-one should be forced into working on it.

She is now looking to get me moved to a Urology ward which is a much better option for me.

[augigi, CNS]

Since it sounds like you already made up your mind and are determined to argue with anyone who answers, I'm glad you are getting transferred. ICU patients need intensive care, as do their families. As a nurse, it's not for you to judge the value of their life, or when they should die. I hope your attitude improves and you enjoy your next job.

[cardiacRN2006, ADN, RN]

Since it sounds like you already made up your mind and are determined to argue with anyone who answers, I'm glad you are getting transferred. ICU patients need intensive care, as do their families. As a nurse, it's not for you to judge the value of their life, or when they should die. I hope your attitude improves and you enjoy your next job.

Well said!

[MVH119]

The end of this sorry episode is as follows.

I was moved back to the surgical wards at the new site. I'm doing fine there as I love surgical nursing and it really does not matter which speciality it is I can handle it.

Management concedes that I never should have been put on ITU. I do not have the detail-orientated nature to tolerate the futile fiddling with numbers. My ethical concerns were also well-taken/

Kudos to the Trust. They did right by me.

[Celia M, ASN, RN]

Glad you have been reassigned, you and your patients are much better off this way. It would have been a shame to loose a nurse with expertise due to a forced relocation. Good luck. Celia:nurse: