Anyone bored/unhappy with ICU?

lady_jezebel · Apr 22, 2005

bumping post, would love a response

butterflynurse03, RN · Apr 22, 2005

I think that you will learn a lot. You MUST know the whole picture of what is going on before you even think of calling a doctor. You will learn how to pull it all together and your critical thinking skills will improve. But just dont kid yourself that there are no politics, there are. That is just life in any job. Keep a positive outlook, you can make it what you want if you are willing to try.

Trying to get there myself. Have fun.

pricklypear · Apr 22, 2005

I felt the same way after 3 years on a busy surg/cardiac tele floor. I learned a lot those 3 years, but after a while I felt stagnant. The only challenge I felt was how the H*** am I going to get 12 charts/medexs checked in 12 hours while trying to meet the needs of my patients with no aide, admissions, staffing, blah blah blah...

I went to an ICU where a friend of mine worked. It helped ease my anxiety to have someone I knew there. I was scared, but found a REALLY supportive staff, who have become great friends. I felt like a dry sponge, soaking up everything...and I loved it!! I will NEVER go back to floor nursing of any kind. I love knowing everything about my patients, being able to care for them in ways I never could with 10-12 patients.

Boredom can be an issue, but only if census is low for some reason. It's either feast or famine usually. But whenever I get to feeling bored with easy patients, I just think back to the days of staying 2 hours late after my shift to finish paperwork, being nauseated on the way to work, and feeling totally overwhelmed. That is not so say I don't feel overwhelmed at times now, it just happens few and far between. And Butterflynurse is correct, politics exist in the ICU too. Sometimes it can be worse that anywhere else because of the overinflated egos you sometimes find in ICU settings. Luckily, it's not too bad where I work.

I think you are going into your new job for the right reasons, with a good amount of organizational skills from working a busy med/surg floor. I wish you all the best of luck!! Let us know how you are doing!!

lady_jezebel · Apr 22, 2005

I felt the same way after 3 years on a busy surg/cardiac tele floor. I learned a lot those 3 years, but after a while I felt stagnant. The only challenge I felt was how the H*** am I going to get 12 charts/medexs checked in 12 hours while trying to meet the needs of my patients with no aide, admissions, staffing, blah blah blah...
I went to an ICU where a friend of mine worked. It helped ease my anxiety to have someone I knew there. I was scared, but found a REALLY supportive staff, who have become great friends. I felt like a dry sponge, soaking up everything...and I loved it!! I will NEVER go back to floor nursing of any kind. I love knowing everything about my patients, being able to care for them in ways I never could with 10-12 patients.
Boredom can be an issue, but only if census is low for some reason. It's either feast or famine usually. But whenever I get to feeling bored with easy patients, I just think back to the days of staying 2 hours late after my shift to finish paperwork, being nauseated on the way to work, and feeling totally overwhelmed. That is not so say I don't feel overwhelmed at times now, it just happens few and far between. And Butterflynurse is correct, politics exist in the ICU too. Sometimes it can be worse that anywhere else because of the overinflated egos you sometimes find in ICU settings. Luckily, it's not too bad where I work.
I think you are going into your new job for the right reasons, with a good amount of organizational skills from working a busy med/surg floor. I wish you all the best of luck!! Let us know how you are doing!!

Thanks so much for your input. This is what I needed to hear! :rolleyes:

lady_jezebel · Apr 22, 2005

I think that you will learn a lot. You MUST know the whole picture of what is going on before you even think of calling a doctor. You will learn how to pull it all together and your critical thinking skills will improve. But just dont kid yourself that there are no politics, there are. That is just life in any job. Keep a positive outlook, you can make it what you want if you are willing to try.
Trying to get there myself. Have fun.

Thanks for bringing up the politics issue, Butterfly. I will prepare myself for that.

PJMommy · Apr 23, 2005

I hate to say it...but I also think the docs treat ICU nurses better. Most of the docs know all our ICU nurses by name and respect that, if that nurse is calling them, it's something that really does demand their attention. I have found a bit more comradarie between docs and nurses in ICU -- it almost has to happen when you are shoulder to shoulder with them every shift, putting in lines, coding patients, watching unstable blood pressures, etc. Of course, this doesn't happen overnight -- the docs always wait to see if the "new nurse" is really going to fly in ICU. :)

mysticalwaters1 · Apr 23, 2005

I have been an RN for 1.5 years now on a med-surg floor. We are "ortho", but daily have spine surgeries, sarcoma/cancer, and medicine overflow. It is really busy much of the time. I feel burned out on the type of stress we have to deal with on the floor -- poor communication b/twn disciplines (this is the BIGGEST problem), poor staffing, pts kicked out of the icu onto our floor (where we have no monitors) b/c there is no hospital step-down unit, arrogant surgeons (and some ortho residents) that treat the floor nurses like pee-ons, complicated/incomplete discharges (where the RN ends up calling social work, the home health company, several physicians, physical therapy, etc.... spending HOURS on the phone in order to get a pt what they need for discharge), and all of the running around (my patients are usually scattered among 3 hallways). Additionally, I'm not really learning anything anymore -- the learning curve is not the same as my first 6 months, and there is no time to read charts & actually understand what is going on with a pt medically. Often, I feel like a secretary or waitress pulled in a million directions.
I am transferring to the ICU b/c I want to get back to learning patho/pharmacology, ie. more technical rather than administrative stuff. I need a new challenge, and am looking for a different type of stress.
Question: Do I have unrealistic expectations of the ICU? Is it boring in that it is so structured? Also, will I REALLY learn more about the medical side of pts in the ICU? Or is it also rife with administrative B.S.???
Any thoughts much appreciated. I'm hoping that I will love my new job (Med-Surg/Transplant ICU).

WOW! Thanks for asking this because this is EXACTLY what i'm going through and recently decided to get into icu nursing but want another year of medsurg and study my nuring books again to be somewhat prepared! I am very detailed so i thought being detailed with less pt load yet more critical and probably just as much work but more focused may be good for me, more interesting and more knowledge to obtain. And you know what i find that too that the doctors seem more respectful or maybe not respectful but almost as equals and highly valued than the med surg. Not that the med surg nurses are not respected or valued but i guess high acute setting makes it like that then me harrassing for cough medicine.

NurseFirst · Apr 23, 2005

WOW! Thanks for asking this because this is EXACTLY what i'm going through and recently decided to get into icu nursing but want another year of medsurg and study my nuring books again to be somewhat prepared! I am very detailed so i thought being detailed with less pt load yet more critical and probably just as much work but more focused may be good for me, more interesting and more knowledge to obtain. And you know what i find that too that the doctors seem more respectful or maybe not respectful but almost as equals and highly valued than the med surg. Not that the med surg nurses are not respected or valued but i guess high acute setting makes it like that then me harrassing for cough medicine.

Well, there are the secret techniques of impressing physicians. (Speaking here from an experience I had.) Know something about their specialty (such as details about anatomy) that they don't expect a nurse to know (or remember). I (and I am a student) obviously impressed an ophthalmologist when I was telling a status post globectomy patient (who had been my patient the previous week) about how there are 7 bones that make up the eye orbit. He remembered my name, and called me by it! :)

NurseFirst

PS -- sphenoid, ethmoid, lacrimal, maxilla, zygomatic, frontal, palantine.

Interestingly, it is the "palantine process" of the maxilla. I've forgotten the name of the process of the palantine bone which makes up a part of the eye orbit--it is this bone that is hardest to find out about--many anatomy books just don't show or tell about it as part of the eye orbit. I've only seen one picture of the complete palantine bone--but it boggles my mind to think the bone that forms part of the hard palate ALSO makes up part of the eye orbit! Think about it! And no, the nasal bone does not make up any part of the eye orbit!

lady_jezebel · Apr 23, 2005

Well, there are the secret techniques of impressing physicians. (Speaking here from an experience I had.) Know something about their specialty (such as details about anatomy) that they don't expect a nurse to know (or remember). I (and I am a student) obviously impressed an ophthalmologist when I was telling a status post globectomy patient (who had been my patient the previous week) about how there are 7 bones that make up the eye orbit. He remembered my name, and called me by it! :)
NurseFirst
PS -- sphenoid, ethmoid, lacrimal, maxilla, zygomatic, frontal, palantine.
Interestingly, it is the "palantine process" of the maxilla. I've forgotten the name of the process of the palantine bone which makes up a part of the eye orbit--it is this bone that is hardest to find out about--many anatomy books just don't show or tell about it as part of the eye orbit. I've only seen one picture of the complete palantine bone--but it boggles my mind to think the bone that forms part of the hard palate ALSO makes up part of the eye orbit! Think about it! And no, the nasal bone does not make up any part of the eye orbit!

I knew this kind of stuff in nursing school, too... but after spending time on the actual job, you forget a lot of the anatomy, physiology, and pathophys (except for the info directly related to your specialty). This is why I feel like I need to make a change NOW, before I forget absolutely everything from school. Also, I've started reviewing my books again. I'm excited about this new challenge.

PJMommy · Apr 23, 2005

Well, there are the secret techniques of impressing physicians.

Yep. I think this is very true. In critical care, you have to know SO MUCH pathophys, etc. because you are watching for the same things as the docs (and making sure a new resident doesn't kill a pt). It can be little things like giving them the last K+ level when you're explaining findings that would indicate pt needs diuresed. Or reporting in after 4 units of prbc's transfused and giving a calcium level...or asking 'can I get you a repeat cbc now?

So...I've found the best book for review is PASS CCRN. You don't have to be even thinking about going for CCRN certification -- but the book is an excellent, comprehensive review of the anatomy and patho of the major systems. I pull it out just for reference a lot.