Considering ICU-Not sure of jump

snowboarderRN · May 3, 2004

Every area of nursing seems to attract different types of people, ICU nurses tend to enjoy the problem solving and critical thinking/education. ICU can be very stressfull ie codes/crashing patients/families but it has been very rewarding to me. I say go for it!! As long as you are trying to learn and are open to new things you will love ICU. Sometimes 12hrs is a lifetime with a patient that is confused or wild on the vent but the amount of detail and perfectionism that is ICU usually keeps your brain going!

Stlcardsrock · May 3, 2004

I chose ICU over ER 6 years ago. I found out that working in a trauma ICU was non-stop. From the minute I stepped on the floor til the hour late that I clocked out every day; patients in the halls, janitor closets, linen holding areas, wherever there was space, there was a warm body and 7 family members.

In an ICU it's one room, one patient, 2:1 ratio normally. All of the factors are controlled. You have the patient hooked up to all the monitors and have all the hemodynamics your heart could ever want. I have time to plan, think and act. Good vigilance will almost always predict patient's turning south, and give you time to react. Snowboarder was right, you need the ability to troubleshoot and critically think. You need good organizational skills. You also need a good medical floor or tele floor background. If you have never had tele experience, I would recommend it first. The ER nurses that transfer up here that I have precepted don't do well because of their lack of experience with the simple tasks like dressing changes and NG tubes and hygene. Usually these remedial tasks are distractions when they are learning the higher concepts.

The staff of the ICU is very important. Is this a group that you could gel with? Anyhoo...best of luck.

Dinith88 · May 3, 2004

The biggest difference between ICU and all other areas you can work is that in the ICU you're ALWAYS dealing with families in crisis. Thats not to say that other units don't have this to deal with, only that in ICU the patient is ALWAYS critically ill(or can go bad quickly). Sure, other areas deal with freaked-out families, but in ICU, you see these issues every day, all day long. This is true even more so than in the ER because the majority of ER patient's are of the more mundane variety (despite all the cool tv-shows)...and if the critical variety of patients survive the ER they come right over to the ICU (usually at shift-change...but thats a different story.. :) )

That being said, it's my opinion that in order to be an effective ICU nurse, you've got to be prepared to deal with families/friends who are angry, in mourning, in shock, etc. YOu've got to be able to deal with them, sooth them, teach and inform them....it can be VERY exhausting.

A few ICU nurses will wrap themselves up in the 'hippa cacoon' and give/teach the family very little...and this usually has a detrimental effect on the nurse-family relationship...and can make the nurse look like she is using the 'rules' to hide her lack of info/understanding of the patient's condition(and usually hightens the family's anxieties!). It's usually best to be frank and up-front with families...but do it intelligently....(and without breaking any rules,..)

(as an aside, when was the last time a family-member said "..AH HA! YOu just told me her labs! NOW I can sue according to HIPPA!!"...that crap just doesnt happen )

And thats only half of your job. You'll have to to know your stuff inside and out...(it will be expected). You'll do stuff(technical and otherwise) that isnt done in any other department. You are where the buck stops.The patients will get better...or die.

alwayslearnin · May 3, 2004

Snowboarder, Stlcardsrock and Dinith 88,

Thank you so much for the replies. Wow, a lot of food for thought. Guess I hadn't realized how much of the family dynamics were a part of the ICU. And the last statement from Dinith 88- "they either get better or die" was a good reality check. I am going on the interview tomarrow to find out more about the position-especially the training aspect. I will try and get a sense of the staff there and if we can "gel". As I read through the posts, I felt excited at the apparent in depth knowledge base needed and the need for critical thinking/trouble shooting..Yes that's right up my alley!

Again-thank you for your thoughts/experiences. I have more info to make this decision with. I'll let you know how things go.

Have a great day!

P.S. Sounds like we have a snowboarder and St. Louis Cardinals fan-is Dinith 88 a couple names or ???? Just curious :)

Alwayslearnin

surferssoulmate · May 4, 2004

I agree wholeheartedly with Dinith 88 - you MUST know your stuff and that includes so much - meds, assessment skills, lots of equipment, etc. But I think the most important thing you'll learn over time is to anticipate whats happening with your patient. That's all part of critical thinking. Good luck, if it feels right, go for it.

tsgarman, RN · May 12, 2004

Why did I choose ICU? I choose it at first because I wanted to pursue a career in flight nursing, which I am still thinking about doing. But I also choose it because I did not wnat to do floor nursing. I can't handle having 10-15 pt's at one time. I need the 1-2 pt's where I can focus more time and energy on them and actually feel like I am doing something worth value. Not to say that floor nurses don't. I just need more of an adreneline rush. The bad side of ICU is the families, not all but some. You get some crazy ones! I have also come to find out that ICU nursing is a lot of pysch nursing too. Not one area I really wanted to be in. I started out right out of school as an ICU nurse and would not do anything else at the moment. If you are a person who loves the adreline rush and can handle stress really well, and make quick decisions then I would say go for it!

Good Luck!

Tami