Getting all worked up in ICU

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I've been a nurse since November 2005 on a Telemetry unit. 3.5 weeks ago I went to ICU. My first week on my own, I had a code. When I came to work 3 days later, I had a respiratory code right at shift change and the patient was intubated. The next night I came in, I got a patient from Med Surg, who was made a DNR about an hour after getting to me. He passed away 3 hours later. Ugh! After these experiences, I have been a nervous wreck! I dread going in, and I am soo stressed. Outwardly, you would never know it, but inside, I'm cringing. On tele, I never had a code, and the patient's weren't very critical. I'm terrified to keep going. Any advice would be appreciated!

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Specializes in NICU.

3.5 weeks ago you transferred to ICU and you're already on your own? You need a longer orientation than that in the ICU.

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Wow, I agree, you need a longer orientation. Most likley, you'll feel stressed in ICU. That's why they call it critical care. But, most of us critical care nurses get off on the tension. Hang in there. Use each incident as a learnign experience, think about what happened, what you could have done differentley etc. it will get better.

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Specializes in PICU, surgical post-op.
My first week on my own, I had a code. ... I'm terrified to keep going.

This may seem trite, but at least its over! I started in PICU right out of nursing school, and my own patient didn't code on me until ... a year and a half later. I lived in fear up until then as to whether or not I'd be able to handle it. And here you are, a week on the job and you've already survived most of what goes on in a ICU! That probably doesn't help, but I think if you're still standing at the end of a week like that, you're going to do okay.

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Specializes in Geriatrics, Wound Care, Infection Contro.

I understand your dismay. I work on Tele and we run our own codes. We are the designated step down unit for the open heart & get Patients directly from the cath lab. My first week two years ago was just like yours. I was petrified but I survived. I was able to because I asked for help and talked with my co-workers. They all had stories of how awful things could be even after years of experience. Good luck to you.

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Specializes in ER, Occupational Health, Cardiology.

You've been a nurse for 2 years and never had anyone code? That is amazing! Where you have transferred to, it is a rare day NOT to have a code, of some type. Surely you knew this, going in? The acuity of the patients and the types of illnesses they have is significantly higher and worse than anything that you will see outside of the ER. Therefore, there will be an incresed chance of a pt coding, and also, failing to respond well to the code. If this doesn't sound like something that you think that you can deal with, day in and day out, is it too late for you to return to the unit you had been working on?

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You've been a nurse for 2 years and never had anyone code? That is amazing! Where you have transferred to, it is a rare day NOT to have a code, of some type. Surely you knew this, going in? The acuity of the patients and the types of illnesses they have is significantly higher and worse than anything that you will see outside of the ER. Therefore, there will be an incresed chance of a pt coding, and also, failing to respond well to the code. If this doesn't sound like something that you think that you can deal with, day in and day out, is it too late for you to return to the unit you had been working on?

I knew about the acuity of ICU patients when I went in. I never said anything about wanting to return to tele. I just need to calm my nerves a bit. It was a bit overwhelming during the first week on my own in ICU to have so many things happen. I'm not saying that I will not be able to handle it...eventually.

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Specializes in ER, Occupational Health, Cardiology.

I didn't say that you should return to Tele. I asked if it was too late to go back, basically. The reason for that is if you were comfortable on Tele and you are not comfortable in ICU, and don't see much hope of getting comfortable with that level of stress, perhaps you could go back. We see over and over on these boards nurses stressed to the max. It is often the nature of the beast (profession), but if it seems unbearable there is no need to put ourselves through such emotional agony, if there is an alternative.

Take care of yourself, and best of luck.

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Specializes in PICU.

Wow, that sounds a o=lot like my year in the PICU, during orientation, I had pts code, code and go on ECMO, throughout my first year I have had thre codes (compressions, intubation and meds) several emergent intubations, several medical codes (pushing just a few meds, epi bicarb, calcium) but I have also had the regualr PICU intubated pt. Your recent experience sounds pretty typical in the ICU world. I sometimes get bummed if it was a heavy week, but it lasts a day or two, I just do something nice for myself, then I think that there are other pts and they need my full attention. Good Luck in the ICU, I couldn't imagine working anywhere else, I feel vindicated if I can successfully wean my Dopa, or get my pt extubated my shift, I know small victories, but it makes up for the next day when the pt crashes.

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Specializes in Travel Nursing, ICU, tele, etc.

It is really unusual to have that many codes in that short of time, even in the ICU. You are one of those nurses who has that karma happening right now. I don't know why it happens that way. But I know someone who had codes constantly for a long time, she called herself "nurse death". Do you notice that you are never alone at your codes? The code team comes in and everyone does their job. The most important thing you need to do, is to know the story and the history on your patient, since you are considered the "expert". I would look at your patients that way, as if you needed to tell the code team their story and then you just be the best nurse you know how to be. The codes will ease up! Hang in there. Keep yourself calm. You are so new, that no one is expecting you to know how to handle a code like someone who has been there 10 years. Just let the team do their job and you be there giving information. That is the main purpose for the primary nurse during a code. Relax, keep breathing...you can do it!!

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ICU with only 3.5 weeks orientation is not enough, you need more orientation and I think you should ask for it. As for the code, it is very common in ICU. I don't work in ICU but almost every day that I worked, I hear a call for code in ICU.

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It gets better. ICU can really be a weird place. In my 10yr experience in ICU I can say that you will have several weeks that are really bad. Days where you go home and debate wanting to quit. Then the next week it's a whole other place it seems. Calm, no codes, no death. Maybe a bunch of call light pushers asking you to pick up their remote. That's how it goes.

Look at it as a learning experience. In a years time a code will seem like just another part of your job. Sure, it still sucks but it isn't nearly as horrible as when you first started.

Hang it there! I also 2nd the previous posters who suggested speaking to your nurse manager regarding a need for more time in orientation.

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