Hates ICU Job

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Hates ICU Job

Dear Nurse Beth:

Is ICU for me? I accepted a position at a small specialized surgical ICU at a teaching hospital. Unfortunately, I HATE it. Most of these patients are on the unit several months to a year and should transfer to the floor, but the physicians don't trust med-surg nurses to take care of them. It feels more like a LTAC than an ICU. These patients are not vented or on any special drips. All have tubefeeds which means crushing pills all day, plus diarrhea and constant diaper changes. All are bedbound because they don't get enough physical therapy, meaning constant repositioning. Physicians, residents, and NP's constantly enter new orders and want them completed yesterday. Like EVERY department in the hospital, we are short-staffed and don't have nursing assistants. Charge nurses take patients and precept new nurses. Staff barely has time to eat lunch. I don't eat until it's almost time to go home.

Since I've been here, I fell on the unit and hurt my knee. I had to wear a brace for a month. From the constant repositioning, I have sprained my wrist and wear a brace all day. My doctor wants to do surgery. I have lower back pain and muscle spasms in my neck and wear a lidocaine patch. I have developed hemorrhoids from the strain of lifting. I have migraine headaches from the stress.

Is this typical of most ICU's? So physical taxing on the body? My contract will end in a few months. I don't know if I should apply for another ICU job somewhere else or take a med-surg travel assignment to clear my head. My husband thinks I should try ICU again at a different hospital or find a different position that is not physically stressful.

Need your advice. Thanks!

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Specializes in Tele, ICU, Staff Development.

Dear Is ICU for Me?

I'm sorry you're having such a challenging experience in your current ICU position. It sounds like you are dealing with significant physical strain and high-stress levels, which can affect your well-being. Let's address your concerns and explore potential options:

  •  It's essential to recognize that not all ICUs are the same. Each unit can have different patient populations, acuity levels, and staffing ratios. The issues you've described, such as patients being on the unit longer than necessary and heavy physical demands,  are not representative of all ICU settings. Some ICUs are fast-paced, challenging, and exciting, with vasoactive drips, ventilators, continuous renal replacement therapy, post-op open hearts, and so much more.
  • Reflect on your preferences and strengths. Take time to evaluate your professional goals, interests, and strengths. Reflect on whether the critical care environment aligns with your career aspirations and personal satisfaction. Consider what aspects of nursing you enjoy the most and if other specialties may better suit your interests.
  • If you're still interested in pursuing a career in critical care, consider exploring opportunities at different hospitals or within different specialty ICUs. Research potential workplaces' reputations and patient populations to gain insights into their practices and work environments. If possible, reach out to nurses who work in those units to gather their perspectives and experiences.
  • Consider alternative nursing specialties. If the physical demands of critical care are too challenging for you, it may be worth exploring other nursing specialties that are less physically taxing. Med-surg travel assignments can provide a change of scenery and a chance to reassess your career preferences.
  • Prioritize your well-being. Your body has taken a beating, and you need to recover. Your health and well-being should always be a top priority. Chronic pain, injuries, and stress can have long-term consequences. Consult your healthcare provider about your physical ailments and the recommended treatment options. Take the necessary steps to heal and recover before making any decisions about your next career move.

Remember, it's important to take the time to reflect on your experiences and assess what is best for your personal and professional growth. Make decisions that align with your well-being, interests, and long-term goals.

Best wishes,

Nurse Beth

Specializes in Physiology, CM, consulting, nsg edu, LNC, COB.

Short answer to your question: Heck no, all ICUs are not like this. If you are a travel nurse slotted into this lousy job, that tells you they were already short-staffed there, and if this is what conditions are like, it's no wonder. 
Next time you interview for an ICU job, make it at a university hospital, not community; ask about ALOS (average length of stay),  and get a tour of the unit so you can see what it's like. My first job outta school was critical care and it was a gas, learning new things all the time with a strong staff and great relationships c the surgical teams. 
Good luck!

 It sounds like the ICU you're currently working in is placing a significant physical strain on you, and you're considering your options for the future. While not all ICUs are the same, it's understandable that you're questioning whether this level of physical demand is typical. Given your health concerns and dissatisfaction, it might be worth exploring other ICU positions at different hospitals or considering alternative roles within healthcare. Taking a med-surg travel assignment could also provide a fresh perspective. Ultimately, prioritize your well-being and professional goals when making a decision.

Specializes in ICU.

I could have written this myself. We do have trach to vent patients on our floor, but it's exactly as you say. Even down to the physicians "not trusting floor nurses.”We are mostly neuro ICU/MSICU in a level 2 trauma hospital and some days we don't have a tech. My back is in rough shape. I think the issue is our hospital doesn't have a "step-down" floor.

The Intensivists are great in that they get people off drips and vents sooner, but that means patients aren't staying ICU for long... thus they upgrade, and stay on our unit forever.

After 7 years as a nurse and 4 as a tech prior, I'm leaving the bedside next year. I think we have a universal experience (at least it's common enough). Some shifts it's not so bad, others it's awful and I'm personally jumping off this train.

You can try another ICU that's possibly in the city or trauma one. Or you can try your hand in CVICU, it's a different patient population. 

You might want to reconsider about stepping down to something like Med/Surg. considering your physical condition. It's true that the level of acuity is lower than ICU, but you'll be loaded down to up of 8 pts, and a number of them will require turning/repositioning with the good chance that you won't have techs. 

Specializes in Medical/Surgical Geriatric.

don't trust med surg nurses? Interesting.... 

Medsurg is more taxing, IDK why people think it is easier. The load you are discussing is medsurg all day long....

Consider a telemetry unit these are usually the least physically taxing and better for you.