ICU acuity

Long Term Care Columnist / Guide · Feb 11, 2005

Does that mean that the feces of a 120-pound adult are somehow less offensive?? :stone

I must be missing something here........what's the big deal about wiping butts? I'm a float nurse who works OB-GYN, med/surg, and ICU, and I clean up just as much poop in 'the unit' as out on the regular floor. So what. I went into nursing to help people, and cleaning up fecal incontinence is part of the job. It's not my favorite part, but it's got to be done, and I can always wash afterwards.

Do any of you think most patients would 'go' all over the bed if they could help it?? Old people, demented people, fat people, sick people.........can you imagine how it must feel to be in their place, unable to take care of your own personal needs?

IMHO, if you'd choose a nursing position based on the amount of sh** you have to deal with, you (and your patients) would be better off if you went to business school instead. Not everyone is cut out to be a bedside nurse, but if that is indeed what you want, be prepared to sling a few bedpans and wipe up some poop. :stone

*PICURN* · Feb 11, 2005

Does that mean that the feces of a 120-pound adult are somehow less offensive??

I was just trying to make a comparison...doesn't matter if the adult is 80 lbs, for some people cleaning up after a child is easier. I'm not talking about the volume (although that may or may not matter), I'm just saying that some people may feel more comfortable cleaning up after a child than an adult.

Of course in any ICU you are going to be cleaning up feces, as well as almost EVERY nursing area. I think the original poster just wants to make sure that cleaning up feces isn't her "main" duty as an RN. I think in the ICU you would have LESS mainly b/c you are taking care of less patients, however on the floor you will have patients who are ambulatory and can get to the bathroom on their own (or with assist). So....I guess it depends on the day honestly.

I will start an ICU clinical this March and I really would like to think it will make me exercise my mind and allow me to learn techniques which require some skill.

ICU is definately more "technical" so to speak than the floors. You are dealing w/a lot of machinery that usually isn't found on the floors. I think you will be able to "exercise your mind" on either the ICU or the floors, it will just be a different type.

I'll be interested to see what your opinion is after your ICU rotation about all of this. Deciding to work ICU vs the floor should definatley be more than just about the amount of sh** you have to clean up.

NoCrumping · Feb 11, 2005

Reality Check.....
Okay, now I'm really worried. I was hoping someone would tell me otherwise. ICU was my last hope after realizing that I couldn't stand working on a floor with 6-10 patients. I am a bright person but maybe not as much as I thought as I chose this field to go into. It seems as if I have chosen a dead end that will not only gross me out but wear me down both physically and mentally. A BSN was a mere stepping stone at one point for me, as I had considered getting a masters as an FNP. Then I find out jobs can be scarce, you could be underpaid/overworked, and, you could make the same as when you just had the BSN. I have a minor in Chemistry and love Pharmacology, so I thought CRNA might be a good route.
Am I missing something here or have I pretty much come to an accurate conclusion? I am really bummed out about the whole thing and it's hard to stay motivated to even finish my BSN program.
zzzzgirl

zzzzgirl I hear you, I AM YOU!! LOL I quickly found out that med surg, ICU, etc, WAS NOT the place for me, I just simply am not willing to do the poopie patrole for anyone besides a family member of course..... And, I am not even good at it, I just make a disgusting mess ....lol I just wont do it, and I wont work with adults, period IT BORES ME..... I work in a Neonatal ICU.(poops are microscopic), now, this is not for everyone, but there are options... do you like L&D? mother baby? OR? My last year in nsg school, I felt guilty about my abhoration for these "duties" , I felt, then, that I was not "real " nurse, if I did not want to do that, or at least be willing to. Not the case, thankful I found out, because I was thinking I wasted 4 years of nsg school and time, and almost didnt go into nsg. Your right about what you said. Dead straight, in my opinion. But, I found something not only I can tolerate, which was what I was desperate for, but something I can never picture myself NOT doing...... BUT EVEN THEN, the way our healthsystem is, most of the time it will disgust you, wear you out and everything else you mentioned.....Finish the BSN, I am assuming you are at least 3/4 way finished? You DONT have to do med/surge or even ICU first, dont let that myth fool you. There is an a** for every seat, and there are great nurses who are willing to chalk it up to a part of the job, ....not everyone, certainly not me, I am not even WILLING to do it temporarily....I remember ppl in my class saying "i'll just get my year or 2 in med/surg, then I will think about what i wanna do next" I was, like, ONE OR TWO YEARS!!!! God bless them.... anyway, enough ranting,,,, just wanted to give you encouragement, while still saying, your right, and I HEAR YOU.

NoCrumping · Feb 11, 2005

Does that mean that the feces of a 120-pound adult are somehow less offensive?? :stone
I must be missing something here........what's the big deal about wiping butts? I'm a float nurse who works OB-GYN, med/surg, and ICU, and I clean up just as much poop in 'the unit' as out on the regular floor. So what. I went into nursing to help people, and cleaning up fecal incontinence is part of the job. It's not my favorite part, but it's got to be done, and I can always wash afterwards.
Do any of you think most patients would 'go' all over the bed if they could help it?? Old people, demented people, fat people, sick people.........can you imagine how it must feel to be in their place, unable to take care of your own personal needs?
IMHO, if you'd choose a nursing position based on the amount of sh** you have to deal with, you (and your patients) would be better off if you went to business school instead. Not everyone is cut out to be a bedside nurse, but if that is indeed what you want, be prepared to sling a few bedpans and wipe up some poop. :stone

The big deal is, some nurses are just not willing to have that part of their regular duties. There are other ways to help people.....Like I mentioned in another post, there are nurses who feel as you do, and honestly, I thank god for you and them. But not everybody feels that way, and thats OK, too. There are other areas where this is not an issue.and thats where nurses, like myself, belong, and nurses, like yourself, belong on those units that require that type of care, because you are willing to do it in the scope of your career, and consider it part of the job...... others wont

JVanRN · Feb 11, 2005

hmmmm.....you know PICU there is at least SMALLER poop (most of the time)
...and I don't think cleaning up baby/kid poop is as gross as some 200 lb adult!

I agree here to...that's not why I like NICU but you don't scoop nearly as much poop and it's so much easier on the back. My biggest pt so far has been 12 lbs. and While that is pretty darn big for a baby, it took about 18 of him to make an average pt on med/surg for me!

skipaway · Feb 11, 2005

I'm still trying to figure out how this thread relates to Nurse Anesthesia :)

sway · Feb 12, 2005

I'm still trying to figure out how this thread relates to Nurse Anesthesia :)

It doesn't really, except that people don't want to wipe butt so they think that being a CRNA would suit them.

Cleaning up poop isn't really that big of a deal. I think you'll find that most of the people who write posts objecting to it are relatively new to nursing. I can remember hating it when I started, but now, it's just part of the job. Like someone else said, the patiens are usually terribly embarassed (the ones that are alert) and I usually just feel sorry for them, and want to help them however I can. I find that how I act and present myself when they crap the bed has a huge effect on their mood, and so I use it as an opportunity to make them feel like even though their situation sucks, they'll get through it. Besides, seeing the smile on their faces after you get them all cleaned up with new sheets is worth every bit of inconvenience to me.

Like it or hate it, if you want to be a bedside RN, you'll clean poop.

futuregasman · Feb 15, 2005

My most favorite place to work was Open Heart Recovery. No poop. Never!

Until they get on Prisma then get septic and they start to have a GI bleed.

begalli · Feb 15, 2005

This is an old thread, but ICU is about much more than cleaning poop.

Heck, I sometimes do a happy dance when I see my patient has pooped! It's very important.

Do I like cleaning it up?

No.

Where is poop on the list of the things I do and the decisions I make in the ICU?

It's not even there.

Minimal...minimal.....minimal.

BUT, I have found the worst poop to be the poop that is bound to happen after an emergent open repair of an abdonimal ao aneurym who almost always goes septic.

I think that sometimes the smell of some ICU patients in general is worse than dealing with the occassional poop. It's a smell that permeates everything and sticks to your nose hairs and doesn't go away for a couple of days. THAT's worse to me than any poop.

ICURN2BCRNA · Feb 26, 2005

I've worked in several ICU's and seen a variety of poop but the best place to be to avoid seeing the poop is Cardiac Surgery ICU, open heart unit. most patient's have been NPO, have their surgery, and usually once their extubated and drips turned off they are moved out and usually don't have a BM while they're in that ICu

blueinplaid · Feb 26, 2005

I hated the code browns as well on the intermediate floors. I chose Pediatric ICU for the smaller poop missions. I work my brain calculating drips and clinically when I'm assessing at my bedside. There were no techs on my floor and we did have teenagers that could compete with adults on that "end", but it's not every night. I love the PICU. Look into it and don't get discouraged. Oh, and before you get turned off because maybe you didn't like peds in school, PICU is not peds...it is not a clinic. I enjoy it whereas I don't like pediatrics...go figure. Good luck to you! :rolleyes:

kirbykd · Mar 1, 2005

ZZZZZ...you sound just like me when I started nursing. I thought "I'm a smart girl...why did I just spend 4 yrs at a great university to wipe *** for the rest of my life!" I worked in step-down for a year. Almost immediately,I knew that I'd either go into something like anesthesia (where I could use my brain a bit more) or I'd change careers. Once I switched to ICU, though, I thought things looked much brighter. For one, I felt much more respected by patients, family members, and physicians. I also switched to a large university, teaching hospital. I worked in SICU where we had very sick surgical and CT surgery patients. I felt much more challenged and there was MUCH LESS POOP. You could go days (maybe a week or two) without a code brown! It was a great launching pad for anesthesia school b/c of the gtts and conditions that I saw. I'm now in CRNA school and will be graduating in August. It is the best thing I've ever done. I look forward to an everchanging, challenging career.

So, my advice....go for the surgical patients if you want less poop. SICU or CTICU. These patients are NPO or bowel prepped pre-op and probably wont eat the whole time they are in ICU!!! Good luck! :)