ICU nightmares

calivianya, BSN, RN · May 29, 2016

I left my epi drip on hold accidentally when I went to pee once. I had hit run but we have really old pumps and sometimes you have to hit the buttons more than once even if it looks like it's running. The patient lived. I just had a run of SVT myself when I got out of the bathroom and saw a pressure of something like 50/20, which was very quickly fixed. Patients are hardier than you think they are.

I can count on one hand the number of patients I've had that have died immediately after care was withdrawn (i.e. the type of patient that would die in the amount of time it would take to hang a new drip if you did run dry). Most take at least fifteen minutes. It's not at all a challenge to pull a drug, get IV tubing, prime, and hang something in less than fifteen minutes. Sometimes, even that person on four different pressors will linger for hours once the drips are turned off. I had a patient last 16 hours with a systolic in the 40s once. The human body has an amazing drive to live despite impossible, non-survivable conditions.

If you have any sort of decent coworkers, nobody's just going to let your drips ding. If somebody hears a beep, and they know you have true ICU patients, they are going to investigate and fix it. Odds of your drips running dry and nobody fixing them are low.

Heck, YOU not being aware of your bag volumes is rare once you're used to ICU. If you are running something quickly, you are going to know. You are not going to forget about your maxed out vasopressors, sedation, whatever it is. If it is running fast and not having it is incompatible with survival you are going to be intimately aware of how much time you probably have left on the bag that's hanging before you need to go spike the one you've already scanned that's behind it. You will forget everything else before you forget about those.

A little bit of anxiety is a good thing, but this level seems a little extreme. If these nightmares persist for very long, you should really go talk to somebody. You can't possibly feel rested if you are having those sorts of nightmares frequently.

Horseshoe, BSN, RN · May 29, 2016

I had this nightmare repeatedly. I've been floated to stepdown. After a long 12 hours, I'm giving report on my two patients. Nurse says, "Okay, good. Now, what about Mr. Brown in 109?" I reply, "Oh, he wasn't my patient." Nurse points to assignment board. "Yes, he was your patient. See?" Me: "Oh MY GOD. " I'd never been in his room the entire day. No patient care given, no meds, no orders noted and done.

I'd wake up from this dream in a cold sweat. Even years later, I have this dream occasionally.

Editorial Team / Moderator · May 29, 2016

Sometimes I dream that I have been at work in the ED for hours, it's time to give report for change of shift, and I realize that I haven't seen my patients for hours and I have no idea what is going on with them! I sometimes have Afghanistan dreams, but those are thankfully rare.

Your brain is working out your stress, CardiacDork. I hope your anxiety dreams will diminish as you become more adjusted to the ICU. :)

quazar · May 29, 2016

I had this nightmare repeatedly. I've been floated to stepdown. After a long 12 hours, I'm giving report on my two patients. Nurse says, "Okay, good. Now, what about Mr. Brown in 109?" I reply, "Oh, he wasn't my patient." Nurse points to assignment board. "Yes, he was your patient. See?" Me: "Oh MY GOD. " I'd never been in his room the entire day. No patient care given, no meds, no orders noted and done.
I'd wake up from this dream in a cold sweat. Even years later, I have this dream occasionally.

I've had that dream so many times, and I work L&D. Omg. Talk about waking up in a panic....

TheCommuter, BSN, RN · May 30, 2016

Moved to the Critical Care forum so this thread can attract more replies.

Julius Seizure · May 30, 2016

My "new grad in the ICU" nightmare was always the same one - that I did my initial shift assessment at 2000, and then went to take a nap until the next assessment time (which was apparently the standard practice in my dreamland-ICU)....and then didnt wake up again till the next morning. At which point I would panic because my patients hadn't been seem in twelve hours and what if one of them had died???

As time went on, the anxious nightmares about work went away. Yours are more creative than mine though...my dreams sound boring now!

CCRN_CSC_0710 · May 30, 2016

I had this nightmare repeatedly. I've been floated to stepdown. After a long 12 hours, I'm giving report on my two patients. Nurse says, "Okay, good. Now, what about Mr. Brown in 109?" I reply, "Oh, he wasn't my patient." Nurse points to assignment board. "Yes, he was your patient. See?" Me: "Oh MY GOD. " I'd never been in his room the entire day. No patient care given, no meds, no orders noted and done.
I'd wake up from this dream in a cold sweat. Even years later, I have this dream occasionally.

THIS. I've had this dream far too many times.

My most interesting ICU dream was that we pushed adenosine and the pause lasted like 4 minutes. The cardiologist was in the room and kept saying it would come back and wouldn't let me start CPR. I woke up before I found out what happened to the patient.

Editorial Team / Moderator · May 30, 2016

My most interesting ICU dream was that we pushed adenosine and the pause lasted like 4 minutes. The cardiologist was in the room and kept saying it would come back and wouldn't let me start CPR. I woke up before I found out what happened to the patient.

OMG, that is terrifying!!!

Has anyone had the dream in which your teeth are falling out? I try to put them back in, and they won't stay. Or am I just really that weird? (yes. lol)

bgxyrnf, MSN, RN · May 30, 2016

I had this nightmare repeatedly. I've been floated to stepdown. After a long 12 hours, I'm giving report on my two patients. Nurse says, "Okay, good. Now, what about Mr. Brown in 109?" I reply, "Oh, he wasn't my patient." Nurse points to assignment board. "Yes, he was your patient. See?" Me: "Oh MY GOD. " I'd never been in his room the entire day. No patient care given, no meds, no orders noted and done.
I'd wake up from this dream in a cold sweat. Even years later, I have this dream occasionally.

I've had this dream, too.

It's just a variation on the classic of showing up on the day of finals to realize that you hadn't been going to class.

When people talk about dreams (e.g. "living the dream" or "my dream job"), I always reply, "Well, night terrors are dreams, too..." I'm a bit of an iconoclast.

Horseshoe, BSN, RN · May 30, 2016

OMG, that is terrifying!!!
Has anyone had the dream in which your teeth are falling out? I try to put them back in, and they won't stay. Or am I just really that weird? (yes. lol)

That's a common anxiety dream, and yes, I've had that one. :)

I often dream that I am in college, signed up for a math class, dropped it, then realized right before the final exam that I actually didn't really drop it. I've missed class, all homework, and haven't studied for the final.

Hate that one.

**NickiLaughs, ADN, BSN, RN** · May 30, 2016

I had ICU nightmares. I was good at my job but always worried and stress d that I missed something. The only phone calls I ever got at home were for silly low priority things such as "hey the doc didn't order his routine lotion, why didn't you catch this on your shift" sort of BS. Well...I was more worried about his symptomatic bradycardia.....

My switch to ER actually greatly reduced my anxiety level. Go figure.