ICU Nurses: How many of your patients actually get better?

[AZO49008]

I'm waiting to enter a nursing program and am working in the lab of a large, local hospital. The ICU nurses do most of the draws on their patients since they have picc lines, but we go up to do the blood culture draws.

Prior to doing these draws on the unit, I thought ICU might be an area I'd be interested in pursuing when I'm an RN. The feeling I get, however, is that so many of the patients seem "warehoused" there until they die or are transferred somewhere else to die. They are intubated and on ventilators and have a seemingly endless array of issues and complicating factors. I can't count the number of times I've gone up to do draws and seen other patients' families saying last good-byes, etc...

It seems like a sense of futility might set in after a while. Am I just seeing fleeting glimpses of the worst cases? How many of your patients actually improve, and what sense of purpose do you get out of ICU nursing? I'm still interested in it and am wondering if I'm probably just not seeing the whole picture.

[ukstudent]

It depends on what type of ICU it is. SICU, MICU, BICU, TICU and CVICU all have different pt populations.

Some patients die, some survive and some survive and do well. It's a wonderful feeling when they do well.

[bethem]

Nurses in my ICU reckon 1/3 recover fully, 1/3 recover with notable deficiencies and 1/3 die. I guess the sense of purpose comes from knowing that we put up a good fight - nurses, doctors, the family and of course the patient. We didn't just sit back and let it happen.

It's pretty rewarding to see the very sick recover. It cuts like a knife when the 16-year-old girl brought in with meningitis dies within an hour of being transferred. It's bittersweet to see the older gent with DKA go out of the unit to keep on doing the things that brought him there in the first place.

You have to be a certain type of crazy to go into nursing at all, and a very particular type of crazy to go into ICU, I think.

(You can see in my profile I start in ICU soon - I had a lengthy prac in intensive care as a student and am speaking from my experience there, lest anyone wonder where I got my opinions from!)

[dbihl, BSN, RN]

Sounds like your referring to an MICU or Medical ICU. Many of these patients are older, or have multiple medical problems such as renal failure, copd, chf, cancer etc.., and many are trach and peg type patients. While these patients seem "warehoused" until they die, that does not mean that they are an excellent learning experience and also they are in need of excellent treatment because many of them are extremelly helpless.

[dbihl, BSN, RN]

I guess to answer your question, on my floor not many get "better" some may improve but many of them are circling the drain so to speak.

[locolorenzo22, BSN, RN]

The most kind of stat that stuck out there this last week in class while we were discussing critical care...."10% die in the ICU....20% die in the hospital, before discharge...."

so, 30% die overall....pretty high number to be sure....

[meandragonbrett]

I think you're just used to seeing the patients at their worst....they're swanned, vent, a-line, CRRT/CVVH, multiple pressors, septic, etc. Lots of folks do well and recover to either 100% or some have some disabilities, and there are unfortunately those that simply do not make it.

[UM Review RN, ASN, RN]

I assisted in a Code one day and the next week a lady strutting down the hall with her walker and a Physical Therapist called my name.

"Remember me?" she cried gleefully.

I had to look sideways because last time I saw her, it was flat out and being bagged, but sure enough, it was the lady we'd Coded the week before. How she remembered me, I have no idea. I wasn't her nurse; at the time of the event, I was on my way out the door and stopped to help.

Granted, I don't work ICU, but we get enough transfers from ICU to be pretty impressed with our hospital and coworkers. And oh yeah, some of our patients are pretty amazing too.

[rgroyer1RNBSN, BSN, RN]

I agree with brett, I work in SICU, were we get all the trauma pateints, patients with surgical complications, and patients that have had major operations, alot of them get better some dont, but its rewarding when one does.

[RNperdiem, RN]

The recovery rate in Surgical ICU is pretty good.

Many of our trauma patients are young and otherwise healthy. If a trauma patient dies they usually do in the first 24hours.

Some patients are admitted for hourly circulation checks following complex reconstructive plastic surgery-they do fine with good management.

Elderly people with surgical complications do not fare as well.

Medical ICU's as another poster said is where more people are chronically ill and reach the end of the line, so to speak.

Never forget, the human mortality rate is unchanged at 100%.

[meandragonbrett]

Never forget, the human mortality rate is unchanged at 100%.

So true, RN.

[jelly221,RN, MSN]

I really enjoy reading everyone's comments about ICU; I am very interested in doing this after I graduate. I start volunteering in the ICU at a hospital here on Saturday, and I am SOOO excited! I'll be doing a lot of the same things as a volunteer that a unit secretary would be doing, and I'm really looking forward to getting to know the nurses/staff on the floor and seeing how it runs.

As far as mortality and getting better in the ICU, my Grandma has been in the ICU 4 times in the past 10 years, and she's come out great every time (great= mowing her lawn and cleaning her roof at age 82). Most of these recoveries have been due to the awesome nursing care and attention she's received there. This past time she had suffered a minor stroke, a heart attack, had 2 aneurysms in danger of rupturing, and a gallbladder 5x its normal size. She had a heart cath done and then had her gallbladder removed. We (and the doctors) were sure it was the end.

I just wanted to maybe encourage some of you who're already in the ICU that even those hopeless patients (like my grandma!) can come out very well thanks to you!