IR vs ICU

[Cmailes]

Hi! I Would love to hear feedback from anyone who has ICU and IR experience and what you do and don’t like about both and how the daily tasks differ. I am an ICU nurse and I’m very interested in IR.

[dianah, ASN]

It has been awhile since I worked in either.  I worked in ICU the first 7-8 years after I graduated, then worked X20 years in IR.  Each IR department will be organized differently, but I can give you an idea of what to expect.

IR is more procedure-driven than is ICU.  It is still, however, patient-oriented.  I suggest you shadow one of the IR nurses for a day, to get an idea of how things work there.  You will likely be setting up for procedures, interviewing patients, administering and monitoring for moderate sedation, and possibly doing post-procedure recovery.  You will be the one recognizing if the procedure is going south, and will alert the team if the procedure needs to be stopped.  You will need to know your basic cardiac rhythm interpretation, and be pretty autonomous as far as recognizing a patient in distress (or heading there), for whatever reason (e.g.: diabetic patient kept NPO for a procedure, whose sugar has plummeted, either before, during or after the procedure.  I once took report on a patient undergoing a spinal procedure, who converted to a 3rd degree HB once he was prone for the procedure.  No previous history of arrthymia.  His VS were stable, and we proceeded with the [brief] procedure, but he was due in surgery the next day, and I made sure the anesthesiologists knew about the rhythm change, as he would be prone for that procedure too).

You will likely be called on to treat contrast reactions.  Know where the emergency medications are kept (there should be a box with emergency meds quickly available, in a known location, as you will not have time to run to Pyxis to access meds.  This box can be made up in the pharmacy, and will need to be checked monthly for meds in date), and how to administer them. 

Work as collaboratively as possible with other staff members (tech assistants, Radiologic Technologists [who can be a wonderful patient care resource, with good observational skills], Radiologists). 

The Association for Radiology and Imaging Nurses (ARIN) has many recommendations and resources, and one may also obtain a CRN certification.  https://www.arinursing.org/certification/how-to-certify/

When I did a Google search for Interventional Radiology Nursing, several references popped up, for resource books:  1- Fast Facts for the Radiology Nurse, 2 -Pocket Interventional Radiology (Rahim), 3 -Interventional Radiology, a Survival Guide.  I'm sure there are more available if you look around.  Your Radiology Department may have its own library of resources.

Note who will be your supervisor, signing off your annual reviews.  This should be an RN, however some small departments do not have a charge RN, and your immediate supervisor will be the Chief Tech or the Chief Radiologist.  The department may not fall under nursing's perview.  Just something to check out.  Again, your work and reviews should be scrutinized through a nurse's eyes, though IR is quite a hybrid field.

Whatever you choose, I wish you success.  If you read through the other threads in this area, you will see it is an exciting field to work in, and we are privileged to assist with impacting patient's lives and diagnoses in many ways, without surgical intervention.  The things done in IR are amazing.