Our unit takes too many specialized patients!

[sunshineCCRN]

Hi everyone, I'm new here, but I'm wondering if anyone else's unit has this problem.

I work in a small hospital. Our ICU census is usually 8-11 patients. However, we take EVERY kind of patient short of a transplant. A recent census of ours: fresh CABG, a patient in 4-points, a vascular surgery, a sepsis patient, a craniotomy, a crashing surgical, a cath needing sheath removal, a chemo patient, a GI bleed....I could go on. We also do CVVH, IABP, and all stat/first responder/code team calls in the house.

While I like having variety, I am very leery about us getting complex surgical patients only sporadically. In my book, it's nearly impossible to be a perfect CV/neurosurg/MICU/SICU/CICU nurse all in the same week, when you only get to take care of a certain kind of patient once a month or so. Our hospital loves what the surgicals do for business, but it leaves the nurses and patients vulnerable.

Not to mention about half of our staff have less than 2 years experience (i.e. new grads who went straight to ICU).

Is this situation normal? Can anyone else feel my pain? HELP!

[augigi, CNS]

They become theoretical experts, not actual, given that they may only see certain types of patients occasionally. We did have "unit based staffing", where we gave days off when it was quiet and called people in when it was busy, so we did call them when those patients came in, but it was optional as to whether they came in or not.

[HHW2006]

I love the fact that our 18 bed icu gets such a wide variety of patients. I agree with Abel - I love the challenge of doing different things all the time. I think it helps me to keep sharp the skills I have developed and the opportunity to develop new ones.

[LadyNASDAQ]

I think you don't realize that you are suffering some burn out. This is the norm everywhere with most hospitals expecting you to deal with it. I do local agency and also, I do travel Nursing. No matter where you go, you will deal with the same concerns and stress. I've been a Nurse for 28 years and 25 have been in all of the Units. Sometimes it's a good idea to take some time off, or possibly work a different kind of Nursing if you're really stressed which I think you are.

My sister walked out of the ICU and is learning Case Management as a Telephonic Nurse. You have to have ICU experience for this job. It is working with patients on the phone and no more bedside Nursing for her. For me, I haven't burned out because I pace myself. I take time off in between contracts and I work different facilities which has eased any stress. More money, less hours is a good way to work. I found that my stress maker was staff Nursing and left staff Dec. 2000 and never looked back. It's unbelievable how much happier you'll be switching jobs.