Quote from RN416
What is a typical shift like in a medical ICU? What types of patients/diagnoses do you see? Is it more or less stressful than a med/surg floor? Any insight appreciated... Considering looking for a job in the ICU at some point in my career and I don't want to try it only to find out I hate it or I'm not cut out for it. Thanks!
Smaller hospitals have generalized ICUs, where you may find a wide variety of patients and the sickest of the sick get transferred to the Big City Teaching Hospital.
The Big City Teaching Hospital may have as many as a dozen specialized intensive care units. Medical, surgical, transplant, trauma, pediatric, neonatal, oncology, neuro, thoracic, cardiac, coronary, burn . . . the list is probably longer. So the patients/diagnoses you see will depend greatly upon the type of ICU you choose.
You will have only 1 or 2 patients, but those patients will keep you busy your entire shift. Complete assessments are done every four hours, vital signs as often as every fifteen minutes (or every five minutes given some procedures or changes), vasoactive drips are titrated, I & O is done hourly, rounds may take an hour in the morning and half an hour in the evening. Then there are q 2h turns, suctioning, charting, dressing changes, the baths, weights, lab draws -- many patients are on insulin drips and glucose checks are done hourly -- or even 20 minutes of the sugars are labile. Some patients are on CVVHD, others are on balloon pumps or have ICP monitoring. Everyone will be monitored for rhythm, some will have arterial lines or pulmonary artery catheters, chest tubes, feeding tubes, NG tubes, Foleys, rectal tubes, wound drains, or even drainage bags to collect drainage from old venipuncture sites. They'll have transfusions, vasoactive drips, frequent antibiotics, pain medications. And they'll have visitors who must be kept up to date, allowed to visit, monitored to ensure that they're behaving appropriately and following the rules, customer serviced and managed.
I love ICU, I've worked in one or another for the past 35 years. But one ICU is not like another -- you have to think carefully about what you like and don't like and choose accordingly.