"Patient Satisfaction" in the ICU

[AlmostThere19, BSN, RN]

I've learned pretty quickly since I started working as a nurse that patient satisfaction is the hospital's #1 priority. As nurses, we are expected to keep patients happy and get them what they want, period - even if it's bad for their health. I have a hard enough time dealing with this in med surg when patients don't understand that you cannot fluff their pillow or get them more ice water right this minute because you're busy dealing with your high fall risk patient who refuses to stay in bed and is determined to wander off the floor. I would love to work in ICU, but I just know that if a family member or pt. is running me crazy about a meal tray that's wrong or some other trivial thing while I'm busy trying to correctly titrate a patient's life-saving drip...I would snap. How do ICU nurses even handle that?

["nursy", RN]

Most ICU patients are too sick to be that way, but....the families.......now that's a whole nother story. Unfortunately it's the new normal. One of the reasons I got out of bedside nursing.

[etienhh, MSN, RN]

It's doable! Setting healthy boundaries and expectations with patients and their family is a good place to start. It also helps that your fellow ICU nurses have experience with the same thing. Not only will we commiserate on particularly demanding days, but we will also take turns answering call lights if we see one nurse is struggling with their patient load. Ideally, your charge nurse will ensure a well-balanced assignment and help where it's needed, but patient conditions can change on a dime in the ICU.

When I have a vented Patient A on multiple pressors paired with a fairly independent Patient B, I make a point to apologize for not being in there more often and explain in a professional manner than my other patient (Patient A) is quite sick and requiring a little more of my attention. Usually, Patient B is pretty understanding. It helps to try and get them and their needs squared away before popping off to see your other patient again as well as prepare them for the fact that they might have another nurse checking in on them while you stabilize your other patient. In the ICU, it can be a matter of life and death, and it's the unfortunate reality that some better off patients have to accept. That's not to say that we don't care about their wants or needs, but it's a lower priority.

I would by no means let the patient population deter you from exploring nursing in critical care! Like Nursy said, too, a lot of our patients are too sick to make such demands, and when there is family at the bedside, their priorities are usually different than what you find in medsurg ?

[flo136]

Certainly there are patients and families that can be 'challenging' with their requests but ICU is still an amazing speciality to work in. Every shift can be so different and exciting professionally. For those sorts of patients and families we have some plans: short shift allocation (no 12 hour shifts), a lot of getting colleagues to 'pop in' for requests instead of us, going for longer walks out to the sluice! Some times just helping in another bed space for a time can relieve the frustration. You're not alone! ICU has a turnover that means those situations don't last.