Psychological stresses of RN/ICU

SoldierNurse22, BSN, RN · Jun 13, 2013

So I will apply to an MSN program that accepts non-nursing majors next year and I've been pretty excited about it until I started talking to my counselors, RN's, friends, and people in general.
I am not doubting my decision of attending an MSN program, but I just want to know some things before diving in. How stressful is it being a RN working in the ICU?
Can it be traumatizing? I mean, people working in the ICU are exposed to constant death and dying people... Do any of you know any nurses who have developed anxiety or PTSD from seeing horrible things? Most people make it seem like its a depressing place, but there has to be some gratification from helping and saving people, right? any input is greatly appreciated!

You're getting an MSN? And you're not a nurse already? Wow.

Most folks that I know of with MSNs don't work bedside anymore. And especially coming in with NO nursing background--that will be very difficult.

Chances are very good that you will not get into the ICU at first, if that is in fact your goal. New grads, especially in certain areas of the country nowadays, tend to spend time in med/surg and LTC settings after their internships are done. Just getting a job is tough from what I've been told.

Of course it can be traumatizing. You see people at their worst, just like you do in most every part of nursing. Yes, I do know nurses who have PTSD from what they have seen at the bedside, mostly at Walter Reed-Bethesda. When the satisfaction with saving people is gone and you cease to care, it's time to go.

BellionRN · Jun 15, 2013

I started in ICU as a new grad (after spending 3 months on a general surgery floor). Now I work in Emerge.

Can you elaborate on what the two have to do with eachother? I'm assuming you mean Master's of Science in Nursing, my "MSN"? Maybe I'm totally off (just getting ready for my shift! still a little tired ), but just wondering why the MSN course automatically means you'll be working in an ICU setting.

ICU is a special place... I haven't met anyone who has developed PTSD, and I think anxiety is something most nurses find themselves with... all that said, those who might have developed PTSD or did probably got out of that area!

My main issues for needing a change and heading to Emerge was the prolonging of life when it's clear that there is nothing more to be done (you know, the 96 yr old with multiple comorbidities who came in with a COPD exacerbation and is highly unlikely to ever get off the vent let alone out of the hospital) and families just can't seem to make a decision... I used to hate having to do daily regular care and these poor human beings are just so far gone, sometimes it would seem they would look look at you accusingly as you turned them to do their backs... maybe I was imagining it but I felt like I was headed straight to hell for putting these poor people through all this when they should have been let to pass away with dignity and especially, in comfort. Keep in mind, I'm not talking about working on someone who has even a small chance. I'm talking people who have been with us forever and clearly are suffering.

Another problem I was losing my patience with and starting to get some anxiety about was the ICU psychosis that comes along with post-op medication administration in the elderly, high doses of epidurals for big post-ops, etc. Adult medication-induced confusion isn't something I deal well with, and while I know I will deal with adult confusion any where I go, there is something about the ICU psychosis and post-op med-induced confusion/aggression/agitation...

The palliation part I found okay... you are helping someone to pass away who has been through a lot, and to do it comfortably. You are offering comfort to families like no one else can. It's not easy, but you feel like you're doing something good, as opposed to something that is ripping away dignity and causing unnecessary discomfort and stress to the patient (such as prolonging life as described above).

ICU is hard, but you learn a lot, about yourself and about nursing, about humanity and about your co-workers. I wouldn't change the experience for anything, but I always wanted to work somewhere with more turn-over, and I decided to go for Emerge a few months ago. So far I am enjoying it.

Good luck!

Laarnett · Jun 28, 2013

You seem to have a lot of insight into the areas I am interested in. I will graduate in a year and a half, so far with honors. This is my second career as I retired was a police officer last July. Some people think this is a huge change, but I don't see it that way. Police work was an attempt to help people usually in crisis, and nursing is very similar. I was first responder on many, many shootings, accidents, drownings, etc. I know how I handle a fast pace and stress. Amongst other things, I have dealt with distraught family members, jumped in lakes after people, had brain spatter on me and kept people alive with CPR. Will my past work experience possibly offer me the opportunity to enter an ICU or ER position even as a new graduate?

Esme12, ASN, BSN, RN · Jul 1, 2013

Unfortunately probably not.....you will not be a first responder......that is a completely different role. You are helping people but you will NOT be the authority figure......you will not be in charge. You will be in a subservient roll and do as you are instructed. Dealing with families who will be considered ALWAYS RIGHT isn't easy. While it shows you can operate under pressure it doesn't show that you have the nursing skill necessary to deal with the complex ICU patient.

YOU will start out as a new grad.....low man on the totem pole.

New grad positions are few and few between for the ICU/critical care areas.

To the OP.....why do you think that because you are entering in a MSN program that your focus will be critical care. You will rotate to all care areas as nursing education is generalist. Masters entry programs are relatively new so I am not familiar with how they work ....will you finish with a NP certification? At what point will you take NCLEX.

BellionRN · Jul 8, 2013

Laarnett, I think that the experience will serve you well, and you'll have some emotional and mental preparedness that other new grads won't have in terms of what you might see in an Emergency or Intensive Care setting... I also think that it could possibly help tip the scales if there is a decision between you and another new graduate, moreso in the Emergency setting (Trauma, namely), but it's definitely not something I would count on. Like Esme12 said, the complexity of the ICU patient and the delicate balance we maintain with those patients, as well as the nursing care that comes after the first responding in an Emerge setting, is purely nursing skill, experience and knowledge.

I type from Canada, so I can't vouch for job opportunities in the States... I was able to get a job in ICU right away because I worked as a student nurse in my 3rd & 4th years in that same ICU, so they knew me and actually offered me the job when I had applied for another one. My case may have been special. While I was in school, they changed the requirements for applying to Emergency as well, now you need two years experience (in any area) in order to apply. They did hire new grads at one point, but not since I've been out of school.

I don't think your policing experience will help secure you a job as a new grad in a critical care area, but I do think it's something you'll be glad you have! Just the life experience a job like yours brings to the table is something you'll be grateful for, I think!

blondesareeasy · Jul 30, 2013

"Emerge" just frikken urks me. Stop it, child.

RileyRN2013 · Jul 30, 2013

"Emerge" just frikken urks me. Stop it child.[/quote']
I think calling someone "child" is worse

tomsgirl42, ADN, BSN, MSN, DNP, RN · Aug 4, 2013

Irk not urk child...

anotherone, BSN, RN · Aug 27, 2013

Interesting topic that is mostly ignored. I work in med surg and many nurses seem to have some issue with anxiety and or depression. Yes , what you see can be traumatic or upsetting. I try to forget about it but I still think about some awful cases and if we are really helping people or just prolonging their suffering. You don't really get a choice when the family demands that the drs ( therefore you too) " do everything!!!!". it can be a pretty depressing job. Yes , you help people but you see some of the worst that can happen to people and completely change their lives. You are constently reminded of your mortality and susceptibility for illness or tragic events. It depends on what icu, at a small community hospital your patients may be mostly elderly or chronically ill. At a trauma 1 hospital, you may have many young patients .

Oh and the alternative is compartmentalization and desensitizing. I think that happens allt more often. which is why people make jokes and have a dark sence of humor in these settings. outsiders and new people are often shocked by it , as if they expect us to cry about every case...

Altra, BSN, RN · Sep 7, 2013

I have always believed that to stay in nursing for the long haul and really maximize potential as a nurse does require an above-average ability to adapt, withstand stress, and both compartmentalize and integrate different aspects of your life.

jm394, RN, CRNA · Jan 28, 2014

It depends on you. In most areas of in-patient nursing, you will face absurd human suffering. Everyone finds a different way to adapt. From a morbid sense of humor to extreme religiosity to alcoholism, we all find a way to get up and deal with it again. For me, a mix of dark humor, close friendships with coworkers, and spirituality allow me to deal with the extremities of life with a modicum of sanity. And when a family member hugs you or tells you how much they appreciate your hard work, you suddenly remember why you're there. Plus, someone has to do the work, and I'll do a good job, so it might as well be me.