Stress in ICU

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Hi, I want to work in ICU but I know that I would need to learn how to handle stress in a healthy way. How do successful ICU nurses handle stress? What healthy coping strategies do you practice?

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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

Great question!  I thought this might help, in general, before others may give their tips for what helps them:

 

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Specializes in Physiology, CM, consulting, nsg edu, LNC, COB.

I always said I would rather work my butt off with two patients in the ICU than waste a minute of precious percentage of my time running up and down halls in med-surg. THAT's stressful. 
I think it's a myth that ICU is inherently more stressful than anywhere else (except maybe NICU— those lil peanuts scared me ****less).  As c any other setting if it's interesting and rewarding, and you have good educational and social support, it can be great. 

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Specializes in ICU | Critical Care | CCRN.

My med career started via EMS. You don't know who's going to call 911 so hopefully, you got a good partner who'll watch your 6 and you're all set. 

I took similar approach in RN and it became more obvious in ICU ~ as long as my coworkers have my back... 

The biggest thing for me though is this "As long as I can wipe my own @&$ and Breath on my own, I'm already way better then my patients. Add the good staff for the day - it's blessing. 

So I'll eat less (I can use decrease in calories), so I'll drink less (less chances of neededing to go to the bathroom), so I'll walk a BiT more, again I can loose few kgs. 

That being said, I believe it's about perspective, it works for me at least ... Plus for those 12hrs, I have an opportunity to run away from real world problems and concentrate on solving the health puzzle 

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

What particular stress are you concerned about? All nursing jobs have stress, but they're unique to their setting.

If you're concerned about caring for critically ill patients, you're not going to be handed a post cardiac arrest, hemodynamically unstable patient on Day 1. You're going to learn through your orientation what you need to know so that you can provide safe and competent care.

Are you worried about the knowledge required for medications and drip titrations? Again, you won't have 11 channels running day 1, you're going to learn all those medications through your orientation, and some study on your own might be required, but again, you can probably do it just as well as the nurses before you.

Are you worried about the stress of working in a unit that is sometimes known for strong personalities? Learning how to deal with challenging co-workers can always be a problem, but if you approach it with an open mind and a positive attitude, you might find that we're not ALL that grumpy. 

Are you worried about the stress of end of life situations and dealing with patient loss? This is going to be a very individual experience. Some people have a harder time than others when patients die. For the most part, I think we tend to come to an attitude somewhere around "we did our best and sometimes the best still ends in patient death", and that's okay.

Worrying about the unknown is never a reason to step back entirely. If you think you might like critical care, you should give it a shot. 

As far as handling it, sometimes we don't do it well. Just like anything else, taking care of yourself- eating healthy, exercising, sleeping well, etc. all play a role. We've all got a bit of a morbid sense of humor in the units I've worked in and that provides some protection and stress relief. I love to hike and spend time with my family. I don't find the stress to be the biggest problem with the job. 

Good luck!

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Specializes in MICU, STICU, CTICU, CCRN-CSC-CMC.

Stress in the ICU is real, I've seen it come from a multitude of things, whether it's strong personalities worrying about things that haven't even happened yet, to carrying the weight of the day home with you, it's going to be there. Now, I feel that as someone who doesn't drink (or do drugs). Here's some of the things I make sure to do.

1. Never let the stress of the unit weigh you down. There is always a strong personality or two that can make the unit stress a bit, or maybe they stress and take it out on those around them, either way don't get sucked in. 

2. Try to leave work AT WORK. My rule of thumb is that I get the ride home to "chew" on what happened at work for the day. My ride home is usually about 30-45 minutes with traffic, so I try to pick out what went well with the shift, and what did not. I try to set goals for myself for the next shift, and when I pull into the driveway that's the last I'll think about it.

3. Always keep an open line of communication with your nursing friends, whether from school, or at work. They understand the stresses of the job at the same level you do, so having those outlets is important. You can talk through a rough shift with them, but also listen to them when they have a rough shift. 

4. A healthy mind and body is key! So, I am a huge advocate for physical exercise 3-4 times a week, try and maintain a balanced diet (this includes cheat meals), and couple it with the exercise to cleanse your mind. 

5. I set aside an hour a day to shut my phone off and read, or research something of interest to "charge the mind" or learn something new. This allows me to challenge my brain, and get my mind off the stresses of the job, and the stresses of life in general! 

6. ENJOY YOUR HOBBIES! I love to hunt, fish, camp, ride my Harley, etc. I make it a priority to use my days off to do these things, and allow my mind to clear. It's such a breath of fresh air to be able to go out and do these things. 

7. Know your limits at work. This was probably the thing that took me the longest to learn. When I first started I was picking up 2-3 extra shifts, joining committees, coming in to help, etc. Which is great don't get me wrong, but you need to know your limits. Take the time off that they give you and recharge. You don't owe them anything more than the 3 days (or whatever you were hired for), and the hospital WILL RUN WITHOUT YOU. Take some time for yourself, you deserve it. 

8. Finally, don't feel like you cannot reach out to outside help. Therapy has been known to help just about everyone who goes. If it helps, maybe meeting with someone 1-2 times a month even can really bring a lot of clarity, especially when the going gets rough. 

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Specializes in Critical Care.
Hannahbanana said:

I always said I would rather work my butt off with two patients in the ICU than waste a minute of precious percentage of my time running up and down halls in med-surg. THAT's stressful. 
I think it's a myth that ICU is inherently more stressful than anywhere else (except maybe NICU— those lil peanuts scared me ****less).  As c any other setting if it's interesting and rewarding, and you have good educational and social support, it can be great. 

I agree. IDK if it's my brain, personality, experience etc.. but something about working in a med-surg with the number of patients one is required to watch over would have me super stressed. I would rather have 2 sick patients that I KNOW in and out vs just running up and down halls to do this or that and trying to keep track of them all. I like KNOWING my patient's in and out, not just mindlessly following orders. A good preceptor and support system is key. Any unit can be a nightmare if it fails to provide proper training and lacks help from your colleagues. Teamwork is essential and will make or break any job. 

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That's a good question! I work in Pedi ICU and it is very stressful and sad at times. Having good relationships with your coworkers, an outlet (mine is anything outdoors), and leaving work at work.

It's okay to wonder but when you're gone focus on life and your present day. You'll see things that will make you cringe but remember to still enjoy life.

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Specializes in critical care, med/surg.

People die in the ICU as they do most places in an acute care facility. Decide what you can help to fix and what you cannot. Avoid negative people as if they have Covid. Tell the docs when they are wrong and listen when they tell you are wrong. Become a documentation freak. Cultivate friendships with the smartest people you know. Talk to families as much as possible and keep them in the loop. They don't have to like you but they must respect you. Talk to people who are dying and on the ventilator. If they wake up, you are the one they will remember. And if they don't, who knows, you may meet again. And finally, meditation is for real. PAX

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