The ICU and Fatigue

Published

Specializes in Critical Care.

I can safely say I've never felt so tired as a nurse until I switched to ICU.

Ive done general surgery and step down.

Something about a constant stream of alarms, constant life/death situations, sitting in on multiple withdrawing vs futile care meetings with physicians and families of patients, and the notorious withdrawing drug addicts just sucks your soul physically and emotionally.

Sometimes I ask myself why on earth I left the comfort of my cushy post op position where I recovered post appys, cholys, and plastic surgeries.

Like, does anyone literally feel hung over the next day? It's almost like a hung over feeling.

I know it'll take time and in time I'll become tougher with better stamina.

Up Vote Up Vote ×

I've never done ICU so hat's off to you. However I do infusions in an outpatient center where we are the unit that does more drugs that pose risks for anaphylaxis. When I have an infusion reaction I may be at my best professionally but when I go home my whole body hurts. It's like I'm fine during the emergency but afterwards....so I can imagine ICU is like that every day. There is a lot of stimulation and you have to be on heightened alert at all times.

Up Vote Up Vote ×
Specializes in Critical Care.
I've never done ICU so hat's off to you. However I do infusions in an outpatient center where we are the unit that does more drugs that pose risks for anaphylaxis. When I have an infusion reaction I may be at my best professionally but when I go home my whole body hurts. It's like I'm fine during the emergency but afterwards....so I can imagine ICU is like that every day. There is a lot of stimulation and you have to be on heightened alert at all times.

This makes sense from a physiological standpoint. From the moment I walk in to the unit I hear alarms of all kinds. I see on the board we have 5 balloon pumps on the unit. I see a code cart outside the room in the corner. I hear the screams of a withdrawing addict. I see the sobs of a mom and her 18 year old on life support.

So instantaneously my adrenaline begins. The fact is that my body is probably under the effects of adrenaline until I finally get to relax. Then what is left? All the aftermath of the constant adrenaline.

Up Vote Up Vote ×
Specializes in Critical Care.

Any tips of battling fatigue? I want to exercise more but even that is a struggle. What do you guys do?

Meditation?

Red wine?

I spend most my days off sleeping and doing homework

Up Vote Up Vote ×
Specializes in Trauma Surgery.

Do you work days or nights? I work nights on SICU and man, it can be exhausting at times but I am SO glad that I don't work days. It can get so busy and I wouldn't feel like I was getting anything done because they expect you to do some much in 12 hours. The facility I work for has their own designated CICU, SICU, and MICU separately, so I deal with any and every type of trauma and gen surg. Don't get me wrong, we still get druggies and whatnot, but they got to MICU for the most part (sucks to suck, lol Jk). Its kinda hit of miss with us, some days its slow and others are balls to the wall. Most days, I do feel absolutely exhausted and can sleep up to 16 hours on my first day off (especially doing 3 in a row or 4). With co-workers I talk to, a good amount of them like to run or exercise, but mostly run after work. Some sleep and some meditate. Some of us also get together and have breakfast and drinks at a nearby bar and grill after the shift to shake off some of the stress. Most of the time, I just sloth around, sleep, and Netflix. But my husband also works in ICU (sane facility, but in CICU) so it's nice to vent to him and some co-workers about the stress and the dumb/sad/*** crap we deal with.

Up Vote Up Vote ×
Specializes in Critical Care.
Do you work days or nights? I work nights on SICU and man, it can be exhausting at times but I am SO glad that I don't work days. It can get so busy and I wouldn't feel like I was getting anything done because they expect you to do some much in 12 hours. The facility I work for has their own designated CICU, SICU, and MICU separately, so I deal with any and every type of trauma and gen surg. Don't get me wrong, we still get druggies and whatnot, but they got to MICU for the most part (sucks to suck, lol Jk). Its kinda hit of miss with us, some days its slow and others are balls to the wall. Most days, I do feel absolutely exhausted and can sleep up to 16 hours on my first day off (especially doing 3 in a row or 4). With co-workers I talk to, a good amount of them like to run or exercise, but mostly run after work. Some sleep and some meditate. Some of us also get together and have breakfast and drinks at a nearby bar and grill after the shift to shake off some of the stress. Most of the time, I just sloth around, sleep, and Netflix. But my husband also works in ICU (sane facility, but in CICU) so it's nice to vent to him and some co-workers about the stress and the dumb/sad/*** crap we deal with.

I work days on a MICU/CCU. I also have experience in the SICU/CT-ICU.

After my last shift of 3 or 4 in a row I will come home and fall asleep around 11pm or midnight then wake up around 1 or 2pm the next day.

I will decompress and be with a friend or family all day and all evening and sleep again from 7pm to about 10pm then wake up and do homework from 10pm to 3am then awake again the next day around 2pm and get ready for work the next day.

ugh

Up Vote Up Vote ×
Specializes in SICU, trauma, neuro.

Oh my... yes. My ICU gets a lot of trauma. We have preop organ donors...we've had the lone survivor of a family murder-suicide -- the Mama.... a dying mother whose children were dying in the PICU.... small children being brought to say goodbye to their dying parent... I've been present for conversations with a stable pt, being told that their loved one had not survived the accident.

That's not even getting into the futility issue. Death of a pt makes me sad for the family...futile care breaks my heart for that patient.

But after some of those nights described in my first paragraph, I have felt physically exhausted and in physical pain. I have told my husband I would need him to help more with the kids, cook etc. because I was too physically wrung out. (I truly can't imagine how our chaplains must feel. Most of what they get called for is these tragic situations, or initially upon admission when the outcome is still up in the air.)

Red wine can be soothing. ;) I like music... I listen to Christian music on the commute home...sometimes Christmas music in the summer because it sounds so joyful. A lot of Mozart and Handel's music sounds joyful. Sometimes I put some soothing music on and work on a pretty puzzle. I like to watch ocean wildlife documentaries like the Blue Planet series; I feel transported to that quiet world. I enjoy doing landscape photography. I hug my babies. Sometimes I ask the hubs for a massage. :laugh:

And yet...I keep coming back. I love my job most days. I love being able to help in those desperate situations, especially when my nursing care helps someone get better.

Up Vote Up Vote ×
Specializes in SICU, trauma, neuro.

Ok... I will also admit to eating ice cream in bed. :bag:

Up Vote Up Vote ×
Specializes in Critical Care.

Ice cream in bed sounds bomb dot com.

ugh I have a three day stretch starting tomorrow.

Up Vote Up Vote ×
Specializes in Med-Surg, NICU.

I have never worked adult ICU, but I do work in "baby" ICU and I understand getting tired of alarms and the stress. Have you taken a vacation recently? You may be due for one! :)

Up Vote Up Vote ×
Specializes in ER.

I work the ER, but have a similar physical reaction to stress. My first day of vacation I slept 23/24 hours, the second day 16/24. But by the end of two weeks I felt energetic and had a regular schedule. My family wonders if I should switch specialties, but I think I'd be bored silly. I switched to 3/4 fulltime last year and it was the best decision ever.

Up Vote Up Vote ×
Specializes in BSN, RN, CCRN - ICU & ER.

I totally understand. I work dayshift in a busy ICU and I often leave work and collapse into bed at home. I used to work 3 12's in a row, but I have found I have more energy breaking up my work week into 2 12's and then another 12 later in the week.

You must take care of yourself physically and emotionally. Leave work at work and find an outlet you enjoy for your days off. Take care of yourself by exercising and eating well.

Up Vote Up Vote ×
+ Join the Discussion