The ICU sucks sometimes

Nurses General Nursing

Published

For lack of a more eloquent title,

I’ve worked in the cardiac ICU x1 year. I love it for the most part. A few things I LOVE: my coworkers/bosses, my unit’s teamwork approach, the flexibility of 3 12-hour shifts, learning something new every day, watching once critically ill patients get better, and staffing ratios (almost always 1:1 or 1:2).

A few things I HATE: rotating shifts and death. I HATE working night shift and constantly feeling exhausted whether I sleep for 4 hours or 12 hours, and being expected to provide excellent care to very sick patients. I HATE when patients die. I am very much aware that this is “part of the job,” but it is very emotionally taxing on me and, as of lately, I am having a difficult time processing how I am expected to clean the body of someone who has just expired, then eat my lunch 5 minutes later like nothing happened.

I have been in therapy for a little over a month for this and other issues, and I feel like it is helping. However, I’m not sure how long I can work in this specialty without it taking a toll on my emotional health or if I’m cut out for critical care nursing.

Thank you for taking the time to read this.

Specializes in ICU, trauma, neuro.
8 hours ago, ArmyRntoMD said:

I don’t think anything happens when we die, and it just makes me want to live life to the fullest. YOLO! Just kidding. Kind of.

Yes, but if one sincerely believes that death of the physical body is the end then it is logical to be even more emotionally distraught (when someone dies especially when they are young or when it could have been prevented) than if you concluded that we had eternal aspects of our being that survive physical death. For me after a lifetime of study of all things paranormal (from NDE’s, reincarnation, hauntings and many other aspects) I have concluded that survival of the spirit is more likely than not. This has the “Pascal’s wager” benefit of helping me deal with at least the weekly death of clients in the ICU. Their deaths still sadden me and I find myself often thinking and praying (to myself) for many of these patients, but it does soften the impact.

1 Votes
Specializes in Critical Care.

I don’t fear death because I don’t even think we ever “die” at least in our own minds. I think it’s like approaching an asymptote. You only experience what your brain tells you, and how can your brain tell you it’s dead? It’s like falling asleep. How many times am I laying there wide awake and I wake up later like “Wow!? I fell asleep?”

Death doesn’t sadden me for the person. I’m sad for selfish reasons because I won’t see them again, or seeing other people’s emotional reactions make me sad, or if the person is suffering through death, but death itself bothers me none.

1 Votes
Specializes in Med-Surg, CVICU.

Wow, thank you everyone for your meaningful responses!

While I do have the opportunity to work straight night shift (and wouldn’t mind doing so at this point), I still have a lot to learn. There are rarely open heart pts admitted on night shift unless it is an emergent CABG, so daylight is where I need to get experience admitting fresh hearts from the OR.

I originally transferred from med-surg to ICU because 1) I was exhausted from trying to meet the demands of 6 patients at a time (shout out to y’all still working on the floor...not sure how you do it!!!) and 2), I wanted the experience before potentially applying to CRNA school.

Not sure where this road will take me, but I’m taking it one day at a time. Hoping this new year will bring me more knowledge and resilience.

Specializes in Med-Surg, CVICU.
On 1/4/2020 at 2:06 PM, AceOfHearts<3 said:

Yes, the ICU certainly does suck at times and drains a person. Yes, death is not always an easy thing to deal with, especially the ones left behind. For the most part I try to focus on the fact that the deceased is at peace and no longer in pain. Way too often I feel like we are torturing a soul just because the family can’t let go- I find that the hardest thing about the icu (futility of care).

Agreed. I think keeping a patient alive by artificial means with a p*ss poor quality of life is more heart wrenching than a bad arrest.

Specializes in ICU, trauma, neuro.

Well, with regard to making Medical Surgical suck less my advise would be California where at least the ratios are set by law to no more than four to one (3 to one in PCU). Also, their mandatory lunch breaks probably help in ICU. Someone above commented at the challenge of "eating lunch" after cleaning a body. Well, in the ten years I've been at my HCA facility I've been able to take maybe 10 lunch breaks (although we must clock out) since there is no one to safely watch your patients. Rather the routine is "patient dies, rush the family through the mourning process... move the body, so that you can get another body in the room". No to turn this into another "need for mandatory staffing ratio's thread", but California's law is the answer for many of the problems that you face. Only someone who is a sociopath, or very disassociated can not be emotionally disturbed working in the ICU where I work (in my case most people including my significant other say I have Asperger's so my manifestation of emotions and social interaction(s) may be blunted, but I certainly feel them).

Specializes in ICU, trauma, neuro.
5 hours ago, ArmyRntoMD said:

I don’t fear death because I don’t even think we ever “die” at least in our own minds. I think it’s like approaching an asymptote. You only experience what your brain tells you, and how can your brain tell you it’s dead? It’s like falling asleep. How many times am I laying there wide awake and I wake up later like “Wow!? I fell asleep?”

Death doesn’t sadden me for the person. I’m sad for selfish reasons because I won’t see them again, or seeing other people’s emotional reactions make me sad, or if the person is suffering through death, but death itself bothers me none.

Yes, but if you were convinced of the eternal nature of the "soul, spirit, atman" whatever, you would likely be less "sad". That is because you would have some confidence that you might see them again in the future. It is my hypothesis that a materialistic, reductionist world view makes it harder to avoid depression as we get older and face devastating life circumstances (however, even someone who is a strict materialist might ponder that we are probably less than a few hundred (thousand?) years from being able to essentially confer immortality via technological approaches).

Specializes in Ortho, CMSRN.

I am so sorry that you have to deal with that on a daily basis. I'm a med-surg nurse and for some reason.. don't know why (maybe when this happens, God's trying to tell me something and I'm not listening) but when I get a certain type of patient, it sticks and whether or not I get that patient back, it becomes the theme for 2 weeks. The last two weeks has been hospice ready patients whose family haven't been ready to let them go. It has been horrible, and if I knew this is what my job has become from now on, I'd quit. It takes an emotional toll when you must inflict pain upon a person who doesn't understand (such as turns to protect skin, or blood cultures) and they cry for mama the whole time at 90+ years old. Also the young cancer patients. I have a genetic predisposition to certain types of cancer and saw my loved ones suffer through it and die... my family doesn't have the greatest track-record of fighting cancer and winning until recently. Her 3 year old daughter asked me if I was going to "fix her mom". The young ones tear me up and I take it home. Maybe it's the holidays with surgeons off, but I'm ready for my pancreatitis, cholecystitis, hips backs and knees back. I didn't become a hospice nurse for a reason. All I know is... if for some reason, I keep seeing this patient population on a regular basis instead of biyearly, I will find a new niche in nursing to become proficient at where I won't have to deal with this. Life is too short to earn a living from something that causes you emotional harm.

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