What does an ICU nurse do exactly?

zambezi, BSN, RN · Sep 24, 2003

I work in a CCU. Though CC nurses usually have 1-2 patients, Critical Care Nurses have many functions. Critical thinking is a big one.We look at the entire picture and how everything relates to plan for the best outcome for the patient. We look and intrepret labs and determine whether the dr needs to be called for abnormal values and we take steps to correct the values. If a patients condition is deteiorating we look at the big picture to figure out what is going on and support the patient until problem can be solved. We can order ABGs, CXRs, Labs, etc to try and pinpoint problems based on what we see. Often there are standing orders that we have that can be used based on clinical intrepretation to guide our care (ie: to start vasoactive meds, for pain control, to give blood products, for codes, for extubation procedures, etc). We use technology to assist us in our care (vents, swans, icps, and many other things), We titirate medications that are very potent to manage clinical symptoms and "numbers" obtained from our technology. If the patient is actively trying to die, we take measures to save them the best that we can. On top of all that, we do basic care for the patient, keep them as comfortable as we can, take care of their emotional and spiritual needs and we support the family (which can be a big job in itself, LOL). We are the patient's advocate. We are the ones talking to the families to find out the needs of the patient (if the patient is unable to speak for themselves). We coordinate the patient/family wishes with the plan of care and to the doctor. Many ICUs do not have CNAs, if your patient is vomiting or has frequent BMs, is "crazy" etc, it us up to you to do the cleaning, turning, skin care, baths, feeding, etc. It is a great job, both technical/mechanical but the "basics" are just as important to remember! I am sure that others will have more answers as to what an ICU RN does.

Zee_RN, BSN, RN · Sep 25, 2003

zambezi said it very well. It is, yes, very technical. It is also very messy and you are usually the one who cleans up. There is better staffing (usually!) in that there are more RNs. Frequently there is no aide. Rarely are you alone, though; most units function with a great deal of teamwork so when you have a huge "code brown," your fellow nurses generally attend your poop party with you.

Katnip, RN · Oct 4, 2003

We usually have 1 tech to 13 beds, so yes, it gets messy. And there are jobs such as suctioning that get really messy and we don't delegate it to anyone.

Zambezi wrote a very good summary of what critical care is.

OC_An Khe · Oct 4, 2003

Essentially like other areas of nursing you do and are responsible for evrything

british bird · Oct 6, 2003

ICu nursing is a roller coaster ride. you never know what is around the corner, both physically and emotionally. it is different to ward nursing, in the view that i go home every day knowing that i gave the patient ALL the care they required. yet on the wards, you'd be lucky to find the time to say hello to some of them. In the 6 years i've worked in ITU, i have learnt and experienced so much; it scares me to think of the lack of knowledge in certain areas of nursing, that i had when i worked on the wards!!!

HazelLPN, LPN · Nov 22, 2003

I have worked as an ICU nurse for over 35 years and would never want to do anything else. I started out on a med/surg unit where I worked for over 10 years and often found myself having as many as 13 or 14 patients (that was back in the 60s during team nursing....which they are bringing back and calling manager care). I felt that I needed a change and transfered to ICU. Its a different kind of busy than a floor nurse. I find its easier to be organized in ICU. I never have more than 3 patients and its rare to have three. If patients are on 1:3 care we try to get them up to the floor. Usually I have two patients and occasionally I will only have one very critical patient (1:1) or assist an RN with a 2:1 care--usually a fresh post op open heart or just patients who are crashing in general. I much prefer this to my 14 patients of yesteryear. What is more challenging however is that you have to be much more quick on your feet and make quick decisions and things can change so quickly. Its not for everyone as our turnover is pretty high. However, I think it would be a good experience for every nurse to spend just six months working in a critical care setting....you truly get to use all your skills and technology is always changing and there iare constantly new things to learn.

kc ccurn · Dec 29, 2003

Zambezi, GREAT description!

Intensive care nursing is an opportunity to work with pt's and families when they are at their most vulenerable. It is an honor and very humbling to be an ICU nurse. It is an exciting, adrenalin filled, awesome experience one day, depressing and frustrating the next. It can make you cynical and change your sense of humor, it definitly changes your outlook on life and how you live it! There is no other job like it.

I agree with the other posts, you have to be organized and have good critical thinking skills. If you get the chance to "shadow" an ICU nurse for a while, do it! You also have to look at the ICU itself. Different hospitals have different acuties of ICU patients. Some ICU's don't do as much or any of all the invasive, highly technological stuff that other ICU's do. So that's another thing to consider.

Mactempest · Jul 6, 2008

Zambezi summed it up sooo well! I like jobs that are physically mentally and intellectually stimulating... ICU nursing does just that! mactempest.

dorie43rn · Jul 7, 2008

The best points of ICU nursing have been pointed out, but I need to make one more. Don't ever let anyone tell you, or think yourself, "How hard could taking care of 2 patients be?" I started on a busy med surg floor, and that is what I heard alot. Well let me tell you, I have been in the unit for over a year, and I am busier most times then I was on the floor! When you have a vented patient with all the drips, tube feeds, cdiff, ect, I run by butt off all day! So, get any notion out of your head two paitents would be a breeze, because it isn't! LOL:no:

Guest193822 · Jul 14, 2008

i have to laugh b/c when i get asked this question. it's very difficult for me to answer. i tell them i do everything a nurse does are more.

i'm the only medical person in the family & the first in my generation to finish college. i can’t describe what i do b/c it’s hard for me to explain. so i usually tell them to see trauma in the er & baghdad er. that seem to help sort of.

i can say critical care nursing is like no other job. but it’s a job you are willing to take & sacrifice for. there’s a lot to do, learn, work, things to deal with, critical thinking, critical skills, dealing with relationships, technology, mental & emotion tolls.

it’s a lot. shadowing some one is good idea. i let fresh newbies do it all the time. i can only let them decided for themselves if critical care is there way to go.

i will admit i love it. i’m adrenaline junkie. let go:caduceus:

-MNC_RN- · Jul 16, 2008

dorie43rn said:
The best points of ICU nursing have been pointed out, but I need to make one more. Don't ever let anyone tell you, or think yourself, "How hard could taking care of 2 patients be?"

Yeah. That one bugs me. There's actually a reason we only take care of one to two patients and it's not because we're lazy.

Instead of posting the link, I have copied what I once wrote in another post:

Quote
- We do frequent assessments (sometimes every 15 minutes or so) to catch alterations in physiology and body systems that may be leading to compromise.
- We do frequent focused assessments of specific body systems to further understand the alterations in physiology that we see... lung sounds, heart sounds, pulse checks, neuro checks, etc.
- We collaborate with physicians to medically intervene and support the body systems that have been altered so that the patient can heal. Many times--and this is key, because much of the public doesn't realize this--that collaboration is true collaboration. That is, experienced critical care nurses sometimes *are asked by physiscians* for suggestions and ideas. We make suggestions and many times they are listened to. Critical care is a true team approach. Physician, RN, pharmacist, respiratory therapist... the whole team working together, making and listening to suggestions for the good of the patient.
- We independantly diagnose patients' responses to illness and intervene.
- We do for the patients what they can't do for themselves.
- We start IVs, defibrillate (shock the heart in an emergency), titrate critical medications, place tubes to put stuff in or pull stuff out, monitor and analyze heart rhythms, heart pressures, brain pressures, run specialized dialysis, manage ventilators for breathing, balloon pumps to ease the work of the heart... all sorts of stuff. Not all critical care nurses do everything--that's what the team is for. Each hospital has slightly different things that various team members do; however, the critical care RN coordinates it all in collaboration with the critical care physician.
- Critical care nurses work in many different environments: intensive care, emergency rooms, recovery rooms. Some are hired by hospitals only to be part of some sort of rapid response team--to go to in-hospital emergencies. Some critical care nurses ride in ambulances or fly in helicoptors or planes.