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What makes a good ICU nurse??

Posted

Hey all...I'm trying to figure out if ICU is for me:

Honestly, I get REALLY anxious at the thought of my patient going bad or coding...the thought makes me sick to my stomach. BUT that is because I feel like I wouldn't respond correctly. That is part of the reason why I want to go into ICU. I would like to challenge myself to get over that and become comfortable and confident in my skills.

I am VERY detail-oriented, driven, organized and assertive (when it comes to my patients). Currently, I'm doing homecare and I am supervising HHA's (I have med/surg background) Its ALL PAPERWORK!! I miss NURSING! I miss that one on one time (bathing, dressing changes, PEG meds etc.) I LOVE that part of nursing. I hate the politics.

I think this is why I am interested in ICU...the one on one time. I think I would be kick a$$ :wink2:

SO, my question is....What makes a good ICU nurse???

PMFB-RN, BSN, RN

Specializes in burn ICU, SICU, ER, Traum Rapid Response. Has 16 years experience.

Hey all...I'm trying to figure out if ICU is for me:

Honestly, I get REALLY anxious at the thought of my patient going bad or coding...the thought makes me sick to my stomach.

*** Well it's going to happen. Maybe, depending on the type of ICU you work in, it may happen frequently.

BUT that is because I feel like I wouldn't respond correctly.

*** You won't at first. Just yell for help and watch what the experienced ICU nurses do.

That is part of the reason why I want to go into ICU. I would like to challenge myself to get over that and become comfortable and confident in my skills.

I am VERY detail-oriented, driven, organized and assertive (when it comes to my patients). Currently, I'm doing homecare and I am supervising HHA's (I have med/surg background) Its ALL PAPERWORK!! I miss NURSING! I miss that one on one time (bathing, dressing changes, PEG meds etc.) I LOVE that part of nursing. I hate the politics.

I think this is why I am interested in ICU...the one on one time. I think I would be kick a$$

*** SOunds like you will. Especially the assertive and detail oriented part. Are you willing to stand up to a senior surgical resident and tell him no when you know he is doing the wrong thing with you patient? Are you willing to call the attending in to protect your patient?

Like all nurses ICU nurses must be advocates for their patients only more so. SOmetimes you will KNOW your patient is heading down hill and be blown off by the resident on call. You have to be willing to call and wake up the attending at 3 AM. We operate with more than enough autonomy to get ourselves in a lot of trouble if we are not careful. We have a saying in our ICU. "Save the patient first then get an order to do it".

SO, my question is....What makes a good ICU nurse???

RNFELICITY

Specializes in Not too many areas I haven't dipped into.

I think a good ICU nurse is very detail oriented and a whole lot on the anal side...lol.

You have to think outside of the box and be able to connect the dots even when they go in a circle. You are challenged daily. Your heart is broken often by the loses but you just keep coming back.

Personally, I am an adrenaline junky and I love the codes and the excitement although initially, I was terrified.

I think if you love direct patient care and you are willing to push yourself to grow and learn...I say go for it.

You will know if the fit isn't right for you.

There are so many things that make a good ICU nurse, I can't even begin to tell you. But I believe, like all things, it takes practice. I've been in ICU for 5 years now, started as a new grad and pretty much vomited before I went to work for a month for fear of the same things--a pt coding (would I be fast and efficient enough; will the residents/attending/other nurses view me as completely useless, b/c of my inexperience) well, the truth is, they will! But once you get over that and take a deep breath, you'll realize that you know more than you think you do. People will respect you more for sticking it out and improving. Once you're in the ICU though, don't get discouraged if the nurses are on your back for every little detail--take what they say with appreciation and think of it as constructive. See if what they say is really true and use it, don't feel demeaned by it. Remember you're in the ICU where the smallest things can be huge. I can tell by your enthusiasm you'll be a great ICU nurse...good luck! :nurse:

dorie43rn

Specializes in Critical Care.

I have been in the ICU for 1 1/2 years, and these are some things I have learned that makes a good ICU nurse.

No matter how many years experience you have, a good ICU nurse is never afraid or feels stupid to ask a question. Never just guess you have it right.

A good ICU nurse never cares that she has to wake up the nasty surgeon at 3 am because his carotid paitent has a super high BP, remember you are the PATIENT advocate, not the surgeons.

A good ICU nurse leaves her shift with a detailed report, clean rooms, clean patient, and everything checked to make sure things are right.

I could go on, but last: A good ICU nurse feels that is something isn't right, investigate! A short story from the other day at work, and how good this nurse was. The nurse on night shift had two patients with picc lines, so he had to draw the morning blood. The am nurse comes on, with all the doctors filing through and writing orders based on lab results. Bed 4 pt's Bun, creatine and platelets were drastically changed from the day before. The pulmonary doc sees this and consults Renal. Renal comes in an orders Bicarb, mannitol and albumin. Well, the am nurse is thinking that these elevated labs don't make sense, and questions the renal doc. The renal doc just tells the "stupid" nurse that the paitent is just trying to die. The nurse does not buy this, and starts her own investigation with the lab. After many hours of going back and forth with the lab, it was determined the midnight nurse labeled the tubes of blood wrong! The paitent who got all the meds, didn't need them!!! Thank God there were no adverse effects, but we all learn from nursing school to never never take the blood samples out of the room until they are labeled and double checked.

We are awaiting this nurses termination. (its not the first big mistake he has made, and he is very very arrogant.)

Doris

mickey56

Specializes in icu.

I have been working in ICU for 22 years and I still enjoy the challenge of critical care.

You need to be an active learner and critical thinker. Think outside the box, things are not always black or white. There are lots of grey areas.

Be a patient advocate, do not afraid to stand for your grounds.

ghillbert, MSN, NP

Specializes in CTICU. Has 20 years experience.

We are awaiting this nurses termination. (its not the first big mistake he has made, and he is very very arrogant.)

Doris

Mislabelling tubes is a careless. Prescribing and administering medications based on incorrect labs that you didn't bother to check, even when queried, is a serious error in judgement.

dorie43rn

Specializes in Critical Care.

Mislabelling tubes is a careless. Prescribing and administering medications based on incorrect labs that you didn't bother to check, even when queried, is a serious error in judgement.

I totally agree, the doctor was totally wrong in this situation also. How sad that just because the man was 83 that the doctor thought he was just trying to die. :cry:

marnacla

Specializes in ICU/ER/Exec..

I've been in ICU across the country for about 20 years. Stay calm so your brain works. Find an experienced ICU nurse and they will let you know when to rush like a maniac. Never stop asking questions because the key here is to learn. You can always take an antiemetic when nausea strikes. You sound like you'd be an excellent ICU nurse. Follow your heart :)

Always be teachable. No matter how much experience you have, remain open, have humility and be teachable.

sicushells, RN

Specializes in SICU, Peds CVICU. Has 3 years experience.

Hey all...I'm trying to figure out if ICU is for me:

Honestly, I get REALLY anxious at the thought of my patient going bad or coding...the thought makes me sick to my stomach. BUT that is because I feel like I wouldn't respond correctly. That is part of the reason why I want to go into ICU. I would like to challenge myself to get over that and become comfortable and confident in my skills.

More experienced nurses will always help you out in an emergent situation.

The reality is that people are in the ICU because they're very sick (well... not always, there's a post about inappropriate icu transfers somewhere) and very sick people do not always survive. I would hate for someone to go into the ICU thinking that none of their patients are going to die or have poor outcomes. Sometimes our role isn't to save a life, but to respect someone's death, to help them make that transition as comfortably as possible. Or to give them every chance, every technology/med/etc to help them make in through an acute illness... it doesn't always help.

So long as you're prepared to help your patients and their families as much as you can, you should do fine.

I am a new nurse and I want to go to ICU

It was my favorite rotation out of all my clinical experience. I enjoy having to use my mind and if I was not keeping busy at clinical I knew there was something else I could be doing. If my nurse wasn't doing anything in particular, I could help out the tech - there was always something to learn.

However, as a new grad, I have to wonder if the ICU is appropriate? I wouldn't dream of going right into the ICU post nursing school (I know med surg is the place to go for basic nurse training!), except for the hospital I am interviewing at has a year long orientation/residency for new grads, and of course they are looking for ICU nurses. Is it a huge burden to the other nurses to have a new grad in the ICU? I am only thinking of the patients.

I'd like to think I am a pretty sharp individual, and I too possess an assertive personality. I also feel the need to keep busy as a nurse - not "run myself into the ground" busy, but "alert and ready" kind of busy, while of course completing patient care. I ask a lot of questions (sometimes even unintelligent ones), but I work very hard as well.

I hear lots of stories of nurses getting burn out, which is such a shame since nursing is such a noble trade for those who are in it to take care of people because they truly care (I was studying mechanical engineering in school before I changed my major to nursing. Change came because I have compassion for people, and felt like even though my line of study WOULD benefit people, it was much more important to care for people when they're in their most vulnerable state - illness). Actually, that is comical in and of itself, because my father is a nurse and I never wanted to follow in his career footsteps (he's also an ICU RN), but look what happened! -and I've found nursing school to be both a pain in the butt (nursing school was more difficult for me than vector calculus), but also very fulfilling.

I suppose I am just looking for a few honest thoughts. I am very excited about the ICU, but I want to use wisdom as a new grad. Words from experienced ICU nurses are most welcomed (and any new grads in the ICU with thoughts are welcomed as well). Thank you for taking the time to read my post!

RoadRN

Specializes in Family practice. Has 10 years experience.

Hey all...I'm trying to figure out if ICU is for me:

Honestly, I get REALLY anxious at the thought of my patient going bad or coding...the thought makes me sick to my stomach. BUT that is because I feel like I wouldn't respond correctly. That is part of the reason why I want to go into ICU. I would like to challenge myself to get over that and become comfortable and confident in my skills.

I am VERY detail-oriented, driven, organized and assertive (when it comes to my patients). Currently, I'm doing homecare and I am supervising HHA's (I have med/surg background) Its ALL PAPERWORK!! I miss NURSING! I miss that one on one time (bathing, dressing changes, PEG meds etc.) I LOVE that part of nursing. I hate the politics.

I think this is why I am interested in ICU...the one on one time. I think I would be kick a$$ :wink2:

SO, my question is....What makes a good ICU nurse???

One thing I found when I went to work in ICU is that you are never alone. There will always be experienced nurses by your side (if your unit is as supportive as mine) If you are in a code situation, be the recorder and not only record, but watch what's happening all around you. I found that going over the events in my head when I get home helps me in future codes. Not only do I do this after a code, but I do it often so as to memorize what to do next time. Remember your ABC's, airway, breathing, circulation. It's intense, even the most experienced nurses still have high adrenaline during a code, and that's good, it kicks you into high gear to do what you have to do. Keep a sharp mind, remember to breath and slow your mind down because it will race and you will have ten thousand things going through it at once. Again, remember ABC! I love being an ICU nurse, I enjoy total nursing care and you will too :)

Nccity2002, MSN, RN

Specializes in Trauma/Critical Care. Has 10 years experience.

Hey all...I'm trying to figure out if ICU is for me:

Honestly, I get REALLY anxious at the thought of my patient going bad or coding...the thought makes me sick to my stomach. BUT that is because I feel like I wouldn't respond correctly. That is part of the reason why I want to go into ICU. I would like to challenge myself to get over that and become comfortable and confident in my skills.

I am VERY detail-oriented, driven, organized and assertive (when it comes to my patients). Currently, I'm doing homecare and I am supervising HHA's (I have med/surg background) Its ALL PAPERWORK!! I miss NURSING! I miss that one on one time (bathing, dressing changes, PEG meds etc.) I LOVE that part of nursing. I hate the politics.

I think this is why I am interested in ICU...the one on one time. I think I would be kick a$$ :wink2:

SO, my question is....What makes a good ICU nurse???

Commom Sense and a Steel Bladder....

MomRN0913

Specializes in ICU.

I freaked out on my first RRT when i floated on the tele floor that went to the ICu. A month later I became an ICU nurse. Codes no longer freak me out.

Everyone gave excellent examples of what it takes to be an ICU nurse. While it is important to be task-oriented, and most are as floor nurses, get the treatments done, the meds done.....you need to put yourself into a prioritizing critical thinking mode. You need ot look at the whole picture and not "I have to give these meds at 10am" and stay focused on that. There may be other things that take precedence over getting those meds in at 10am....

Autonomy, assertiveness, critical thinking and detail-oriented are all very important. being open to learning and accepting that you are not going ot know everything right away, and asking questions when you are not sure are very important. Listening and taking criticism well too is also key.

I worked witht his new-grad who got a good GPA in nursing school, but when you put her with actual patients in the ICU, she was making the worst common sense judgement calls. The worst was she thought she knew it all, so she never asked. Made some pretty stupid and bad mistakes.... She was given many chances and much mentoring between the NM and the critical care educator.... however, she didn't take the criticism well and just got insulted instead. Then she made the big "bye-bye" mistake.

Good luck, ICU is a great place to work if you have the passion for it.

ProgressiveActivist, BSN, RN

Specializes in ICU. Has 20 years experience.

A good ICU nurse has a solid knowledge of anatomy, physiology, chemistry and biochemistry.

You need to be able to interpret ABG and lab results and trends. You need to know the pharmacokinetics and half life of the meds and especially the drips in order to be able to titrate them.

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