What makes a good ICU nurse??

sicushells, RN · Aug 24, 2008

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.

FaithandSmilesRN · Aug 29, 2008

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 · Oct 31, 2011

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 · Nov 1, 2011

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 · Nov 2, 2011

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 · Nov 7, 2011

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.