Many nursing students have aspirations of becoming critical care nurses. There is a certain appeal/allure to this specialty that draws in the energetic and ambitious individual. It certainly is an exciting field of nursing, filled with an abundance of experiences to gain and a ceaseless fire hose of knowledge to drink from.

An overarching theme in critical care nursing is understanding what’s happening, in regards to the patient’s health, as a whole. Most patients have an collection of illnesses that, when combined, put them in their current, ailing condition. It is therefore crucial to conceptualize how all of the human body systems are integrated, in order to understand the patient’s plan of care towards recovery.

Critical care nurses should also expect to start their shift with a tentative plan in mind, but be flexible enough to change everything at a moment’s notice. Your patient may be stable for the first few minutes to hours, and suddenly something changes that requires your immediate and complete attention for most of the remainder of the shift. These instances are often incited by emergent, life-threatening situations. Patients that find themselves at the center of this much attention require constant, close monitoring.

The main argument against new nurses entering the critical care specialty stems from the understanding that the ICU environment demands a great deal of critical thinking from the primary nurse. Whereas a medical-surgical focused nurse must be able to balance an assortment of tasks and skills between 5 or more stable patients, a critical care nurse typically cares for only 2 critical patients and must manage a vast amount of specific information on both patients. The autonomy that ICU RNs hold is a great privilege. This responsibility predicates that the nurse is able to constantly monitor their patient’s condition and consistently make informed decisions based on a multitude of data. Critical thinking is honed through a nurse’s on-going experiences and training, therefore it is hardly expected for a new nurse to start out with high proficiency.

Fortunately, most medical institutions who hire new RNs into this occupation assist their staff with the tremendous learning-curve through a lengthy critical-care orientation. The new nurse is typically paired with a well-experienced nurse preceptor who can show them the ropes and guide them through difficult situations.

Another major hindrance facing new nurses in this career is the need to develop strong time management. In order to practice safe and efficient care, critical care nurses must constantly prioritize their never-ending, myriad of tasks. They must also find time to chart the assessment findings on their patients and minute-to-minute condition changes. This skill also comes with time on the job.

One final trait of this field that should be noted is the high amount of stress one can anticipate. Nursing students are well accustomed to the extreme stress of making good grades, passing clinical practicums, and studying until they are blue in the face. Critical care nurses endure psychological stress of keeping track of their patients’ changing conditions and the barrage of new (sometimes unsafe) orders entered by an array of specialized physicians. There are also the added stressors of family emotions (such as with trauma patients and end-of-life care), difficult physicians and coworkers (yes, sometimes other nurses too), and regularly fluctuating vital signs that require intervention. Not to mention the stress of a full bladder wishing to be emptied when you know it will have to wait.

It is generally a fairly difficult profession to join directly out of nursing school. With the high supply of new nurses eager to work in critical care and the extensive education required by institutions to train competent nurses, finding a spot in an ICU straight out of nursing school is a very competitive process. Larger, teaching hospitals usually offer new graduate nurses opportunities to work in critical care through ICU internships. Those internships are probably offered near you; check out listings by state!

It’s not always a daily grind, in fact there are some shifts when you are mainly observing your patients who are stable for your entire shift. A critical care nurse, however, has to be well-trained and have the mental fortitude to endure an entire shift, fraught with just about every imaginable thing that could go wrong, going wrong. At the end of such a shift, you are usually too tired to do anything except go to bed, but you always realize how much of an impact you’ve had on your patient’s care and well-being – and it makes the job 100% worth it! If you think you can handle all of this, persevere until you get the job!

This post was written as part of the Nurse Blog Carnival. More posts on this topic can be found at http://thenurseteacher.com/. If you are interested in participating find out more details and sign up.

Eric

Eric is a cardiac ICU nurse in Texas. To compensate for a completely inside-job, he spends his free time running around outside with his 4 yr old German Shepherd, Kita - with breaks to check in on here! ;)

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