5 answers
brittany
Student
Sedro-Woolley, Washington
1
Question
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what does a typical day look like for critical care nurse?
#nurse #medical #doctor
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5 answers
Kelsey M.
Nurse Anesthesia Student and ICU Nurse
1
Answer
Omaha, Nebraska
Updated
Kelsey’s Answer
Hi Brittany!
Excellent question. I was an ICU nurse for 8 years. It completely depends on the ICU you are working in. I have worked trauma and CVICU. On a typical day I arrive around 6:30am. I get an assignment of 1-3 patients depending on acuity. You get report from the precious shift. Verify all medications, review lab results, look at x-rays, and make a plan of care. You introduce yourself to the patient and family and do an assessment and medication admin. Also verifying all your equipment is safe and IV drips are correctly titrated. You do q30 or q1 hour vitals, walk, turn, suction your patient, clean up lots of poop, give bed baths, and keep them alive. You work with the doctors to make changes, improve drips, correct labs, ECT. You do this all day trying to continually avoid negative patient outcomes. I usually got off around 8:30 pm. Being an ICU nurse was awesome and exhausting. No day is the same. Sometimes you are giving 10 units of blood and continually fighting horrible hemodynamic instability and some days are easier but it is always challenging.
Excellent question. I was an ICU nurse for 8 years. It completely depends on the ICU you are working in. I have worked trauma and CVICU. On a typical day I arrive around 6:30am. I get an assignment of 1-3 patients depending on acuity. You get report from the precious shift. Verify all medications, review lab results, look at x-rays, and make a plan of care. You introduce yourself to the patient and family and do an assessment and medication admin. Also verifying all your equipment is safe and IV drips are correctly titrated. You do q30 or q1 hour vitals, walk, turn, suction your patient, clean up lots of poop, give bed baths, and keep them alive. You work with the doctors to make changes, improve drips, correct labs, ECT. You do this all day trying to continually avoid negative patient outcomes. I usually got off around 8:30 pm. Being an ICU nurse was awesome and exhausting. No day is the same. Sometimes you are giving 10 units of blood and continually fighting horrible hemodynamic instability and some days are easier but it is always challenging.
I absolutely agree. It is exhausting but also rewarding!
Erin Smith, MSN, ACCNS-AG, RN, CCRN-CMC
Tequila Langham
Case Manager, Nurse
44
Answers
San Antonio, Texas
Updated
Tequila’s Answer
Hello Brittany,
Sounds like you're interested more in the science of nursing.
ICU nursing is very technically and science based. The ICU nurse must be able to understand human physiology very well. They need to be technologically savvy as well since they work with machines most of the day as well. If you work with adults, I believe strength is important because a lot of time patients are sedated and they have to moved to be cleaned and moved for safety too. I would add that NOT being squeamish is important because an ICU nurse is exposed to all body parts and all body waste products.
Once you have those basic characteristics, then the typical day includes
Pre shift report
Shift report with previous nurse; at beginning of shift. Provide shift report to support nursing staff, nursing assistants/technicians
Reviewing orders
Planning your day
Providing medications and possibly feedings to patients; those scheduled and those you have available for when you decide it's necessary (the medications have to already been prescribed, or you call provider and discuss which medications patient might need)
Washing patient and/or Keeping patient clean
Collaborating with family, doctors, and other auxiliary staff (respiratory tech, physical medicine therapists, and a few others)
You may have transport your patient to a diagnostic test or perhaps you have a unit that has a designee for these types of duties
Document a variety of things each hour; sometimes every 15 mins. Reporting is essential to what nurses do in general
Respond to phone calls
Provide end of shift report
You typically get one patient depending on how sick they are; or, you might get 2. ICUs that assign more than 2 patients...STAY AWAY. That's chaotic and extremely difficult to handle.
Throughout the day responding to lights, bells, and alarms. You watch your colleague's patient when that nurse goes to lunch; or if you work in a well run hospital, their is another ICU nurse who watches your patient/patients when you're at lunch or on break. Like in California.
Sometimes in middle of your day, there is ad hoc class you have to attend; usually attendance is mandatory.
Once you're skilled, then you get to precept a new nurse.
That's pretty much a typical day. The pace is dictated by the severity of the patient's needs.
If you would like to experience the ICU before you decide on becoming an ICU nurse, ask if you can shade one for a half day. Start with the nurse from start of shift to really get the best understanding of what their day is like.
Continued success in all of your endeavors.
Sounds like you're interested more in the science of nursing.
ICU nursing is very technically and science based. The ICU nurse must be able to understand human physiology very well. They need to be technologically savvy as well since they work with machines most of the day as well. If you work with adults, I believe strength is important because a lot of time patients are sedated and they have to moved to be cleaned and moved for safety too. I would add that NOT being squeamish is important because an ICU nurse is exposed to all body parts and all body waste products.
Once you have those basic characteristics, then the typical day includes
Pre shift report
Shift report with previous nurse; at beginning of shift. Provide shift report to support nursing staff, nursing assistants/technicians
Reviewing orders
Planning your day
Providing medications and possibly feedings to patients; those scheduled and those you have available for when you decide it's necessary (the medications have to already been prescribed, or you call provider and discuss which medications patient might need)
Washing patient and/or Keeping patient clean
Collaborating with family, doctors, and other auxiliary staff (respiratory tech, physical medicine therapists, and a few others)
You may have transport your patient to a diagnostic test or perhaps you have a unit that has a designee for these types of duties
Document a variety of things each hour; sometimes every 15 mins. Reporting is essential to what nurses do in general
Respond to phone calls
Provide end of shift report
You typically get one patient depending on how sick they are; or, you might get 2. ICUs that assign more than 2 patients...STAY AWAY. That's chaotic and extremely difficult to handle.
Throughout the day responding to lights, bells, and alarms. You watch your colleague's patient when that nurse goes to lunch; or if you work in a well run hospital, their is another ICU nurse who watches your patient/patients when you're at lunch or on break. Like in California.
Sometimes in middle of your day, there is ad hoc class you have to attend; usually attendance is mandatory.
Once you're skilled, then you get to precept a new nurse.
That's pretty much a typical day. The pace is dictated by the severity of the patient's needs.
If you would like to experience the ICU before you decide on becoming an ICU nurse, ask if you can shade one for a half day. Start with the nurse from start of shift to really get the best understanding of what their day is like.
Continued success in all of your endeavors.
Tanisha Anderson DNP, APRN, FNP-c
Family Nurse Practitioner
7
Answers
Jacksonville, Florida
Updated
Tanisha’s Answer
Hi Brittany,
I agree with Kelsey. No day is the same. I worked for 7 years in MICU (medical ICU) and these patients can be quite complex. Medical ICU is different in that you’re managing multi-systems; heart, kidneys, lungs, etc. I typical day for me was getting report on 1-2 patients; some patients require 1:1 management meaning thats your only patient. These 1:1 patients may be on continuous dialysis called CRRT that you manage as the ICU nurse or have recently coded, or even be an organ procurement patient. As Kelsey mentioned, checking ALL drips and IV pump settings (accidents happen) with the off going nurse, then checking labs and imaging. I personally worked in a level 1 Trauma center which was also a “teaching” hospital so we had medical interns, residents, doctors from other disciplines such as infectious diseases, etc, a fellow, and the Attending. After rounding on patients, we would participate in rounds with the entire medical team to make sure everyone was on the same page with regard to the patients current status, medication needs, etc. Because you’re the nurse, you are aware of all the patients titratable drug requirements and need to make the team aware in case additional interventions are warranted. All the other duties are routine such as turning, cleaning, bathing the patient. You’ll find that as an ICU nurse, you’re very territorial over your patients and will likely do most of the work yourself. You also have to transport patients off the unit for imaging such as CT scans, MRI, and X-ray. This can be extremely daunting and a long process depending on how ill your patient is and the number of IV drips theyre on. On my worst day, I had to transport a patient with 12 drips running on 3, 4 channel IV infusion pumps. This process involves a respiratory therapist who ventilates the patient if they are able to be disconnected from the ventilator because some absolutely cannot, and other support staff in case of an emergency. I absolutely loved intensive care. The challenge is definitely there. Knowing your limitations and asking for help will help keep you from making a fatal mistake in that setting. Hope this information helps!
I agree with Kelsey. No day is the same. I worked for 7 years in MICU (medical ICU) and these patients can be quite complex. Medical ICU is different in that you’re managing multi-systems; heart, kidneys, lungs, etc. I typical day for me was getting report on 1-2 patients; some patients require 1:1 management meaning thats your only patient. These 1:1 patients may be on continuous dialysis called CRRT that you manage as the ICU nurse or have recently coded, or even be an organ procurement patient. As Kelsey mentioned, checking ALL drips and IV pump settings (accidents happen) with the off going nurse, then checking labs and imaging. I personally worked in a level 1 Trauma center which was also a “teaching” hospital so we had medical interns, residents, doctors from other disciplines such as infectious diseases, etc, a fellow, and the Attending. After rounding on patients, we would participate in rounds with the entire medical team to make sure everyone was on the same page with regard to the patients current status, medication needs, etc. Because you’re the nurse, you are aware of all the patients titratable drug requirements and need to make the team aware in case additional interventions are warranted. All the other duties are routine such as turning, cleaning, bathing the patient. You’ll find that as an ICU nurse, you’re very territorial over your patients and will likely do most of the work yourself. You also have to transport patients off the unit for imaging such as CT scans, MRI, and X-ray. This can be extremely daunting and a long process depending on how ill your patient is and the number of IV drips theyre on. On my worst day, I had to transport a patient with 12 drips running on 3, 4 channel IV infusion pumps. This process involves a respiratory therapist who ventilates the patient if they are able to be disconnected from the ventilator because some absolutely cannot, and other support staff in case of an emergency. I absolutely loved intensive care. The challenge is definitely there. Knowing your limitations and asking for help will help keep you from making a fatal mistake in that setting. Hope this information helps!
Yaeji Kim
registered nurse
10
Answers
Cypress, California
Updated
Yaeji’s Answer
It’s true. No day is the same. As you advance you can have different roles within the ICU sometimes you can take care of Critically ill patients or other patients that are ready to transfer out of the ICU. Other days like on my unit you can be the break nurse. Typically you are responsible for all aspects of the patients care whether it be giving medications coordinating with social work relating critical information to the physician, or dealing with whatever issues may come. There is always a potential that your patient may decompensate and you will need to resuscitate them. The icu is all about noticing minor changes (especially in pediatrics) and monitoring critically ill patients. It is extremely rewarding and an endless amount of learning!!!
Richard A.
physician
2153
Answers
Updated
Richard’s Answer
12 hour shifts caring for 1-3 patients. Start the day with report from the previous shift's nurse and get up to speed on the plan of care. Administer all medications according to schedule. Discharge patients to less high level care. Accept new patients from floor, ER or OR. Take patients to different departments for testing or procedures and give report to team taking over the care during the procedure.
This can a be a high stress job and the ICU at the hospital where I work has a high turnover of nursing staff.
This can a be a high stress job and the ICU at the hospital where I work has a high turnover of nursing staff.