A day in the life of a newbie ICU nurse

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It’s been nine weeks since I first landed at the Intensive Care Unit (ICU) at Nepean Hospital.

ICU

I remember feeling very scared in the beginning. I felt I had been taken out of my comfort zone. I have been an EEN for three years but have mainly worked in the wards.

I spent my first 4 months as a new graduate in Endoscopy, so ICU is definitely a whole new unknown world for me. The orientation helped a lot, plus the one week I am supernumerary – I worked with a nurse buddy for the whole shift. My buddy showed me the basic stuff and the routine.

Now, after nine weeks working in ICU, I am ready to give you an idea of what a day in the life of an ICU nurse is like…

At the start of each shift we get the complete handover at the nurses station, then a bedside handover of the patient (ventilated)/patients (non-ventilated/cleared for ward) we are allocated for the day.

I start by doing a complete physical assessment on my patient. I also check my equipment and set my alarms.  I check what drips are running and label each line, especially if the patient has central line with chooks foot extension.

Then I update my ICU flowchart, follow doctors’ orders for the day, administer medications due.

When it’s quieter, I focus on patient care. I give them a wash or shower, whichever is applicable. Oral, eye and pressure area care is very important, especially with patients on ventilator support.

We always put them on special mattresses and sequentials to assist with circulation. We encourage relatives to visit as this assists the patient’s recovery.

Most ICU patients feel isolated and helpless, they lose their confidence and interests. Lack of sleep is also a big problem due to the noise of alarms and the bright lights and constant prodding by nurses, doctors and physios.

I can relate to this so whenever I can, I give my patients time to rest and sleep by reducing the background noise and turning down the lights. The last thing I do before leaving the patients is make sure that they have enough pain relief if they need it.

The last part of my shift is spent documenting everything I did for the day. Then I know I’m ready to hand over my patient to next nurse.

What about you? What is your typical day like in your department or unit? Share it with us.

7 COMMENTS

  1. A Day in the Life of a newbie ICU Nurse Hi Ruth,

    I loved your blog post! I have always wanted to work in ICU to experience what it is really like.
    It can quite danting to start working in a new specialty but it’s a great learning experience! You would learn something new each day 🙂 it would be very rewarding as well seeing a patient come into the ICU, caring for them and seeing them move onto the wards and recovering well 🙂

    I have been working in an Emergency Department and General Ward for the past 18 months, it is only a small rural hospital so we have to work in both departments at once so it can become quite busy as there is generally only 2 staff members on (1 RN + 1 EEN)

    Thank you for sharing your day with us! was a great read

    Luke

  2. You have learnt a valuable skill Hi Ruth, The systmatic assessment and care of your ICU patients is a nursing tool that you can apply to any of your patients (including non ICU ones). Once you are trained to use this assessment tool it tends to stay with you always and as you cover all aspects of your patients care/needs, it is a handy tool to have learnt.

    Rich

  3. @Luke — I’m glad that you find this blogpost useful. OMG, I love ED! Would honestly prefer it than ICU, I mean personally! I enjoyed all my shifts there as an EEN trying to help the RNs with their obs, ECGs, meds & transfers to wards. I really wish I had an ED rotation. I love the quick turnover of patients. I bet you love being an ED nurse!

    @Rich — you’re absolutely right, I learnt so many skills being in ICU. They’re precious skills money can’t buy and will stay with me for a lifetime. And I would be more than happy to share it with newbies I would meet in the future.

    @Linda — thank you for the compliments and good wishes!

  4. Newbie ICU Hi, I am also relatively new to ICU (just over 12 months at 3 days per week) at RNSH. I went straight out of being an EN on the wards (casual) without the medication endorsement into General ICU. So I still feel grossly underexperienced compared to many there. Your day sounds pretty much the same as my type of day. Glad you feel that you gained from the experience. I found it tough both personally and professionally (and still often do… I am not as young and energetic as some any more), especially in the initial months. But the NUM and the educators were and still are great. Who you work with and what support and encouragement you get has to be the single most important thing about a workplace. Especially when you are dealing with peoples lives, as it can really affect patient care big time. If you dont have that helpful work environment, then it really makes no difference how exciting the specialty sounds!. Hope you feel that you are making a difference and best of luck !

  5. New in ICU I won’t go into ‘today’ but back in time. When I started nursing, there was an intensive care unit next to my medical ward. I was still a student, so intensive care was ‘out of bounds’ to us plebs, but every excuse was taken to get in there ( and get yelled out by the goddess who ran the place). To me, once I saw the machinery, equipment, computer screens, etc I knew this was the place to be. It had my name written all over it, but not according to the charge nurse (NUM), who threatened me for entering the abode of her senior RNs. So I returned, with yet another excuse for a search for equipment or drugs for the ward next door. I was told you couldn’t get rostered there unless you were an RN, but next roster, while a year 2 student, I was in, at the NUMs request. I was given 2,3,4 patients – on ventilators, peritoneal dialysis. I had support at extremes, but they were mine. I had to hit the ground running, and was constantly encouraged with :” If you can’t cope, you can always resign!” – I ‘borrowed’ books on ECG’s , critical care. I photocopied items ( note the era, as ‘photocopy was me taking photos of the pages, then developing the negatives at a friend’s place, and blowing the photos up!). I read the books once, twice, and again. I got home from work, then read books though the night, allowing 3 hours for sleep. I took home a ventilator (it was out on the verandah awaiting service) and dismantled it, put it together/dismantled it/ put it together, then returned it to the maintenance department. I worked till my feet ached, but never gave in. I gave up sleeping on night shift breaks as the night matron told me she bet I couldn’t last, so spent breaks rewriting books and articles. Then decided to get ahead of the crowd, and subscribed to the “Nursing(nowNursing2009)” journals from the USA, and the UK “Nursing Mirror”, our own LAMP, and RANF Journal. I subscribed to the MIMS (the thick one!), and to Current Therapeutics, as well as “Patient Management”, till I bacame a master of trivia on most topics. I took the NUMs jobwithin 4 years, and my regret was not working with her anymore. She kept me on a constant challenge; on a quest to excell and beat her into the ground. From there onwards, everything else was easy. Her pushing gave me the ability to be so confident in my knowledge that I could adlib on any topic, and teach. Once you teach, your knowledge gets ahead by leaps and bounds.
    What I’m getting at is simple – 100% is never enough, not even 120%. You have to treat every ward, every hospital, every employer as if it were owned by YOU, as if it were YOUR business. That is the path to success and promotion, and, depending on your attitude, on your reputation. Unless you do the best you possibly can to make the ward etc better/more successful etc, then you will adversely affect your own work day and career path.
    Some of what I learnt, wasn’t used till years or decades later, but I was reme

  6. “Who you work with and what support and encouragement you get has to be the single most important thing about a workplace. Especially when you are dealing with people’s lives, as it can really affect patient care big time.”

    That has got to be one of the best sentences that relate to my home town right now and I wish they had this in every staff room so everyone can see it.

    Bernhard – I thought that was an excellent read, it’s so great to see people who would rise to the challenge, as opposed to just challenging everything you’ve been asked to do, and going out of their way to learn the things that would make them better at their job. The amount of times I’ve taken a photo on my phone of a medical book/journal and then printed it to read later, I was very glad to see I wasn’t the only one! We need more people like you in this world.

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