Do you miss critical care?

This blog is not completely in asystole! I took a break from my nursing blog because frankly there wasn’t much to write about, and I didn’t have much inspiration. I could write about old war stories, the future of health care, or how being a nurse is special, but I’m going to bypass some of that (with a LIMA?) for now.

I thought I’d address a question I get asked frequently, as I’m sure many ex-ICU nurses do too.

Do you miss critical care?

In short, no. But it’s really quite complicated.

These are the things I don’t miss:

  • Long hours and bad hours
    • 12-hr nights is just not kind to anyone. Working weekends? Terrible. Working holidays? More terribleness. Some may not mind it, but as I get older, finding a good work and life balance is becoming a higher priority. ICU taught me life is too short. So damn it, I’m going to work hard to enjoy it!
  • Understaffing
    • Tripling vented patients? Doubling up patients that should be 1:1? Having a fresh CABG, a rapid response pager, and a charge phone? Oh, and here’s an orientee.I am confident enough in my clinical skills to say I can handle most anything that comes at me. And if I can’t handle it, I can figure out a way pretty darn quickly whether it be “seeking expert advice” or grabbing more hands.The problem with the scenarios above is that it is just not humanly possible to provide excellent clinical care consistently without a price. Exhaustion, stress, burn out, practice errors, patient harm…those are all potential consequences of working in those conditions for an extended period of time.
  • Emotionally draining cases
    • Sometimes I felt like my heart could only handle so much, like I was teetering at the edge of a cliff. There will always be those patients that touch your heart and you will remember them forever. For me, I will always remember the first patient funeral service I went to, the first patient I lost, my first very critical patient, and the sinus tach to asystole in a split second patient. And of course, there were the times when you felt you were doing more harm than good, when your practice was causing more pain than healing.
  • Being the secretary and coordinator
    • Nurses get a lot of poop, literally and figuratively. We’re the first line of communication with patients, families, physicians, dietary, inpatient physical therapy, inpatient occupational therapy, case management, respiratory, medical imaging, lab, pharmacy, etc. While I appreciate each department in their role in health care, sometimes it can be very overbearing trying to coordinate everything and making sure the best is being done for your patient.

These are the things I do miss:

  • Critically thinking frequently
    • Now I’m getting my fill of critically thinking from computer science and mathematics, but I do miss looking at a patient and figuring out what needs to be done, why it needs to be done, and what will result in these actions. It was a very complex puzzle with a lot of clues.
  • Helping a patient on the balance beam of life and death
    • Whether this is the adrenaline rush of saving someone’s life or seeing a very ill patient recover, to know you helped in this is a really awesome feeling. After all, I did become a nurse with the intention of helping people. Nurses care. We really do. Bad days may hit us like any other human being, but generally we want to make people’s lives better.
  • Seeing interesting things
    • Critical care has its share of interesting things. My curious mind jumped on the chance to see something new and unknown. Most people in the their lifetimes will never see what we see in ICU, probably for good reason.

These are the things I learned:

  • How to be stronger
    • Dealing with stress, losses, triumphs, and mistakes has made me into a stronger person. I could almost equate critical care to a war zone. There were times when I would burst into tears after work, stay late to make a patient’s morning better, and be so angry about something that it made my blood pressure rise. I had 7 years in the trenches, and through it, I’m a stronger person mentally and spiritually.
  • How to triage in life
    • What is important? What can go to the wayside? This ability also spills over into my everyday life. My brain is much faster at analyzing, organizing, and acting than before I was in critical care.
  • Life is too short.
    • Everyday I’m so thankful for my health and ability to do the things I want. Life flies by in the blink of an eye. Take chances. Do amazing things: small or big. There is no time for regrets.

To all the ICU nurses out there, you’re amazing! It’s a tough job in so many aspects. May I wish you good staffing, filled medication bins, less C-Diff, and more potlucks.

One thought on “Do you miss critical care?

  1. Alissa

    Hi, thanks so much for articulating exactly how I feel about Critical Care. I miss some of it but overall, I am much happier where I am now. Most of all, I miss the new and interesting cases. And it definitely gave me confidence after seeing code after code and being able to handle it.

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