I’m an ICU nurse, AMA

[Pinkplasticbathcup]

I guess there may have been a few of these a couple of years ago, but in case anyone’s got any more questions

@LawksaMercyMissus

Hey I’m sorry for your loss, I lost my dad also from a Cardiac Arrest in April 2021, I still struggle with his loss and often have lots of questions going through my head more so at night ( when my children are in bed ) I find myself googling in hope for some answers. My dad lived 18days in total we agreed to remove the ventilation on day 7 as it was causing him to have a chest infection, They said he would likely pass within a few hours of removal but managed a further 11 days, also all his organs was working how they should for many of them days.

How are you coping?

What I did forgot to say in my original post is that all nurses but especially the ICU nurses are amazing and Thank you

❤️NHS

Haha 😄 ah that was asking for it!

Icu is my safe quiet haven i have to retreat to when been in resus too long. Can't hack the infusion lines tangles it's totally the worst part of icu

@Obeythedancecommander sorry this reply was for you, I tagged wrong person ( new to mumsnet ).

Very diplomatic! ;)

Do you think you think ICU nurses should get paid more than other other nurses? And how much do you think you should get paid?

My question is;

When my dad's life support was withdrawn (hypoxic brain injury that looked relatively normal on scans, caused by severe heart failure causing cardiac arrest) it took around 20 hours for him to die with his sats dropping a bit then climbing back up again again and again.

Almost at the 20th hour the nurses aspirated some fluids to stop the loud rattle/snoring sound my dad made as they had been doing all along. I left the room to the wash room/cupboard at the side and they said he was sick so they did a quick bed sheet change etc so they had to move him on the bed I presume. Anyway after I came back in the room after his change his sats all tanked very rapidly and about 20 mins after he was gone.

Have you experienced anything like this before? Would the moving of him to clean up a bit cause that really quick deterioration and why? The nurses were so keen to keep aspirating him and kept apologising for his noises but I really didn't mind them. I just think back to the quick deterioration and wonder if the two things are linked.

ITU nurse here too!

for anyone who is still suffering from intrusive thoughts from admission or have had experiences with relatives the icu steps charity is excellent.

icusteps.org/

I have read that patients in comas/otherwise unconscious can have terrible dreams and/or be aware of what’s happening but unable to communicate and is sometimes a source of PTSD afterwards. Can’t remember the name of the phenomenon, but that is one reason why medical staff talk through what they’re doing to unconscious patients.

Also that some patients have a diary kept of key events or visitors etc. so they can review it afterwards and try to piece together what happened during their time. Either of those true?

When I say going in and out of a natural coma this was during a 18day period and was off the ventilation on day 7. All of his organs worked as they should and needed little support breathing from the ventilator by day 2.
I cannot be sure what kind of scan he had but he had a Cardiac Arrest.

how is it decided how long the ( cooling brain down ) period should be used. Is it likely his odds would of been better if it was longer than 24hrs?

I just want to say thank you for your amazing work ..xx

I'm laughing at the question... do you think you are better than other nurses?
The thing is ICU nursing and A&E nursing are the 'trendy' nursing jobs. As OP has said that when people ask what they do, they say ICU nurse not just I'm a nurse.
I remember as a student these were the places that people wanted to work in.

Whereas I wanted to work in gastro medicine. In the hospital A&E, theatres and ICU/HDU mainly keep themselves to themselves.
Interesting in the view of the ICU reg stating that the knowledge from
ICU nurses were better. As a nurse isn't my experience. As pp have said there are a lot of different specialities and ICU is a very specialised area no therefore knowledgeable about that specific area.

Now I'm a nurse practitioner in the community (working autonomously, no back up at all, no doctors, no scans/X-rays)
When random people ask what my job is a lot of the time I don't want to be identified as everyone tries to get me to diagnose ailments. Therefore I say that I'm an Occupational therapist as not a lot of people know the ins and outs of that job therefore stop asking questions.

Fwiw OP I praise you for working in ICU it isn't a specialty I wanted to/could work in! I'm glad nursing can be so varied!
Too many machines/readings/lines and tubes for me!

@HelloNeighbour2021

Wow, my dad was April 2022. Sorry to hear it was your dad you lost.

Goodness I relate so much to you on this. I go through periods of googling different things relating to cardiac arrests, heart failure, brain damage etc late at night when my children and the world are all asleep. I know it won't chnage anything so I'm not sure why I still torture myself with all these questions but there we go, it must be normal if you do it to :')

Did you have a cause for his cardiac arrest? I struggle with not ever knowing if my dad knew I was there with him. He was admitted to hosp with breathing problems after having covid where they discovered he was in acute heart failure due to dilated cardiomyopathy. I wasn't allowed to visit him on the cardiac unit because of the risk of spreading covid and the next day he arrested so I never got to have a proper talk with him. I torture myself with wondering if he knew I was there with him or if he had any idea what was going on around him as essentially all he would do is open and close his eyes yet his scans were all deemed okish.

I googled that people with heart failure as bad as his heart was rarely live longer than a year so in some ways I wish they werent able to defib him back at all as then at least I'd have known he would have just lost consciousness and faded to black rather than wonder what he was aware of. it eats at me that I'll never know.

I'm doing ok if I pretend he is still alive and I try to avoid thinking about everything. When I do try to think of him in any capacity I end up mostly a mess and some how I always end up going to memories of the ICU and watching him take his breath and horrible things like that which I can't seem to not think about.

My dad was 13 days post arrest before support was removed... they waited quite a while because his scans were so normal. I feel dramatic saying it but thinking of the ICU feels quite traumatic to me. I don't know how on earth nurses and doctors do this every day.

I cant imagine being there for 18 days in total as you were, and waiting all that time after removing ventilation must have been just the hardest thing to cope with ever, I'm so sorry. I can only imagine the questions you must ask yourself. Do you struggle with remembering your time in ICU with your dad?

How are you coping almost 2 years on?

I'm constantly googling to try to find other people with similar experiences to read about so weirdly this thread has brought me some comfort.

Do you have many patients in ICU due to Covid these days? What are the treatments and outcomes like for covid patients compared to during the pandemic?

What a rude thing to say!

I'm an RMN. I sometimes see shifts for RMNs on the bank for ICU. However I assumed that all of your patients would be unconscious, is this not the case? Why would an RMN generally be required in ICU? Would a patient require one if they are on a detention, despite not being conscious? Or would the RMN be for the patient wakening up if they are particularly confused/distressed?

Just something I've wondered for a while now ever since seeing these shifts advertised! Apologies if it's a bit of a silly question!

@Obeythedancecommander I'm really sorry for your loss, it sounds like something that still affects you greatly. Have you considered bereavement counselling?

@Obeythedancecommander

Its very sad but also comforting that I’m not the only one with the same experience and still struggling with our loss, I tend to not talk much about it these days as I feel that people would likely be thinking I should be over it by now it being 2 years later, so I tend to spend a lot of my nights on Google hoping to find comfort.

My dad as never had any problems with his heart and although we do not have any hard evidence we all believe sadly it happened due to the covid vaccine. He needed the vaccine as he did have COPD he was 62 by the way. After his first vaccine he had what we now believe was a mini stroke he collapsed ( still conscious) and his eyes went back of his head he was telling us to ring a ambulance which we did but then he seemed to come round while we was on the phone and told the operator he was now fine now to come and went and got in a shower ( apparently common urge when had a stroke ). My dad had isolated for many months due to him having COPD. I’m not sure if he had any more attack that we are not aware of but he suddenly wanted to see all his children after spending months in isolation. He was making comments to my mum like I’m not bothering what she decided me to do with him ( when he dies ) and also wanting to get certain jobs done around the house. The morning of his cardiac arrest he came to my house and helped me paint my bathroom and also lawnmower a neighbours garden. He was telling me that he thinks maybe he should go to the doctor as he’s feeling bloated and gassy and I joked it off saying what’s new there you are always gassy. Now if I had of taken him seriously who knows he may have still been here and I guess that’s something I’ll have to live with anyways his cardiac happened 5 days after his second vaccine.

2 years on I suppose I am doing better as I couldn’t speak about it without crying, I do often suffer from flash backs of the night of his CA it’s like I re live the whole thing I can see him lying on the floor and everything that was going on around my and the noise that was coming from me that I’ve never heard anything like because I also ask myself maybe I didn’t do the CPR good enough. I also suffer from anxiety I am scared that I’m going to find my mum dead and when she’s doesn’t answer her house phone ( she doesn’t have a mobile ) I panic if she’s not told me she was going somewhere, luckily I live only a minute walk so I can go check to ease my mind, Or if she goes out for the day but isn’t back by late evening I panic.

Our time in ICU was a roller coaster, I didn’t know much about ventilators and when I went to see my dad that morning I was expecting him sat up on his bed ( after the surgery on his heart the night before ) drinking a cup of tea. The thing I found hard was leaving him as my dad would not go to the doctor without my mum or someone so I knew if he was conscious he would hate being in the hospital on his own. I am very lucky though as me and my 5 siblings and mum was able to visit him often so we usually do two in a morning and two afternoon and we was also allowed to stay the night ( this was covid times so we are so thankful).
Although all staff was lovely they had basically given up on my dad by day 3 I’m guessing his age came into this and it was a constant fight in us refusing to give up on him and remove life support. By day 7 we agreed to remove ventilator and by day 11 we was basically moved to another ward to which it felt we was in a tiny little cupboard waiting for him to die as food and water was taken away from him by day 15 as it was causing him to choke on his secretions.

How old was your dad? Xx

@StressedToTheMaxxx
.I finally went to the GP last month and have been assessed and im on the waiting list for some sort of self guided CBT 35 minute sessions thing. I'm not sure it will help me but it was the only thing the NHS would offer me that was face to face... everything else was a facetime or online self help thing only. I specifically want some sort of bereavement counselling but doesn't look like I have much of a choice unless I go private (I would be willing to do this) but find it overwhelming where to go for this.

@HelloNeighbour2021

Goodness, my dad was also 62! I know they weren't the youngest deaths to have ever occurred but I find it particularly hard to deal with how young 62 is to go. My dad's mum only died 3 years previously at the grand old age of 95 so for my dad to follow so young just feels like no time at all and so unfair.

Reading your post has made me so emotional for you. I feel lucky in a way that my dad had his arrest in hospital and I was spared of having to do cpr or find him dead at home. I read that cardiac arrest survival rates are very low, out of hospital arrests survival rate only being 4% or something so you must have done absolutely amazing to have even gotten him to the hospital. I cant imagine how traumatic it must be to go back to that day. One of those life altering events you never ever imagined would happen.

Its shocking how different these events are to that of those depicted on TV... a quick shock and everyone back to normal again! I'm not sure what I was expecting going into the ICU but nothing prepares you for it. Just sheer disbelief at all the wires and machines. I too half expected my dad to be sat up in bed. Then as I googled I expected him to be completely brain dead as it took 10 mins of cpr and 2 shocks to get his heart going again, only for the scans to be ok which no one was expecting.

It's so easy to blame ourselves for not picking up on things prior to the arrest... being bloated and gassy is just something we all deal with day to day so absolutely impossible for you to know it was anything significant which I'm sure you have rationalised and then tortured yourself with again and again. My dad was never the healthiest as he smoked and drank far too much (most likely caused his heart issues) but all that had changed was he lost weight and gained it again in the previous 2 years (wouldn't go to drs about it) and he was tired a lot more and having a nap in the day, but we both just thought it was him being 62. Had no idea his heart was so poorly. Coincidentally on my dad's MRI they found infarctions indicating a historic mini stroke which my dad new nothing about and neither did I!

Sometimes people will say "oh its still raw for you" regarding his death but I'm honestly dreading the day where its expected to be 'over it' like you say. These past 11 months have flown by and it feels like it was last month that it happened. I too panic about my mum a lot more now and I'm very frightened of losing her. My mum and dad divorced when I was little and I was my dad's only child so I find it very hard to have no one to relate with about what happened specifically with the same relationship to him as me. It was just he and I until the very end.

I found 20 hours waiting for my dad to go just unbearable. I cant imagine what you went through for all that time with him. I often think back to just a few years ago and how blissfully unaware I was of what was to come.

I'm so sorry, what a shitty club were in.

I read your OP, I haven't read any of the thread, so leaping in blind:

Bloody hell! How do you do it, how do you know so much? And yes, way more than a B6 out-patients nurse. How hard must it be to help manage family expectations? I watched you, first-hand, during the pandemic. Whacking a saucepan on a doorstep doesn't cover it.

How much do you hate the radiographers wading in (😉) 5 minutes after you've just turned your patient, for a CXR? That's my AMA. 😂

And, as for strikes, I am 100% behind you. I know this isn't just about money (although the awarding of PPE contracts to Tory mates, apparently was....).

It really is about safety.

I am a final year student and have applied to a surgical special care ward, which in our trust comes under the ITU division. I previously worked on the surgical wards and loved it, but surgical special care with more unpredictable patients and more intensive needs was always my goal job.

What advice would you offer to an NQN going into this role and speciality

Many ICU’s have follow up clinics afterwards and psychological support is a part of it. Definitely contact the ICU or the PALS service of the hospital and see if they can offer you anything.

Wishfulthankin

Do you think you're better than other nurses?

I've spent all my working life in the NHS and, unfortunately, more recently have spent quite a lot of time as a patient.
Imo, they are streets ahead of other nurses.
I'm sure this is partly because of of the higher staff:patient ratio, but absolutely not just because of that.

Well it seems as if @Destiny123 has taken over and answered most of the questions for me!
I’ve met a few doctors like that….

I’ll work my way through and answer any others throughout the day. Thanks for engaging everyone and thanks to everyone who has thanked me, on behalf of all ICU nurses xxx