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

See, I feel bad now.
Like many others, I had an experience of ICU that showed up how much better the nursing care was there, so bristled and wanted to defend the nurses there.
But that's not what Wishfulthankin meant - sorry, Wishfulthankin.

Pinkplasticbathcup

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….

Ones that are right?
Their answers seemed accurate to me.

I'm sure it was a joke. I bet Destiny123 doesn't even play golf.

Just sad to see even professionals using the same old stereotypes.

I’m confused now, is Destiny123 the OP under a different user name, or have they come in and taken over the thread?

Thank you, @Pinkplasticbathcup

Sadly, I am spending every day in your work environment at the moment with a very ill loved one. I’d no concept of what critical care was like, and I honestly wish I still didn’t. But thank you- I am so grateful for the work you and your colleagues do.

If you were there with a loved one rather than in a professional capacity, what questions would you be asking the staff? What would you want to know? I feel like I’m completely helpless at the moment, and so want to be getting things right for my family member, who is so vulnerable.

So sorry to those on the thread who have had such awful losses, too apologies, am too scattered at the moment to confidently tag the right people.

I don't know.
I don't see why the OP would suddenly post under a different name, so assume Destiny123 answered some questions in the OP's absence.

Just wanted to say 'thank you' to you and your colleagues for the amazing work you do.

I only spent 24 hours in ICU ( bad reaction to GA) but staff were wonderful.

Do you find patients struggle to get back to normal sleep patterns when they wake up from sedation? My 8 month old son was on a ventilator in paediatric ICU for 5 days last week. Since he came round it is like he has forgotten his to sleep - won't sleep in his cot, doesn't know day from night, just wants to be held all the time etc. I don't know if it is normal. Thank you

@Pinkplasticbathcup

Not really I question more of an observation.

Working in ITU is a learned skill, the same as any other. ITU nurses have a different skill set and knowledge base to other specialities. It doesn't make them better.

If you dropped an ITU nurse in a ward and told them they were responsible for 12 patients, including the 2 who need a higher level of care but there aren't any beds for them, I'm sure they'd struggle to start with too.

I agree that ITU nurses should probably be band 6 after a year, maybe two. But I think ward nurses should all be band 6 too

We all work incredibly hard in difficult circumstances.

Ive also known doctors like the 1 who took over and was dismissive of other kinds of nursing care. Not surprised they work in ITU. Definitely conforming to type

No @LaMarschallin @Overthebow I haven’t changed usernames. I’m back and will be working through questions today.

Finished nights yesterday morning and was awake all day so had an early night!

@Notagainst yes absolutely. There are some surgeries where it’s absolutely routine. In others, if the surgeon thinks it’s going to be a particularly complex procedure or if the patient has other conditions that mean their recovery might not be straightforward or they’ll need a higher level of nursing care, then an ICU bed will be booked.

I wish you well and hope you recover quickly!

Ha! Hello from the other side!

It depends what shift I’m having if I’m honest and how bad a state the patients in and whether you’re helpful about the monitoring!!

I’ve worked in ED. Couldn’t give a monkeys about untidy but I hope it goes without saying wet or dirty is a no no.

If you walk into a clusterfuck and there’s only the receiving nurse trying to settle the patient and you just stand at the end of the bed looking impatient instead of helping to swop it over I might get a bit pissed off, yeah!

We’re all under the pump ATM though so I do try to remember that.

@JoonT before i had my little one I wasn’t frightened of death at all, but terrified of suffering. I would never have wanted to go through what some of my patients go through to live.

Since I’ve had him I would put myself through anything to be here for him and see him grow up.

@

@TheBobRoss real, every year. You can’t beat a real Christmas tree!!

@YerAWizardHarry i love having conscious patients!! A mix of conscious and unconscious is perfect. We get to exercise all our knowledge and skill with the unconscious/very sick ones (they’re not always the sickest but just to simplify) and then relax and have a chat and get to know you as you recover 😊

@Botw1 that was the point I was making. It's like putting a ward nurse in the community and vice versa. It's so different.
We have a few ex ICU nurses work where I am now and when they came knowledge of basic medications,minor injury/illness and some long term conditions and management in the community and exacerbations isn't there also with palliative care. They don't take blood or insert cannulas as patients have central lines etc.
it's just a totally different skill set.
Same as if I went onto ITU working out blood gases etc takes me a long time, I would have no idea how to manage ventilators/bipap/cpap. Managing all the infusions that maintain blood pressure, intercranial pressure and so on! I wouldn't have a clue!
They have doctors there all the time, whereas on the wards and in the community you don't.
You just can't compare!

@MoserRothOrangeandAlmond

Exactly

There are some kinds of nursing that are less skilled, that's undeniable.

But again they will have a different skill set that the more technical ones don't.

It's not about being better. There are shit ITU nurses too (I've worked with them)

But as I said, I wouldn't be opposed to a specialist rate for working in ITU.

I think though that all nurses and carers deserve better pay and recognition.

@Pinkplasticbathcup I have a question. I always see people suggesting thank you notes for staff. I’ve always wanted to write to the picu nurse who was with us during (and after) dd’s last hours, but it has been 4 years. I’m sure she won’t remember us (we only met very briefly as everything happened so suddenly). Would that be an odd thing to do? I wanted to write and thank her for being so wonderful, professional and compassionate but don’t want to be weird…

@Bunny2607 I’m so sorry to hear about your nana.

With a brain injury like that the opinion of the team would be based on a combination of things, scans and other tests like EEG’s (which assess the messages that are being passed through the brain, the ‘brain waves’ if you like) as well as clinical signs like level of consciousness and the presence or absence of seizures. When we turn off sedation we assess a persons response, and either there is no return of consciousness or they wake along a scale of consciousness. They can also, with a brain injury, become agitated, distressed in trying to breathe with the ventilator or suffer very high heart rates or blood pressure. However, we have to keep them off sedation for long enough to decide that they are not going to wake up in any meaningful way. It would not have been the withdrawal of sedation that caused her to pass away.

Obviously I can’t comment really on your Nanas case as I wasn’t there. But, she would have had a raft of tests to ensure that her brain was so damaged that she had no prospect of recovery. We don’t really know to be honest whether people can hear us although we always try to behave as if they do, but in my opinion if someone’s brain is damaged that badly then although they might hear they would probably not be able to interpret the sounds as speech. However that is not say that there is no point in talking to them.

The brown liquid coming out of her mouth would have been very distressing to see and I’m sorry you had to experience that. It would likely have been a little bit if stomach contents coming up the oesophagus and coming out of her mouth.

In conclusion, if the ICU team and neurologists were confident that there was no chance of meaningful recovery then I’m sure they were right and no amount of time would have changed that. Once again I’m sorry for your loss.

@blondieminx we give patients bed baths every day, clean their teeth and wash their hair and shave the males if that is their usual practice. It’s nothing like as good as a shower which most patients are desperate for when they are well enough but we do our best!

With regards to covid, I now work in a very specialist centre and haven’t seen a covid patient for yonks, I’m really sorry. Maybe someone else can answer your question (and yes I’m inviting someone else!)

Thank you for explaining a little that’s been helpful😊 and for all that you do too! I remember the doctor showing a picture/scan of her brain and he said it was covered in blood which is why she wouldn’t recover bless her ❤️

Love the username!

Yeah the body’s on its way out now 🙄so I’m thinking about it. Maybe site management? I don’t think I want to be a matron. Or maybe a GP nurse, I might look into that. I’d probably do the odd bank shift to keep my hand in.

What did you go into?

@Overthebow thats really difficult. I’m aware that there are other nurses down the thread who are quite rightly talking about how hard they work and how it’s a different skill set. I guess if you look at our level of clinical knowledge, autonomy and responsibility then there’s an argument for us being paid more. But do we actually work any harder or have less stress than ward nurses? Probably not.

If you look at what nurses are paid in other western nations then I think about 60k (basic, without shift allowances) would be fair for my job role.

Thank you for answering 😊btw my best friend of 40 years is a GP practice nurse. She likes it.