My job as a Senior Nurse in an Intensive Care Unit

"Having worked in the intensive care for such a long time, I like the energy and there is never a dull moment."

ICU Senior Staff Nurse, Susan Bweya, gives a run through of her typical day-to-day working in an ICU ward and outlines the demands of a career in intensive care.

Topics covered in this article

Introduction

The ICU as an umbrella for outreach services

A highly specialised area compared to the wards

Working in coordination with other departments

Communication at the heart of what we do

It's one of the most exciting areas to work as a nurse

Introduction

I work in an intensive care unit as a senior staff nurse and this is what my day in the unit looks like.

The unit is based in Cromwell Hospital, it is a ten bedded ITU/HDU and caters for seriously ill patients or those requiring specialist monitoring and treatment.

Most admissions to the unit are planned and they are usually as part of a major surgery programme such as cardiac, renal transplant and neurology.

But there are also times when patients are admitted to the unit as unplanned or as an emergency admission.

And as a private sector, we also get patients from overseas.

The ICU as an umbrella for outreach services

Currently the unit also operates an outreach service.

When patient's condition changes on the wards, the outreach nurse if the first port of call.

And hence on some days I work on the unit but in a capacity as an outreach nurse.

Whether I am working on the unit or as outreach, I don’t work in isolation, there is constant liaising with doctors and other members of the health team.

For instance, if I feel one of the patients on the wards requires intensive therapy, I get in touch with the registered medical officer on duty who then assess the patient before a final decision is made to transfer to the intensive care.

A highly specialised area compared to the wards

Wherever possible, the patient is made aware of what they can expect once admitted to the unit.

Being a specialised area, my work involves using a lot of equipment - so the patient is actually swarmed by all sorts of wires, tubes, and different machines which all help me as a nurse to monitor and track my patient’s progress.

Each and every piece of equipment being used on the patient has a message that it conveys to the nurse.

I must admit all those connections and attachments are a source of inconvenience for the patient, but to me as the nurse they are an invaluable part of the patient’s treatment journey while in the ICU.

The numbers and all the readings on those monitors and machines help to drive care in the right direction. And by nature of the environment being very technologically driven, some patients may find their stay in the unit very stressful especially at night when trying to get some sleep with alarm bells going off continuously.

And as a nurse it is my responsibility that the patient is made to feel as comfortable as I can.

Secondly, the number of nurses at any given shift is higher compared to a regular ward this is because staffing is influenced by the number and patient acuity which in many cases is in the ratio of 1:1.

Sometimes the number of nurses may exceed the number of patients depending on demands, that can also add to patients becoming anxious.

Working in coordination with other departments

However, as I mentioned earlier, I do not work in isolation.

Help and assistance from other departments such as the radiology, laboratory, theatres, physios, speech and language and dietetics etc just to mention a few is sought depending on the needs of my patient.

Some procedures are done on the unit, which means I have to make sure I have the right equipment for the procedure and for those tests carried out in other departments such as the CT and or the MRI.

My responsibility is making sure the patient is well prepared, having the right equipment for transfer and most importantly checking my patient’s condition is stable enough to go for the test.

All this is done in conjunction with the medical team - so even though the ratio of nurse to patient is 1:1, there is a lot of activity going on around the patient.

Communication at the heart of what we do

I have been working in the intensive care unit since 2005 after a six months course in critical care.

As one of the Senior Nurses, as well as being at the patient’s bedside, I also take charge of a shift.

This involves coordinating all the activities in the unit making sure the shift runs smoothly.

It starts with staff allocation, making sure staff levels are safe in line with unit demands.

Throughout the shift, I make sure my team is supported, I go on rounds with the consultants, making sure that orders are followed and carried out in a timely manner.

If there are any patients to be transferred to the ward, as in charge, I liaise with the wards and the nursing administration for beds and times when patients can be transferred at the same time trying to avoid unnecessary delays in patient transfers as much as is feasible.

Every activity is communicated to the nurse responsible for the patient.

There are also times when as in charge I have to cater for emergency or unplanned admission to the unit.

My role is to make sure I have a bed available and enough nursing support.

Sometimes this may mean having to double up patients in order to accommodate the emergency.

But most of the time we operate a 1:1 work pattern.

Having worked in the intensive care for such a long time, I like the energy and there is never a dull moment.

But just like anything else - working in the intensive care can be very stressful for the nurse too.

Especially when you feel you have put in all your effort to help the patient and they don’t make it.

It's one of the most exciting areas to work as a nurse

However, there are also rewards working in such a fast paced and highly tech environment especially when you admit a patient who is so ill sometimes at death door and you see doctors and nurses working so hard to get the patient better.

And when finally, the patient is restored back to life and see them walk out the unit back to the ward - the feeling is amazing because you know you have made a difference in someone else's life.

There is a lot that goes on in that unit.

I would encourage any aspiring nurses who love working with machines while taking care of a very sick patients to consider working in a job as an ICU Nurse.

It is one of the most rewarding areas to work as a nurse.

There are plenty of Intensive Care Nurse jobs here on Nurses.co.uk - do browse them!