What To Expect From A Critical Care Placement

Alex, a third year student Nurse, gives a comprehensive account of what she experienced and learn’t from her Critical Care placement.  

Hi guys, for those of you who do not know who I am, my name is Alex.  

I'm a third year student studying Children's Nursing, and I'm about to qualify.

Today, I just thought I would give you guys some tips/what to expect type of information about going on a Critical Care Placement. 

And the things that I'm about to discuss are based on my own experience and based on my own opinions. 

What I am talking about is very universal, so it's not just specific to what I've seen as a Child Nursing student.

They could be transferred and this advice could be transferred onto like, if you're going onto an adult Intensive Care Unit, for example, it's all the same feelings and emotions you might be going through in the lead up and during the placement as well. 

A Background To My Placement Experience 

My placement experience was very general or has been very general. 

We really get a few kind of like HDU level in the different areas that I've been in.

I've been in A&E, so I'd seen some kind of like ‘blue light’ resource situations there but I hadn't really seen anything like any really, really sick children to the point where like they're like insulated and ventilated and things like that.

I'd generally looked after mainly quite stable patients.

So when I got allocated to Neonatal Intensive Care, which was my Critical Care Placement. I was really excited, I was nervous.

I was feeling a lot of different emotions because I was like, I dunno what I'm gonna be exposed to.

It's quite scary.

Obviously, as a third year, it was my second placement of third year.

What To Expect In Critical Care

So I was thinking, "Oh my gosh are they gonna be expecting me to know all of these things when I've never actually looked after a patient, that's so sick?"

But I feel like it was a lot less scary than I thought it was gonna be.

I was very excited because I'm so interested in neonates.

I was quite apprehensive about that side of it but I will just talk through more to you guys about what to expect.

So the first thing is, I think this is quite self explanatory but just expect, you know, the very different environment.

It is a lot quieter.

Quieter in a sense of you don't have like patients.

Like if you're used to Children's Nursing, you don't have patients running up and down the ward.

It's a very controlled environment, as you could imagine. Everything is very strict and timely in regards to like medications and just cares and all these sorts of things that need to be done for the patients.

It's very, very regimented which is obviously how it should be but it is very different to maybe more general wards that can tend to sometimes be a bit more busy and chaotic.

Obviously all wards can get chaotic but it's like a different type of chaos.

The documentation will be different.

The charts will look a lot more complicated because, you know, you've got patients that are intubated and ventilated.

You've got patients that might have chest chains in.

All these sorts of things that you might have never even seen before on a normal ward.

So, like things like fluid balance will be very, very strict.

They'll be on a lot of controlled drugs that you might have never heard before.

How You May Feel

So, you'll come across a lot of things that you've never seen before.

That can be quite daunting, but it will be explained to you at the start and they will keep reiterating to you that you don't need to know everything because these nurses they go on specific training courses to become Intensive Care Nurses.

It's not just something you should just know like that.

It's not like that at all.

They're not gonna expect you to know everything.

You're there to learn at the end of the day.

So, in that sense, depending on what type of student you are, you might feel a little bit of imposter syndrome.

You might feel like, "Oh, like I don't feel like I should be here."

Or you might think that you're not good enough or you don't know enough, or, but you do.

As you are, they will give you the kind of independence to do stuff.

Especially if you're put in a more like HDU situation.

You'll have a bit more autonomy with taking your patients and stuff.

A Confidence Boosting Experience

Obviously in Intensive Care, there'll be a lot of things that you can't do because you're not trained but you do still have a sense of autonomy, obviously, under supervision, which still allows you to kind of grow your confidence and understand and identify when your patient's deteriorating or identify things that are abnormal.

Like it is a really great learning experience.

So you can expect that, like you'll still have the same experience and you'll still be able to kind of practice to the level that you're supposed to be practicing at depending on what year you're in.

A Growing Experience

Another thing that I would say to expect is learning a lot about different forms of respiratory support that you may have never come across before.

As I said before, going into the Neonatal Intensive Care Unit, I had never seen a patient intubated.

So that was quite a shock to me.

I'd never seen a sedated patient.

I'm so used to like talking to my patients and interacting with them and things like that.

But obviously with intubated patients, you still talk to them, obviously, but it's a different type of interaction.

That was quite a big shift but I think I got used to it quite quickly.

And I think it's so important that you don't treat patients who are sedated, intubated and stuff, any different to patients who are alert and like self-ventilating because they're still human.

They're still aware somewhat of their surroundings.

They're still, you know, you still need to interact with them the same way that their family members do.

You know, you've got to still talk to them about the things that you're doing. You know, they're your patient at the end of the day, they're still human.

So, you get used to a different type of patient communication.

Which I think is a really good skill to develop.

The Emotional Toll

Another thing that would be good to say. You can't really prepare yourself for this but, it will probably take an emotional toll on you, especially if there are patients that are really, really sick.

You might experience patient deaths or an end-of-life care and being involved in that.

So you might end up seeing some things that are quite upsetting and if you do, and it does affect you, which it will, in some sort of way, hopefully there'll be obviously like debriefs and stuff.

It’s Good To Talk

So you can talk about it within the team.

Speak to people in your university or speak to anybody that you trust around you because, you know, like it does take a toll on you and it can be very emotional working in a such an intense environment.

And on the flip side, it can be emotional in a good way.

You know, if you're involved in seeing a patient get better or seeing them get stepped down from ICU to HDU.

Like that's a really, really, you know, nice thing to see and to like be involved with the family and stuff like that is so nice.

So, you kind of need to expect that you are gonna feel like a whirlwind of emotions, but, most of the time, or hopefully that will be a good thing.

And you'll always be able to learn from these experiences.

Self-Care Is Important

Whether they are good or bad, but yeah just always make sure you're talking to people 'cause it can be stressful. It can be upsetting.

So, please make sure you're kind of looking after yourself and making sure you're talking to anyone, if you're having any concerns or feeling a bit overwhelmed.

And another thing to expect as well on your Critical Care Placement is so much interaction with the patient's family.

Your Relationship With Loved Ones

If you are a Child Nursing Student, you're probably very much used to that.

Very much used to interacting with parents and carers and family members who come to visit or parents who are resident, particularly for like younger children and speaking to parents about different aspects of their care.

Especially if the child is little or the child doesn't have capacity to consent to certain things, with other fields of nursing you may not be as used to that but obviously you'll still be kind of liaising with families and updating families on things regardless of what field you're in.

If you have a patient that is in Intensive Care and isn't able to speak to you but for whatever reason, yeah, you're obviously gonna be speaking to the family a lot, updating them, asking them how they are.

Also teaching them too.

Especially in NICU, you might be teaching them how to specifically change nappies.

If their baby's really premature and fragile, you might be teaching them how to do NG feeds and things like that.

Certain things you'll be teaching under supervision but simple things like yeah, how to wash their baby or helping them hold their baby, helping families with personal cares.

All of that kind of stuff is stuff that you are able to do.

And that kind of family centred, family integrated care is so important in intensive care environments.

So that is something that you can also prepare yourself for.

Which is also really exciting part of Critical Care Nursing.

I feel like those are kind of the main things that I can think of about how to prepare for your Critical Care Placement.

If you have one upcoming, I hope it goes well.

And I hope that this video was useful.

Thank you for watching.