The Faces of ICU Nursing

A long time ago, if someone said, "I'm a nurse," people had a good idea about where they worked. Nurses generally worked in schools, a physican's office, or in hospitals doing general floor duty. But not anymore. With technology changing at lightening speed, nursing is now highly diversified and specialized. This trend in specialized care is most evident in intensive care nursing.
Giving more specialized care to a wider range of patients is a challenge, but one that is being met by ICU nurses at University of Maryland Medical Center (UMMC), Baltimore, MD, everyday. Regina Hogan, RN, MS, Becca Workman, RN, MS, and Judy Slide, RN, BA, are ICU patient care services managers at UMMC and each one has a unique perspective about her specialty.
The Many Faces of ICUs
Even though intensive care units are sub-specialized - ICUs that provide care to critically ill patients with varying needs - Hogan, Workman, and Slide see similarities between their units. As managers, they see the need to attract new and talented nurses to intensive care nursing. Providing top notch, quality care requires many qualified nurses to fill their staffing schedule.
The Cardiothoracic ICU
At UMMC, the intensive care units are divided into subspecialties - neurocare and surgery, women's and children's health, medicine, and shock trauma. Hogan, a nurse for the last 20 years, is the patient care services manager of the cardiothoracic ICU. She and her staff typically care for cardiac and thoracic patients after they come out of the OR. They also care for a large number of postoperative esphogectomy patients. Hogan says, "More of these procedures are done at our hospital than at any other hospital in the area."
Another exciting dimension to her job is the unit's involvement with the National Emphysema Trial. In a partnership with The John Hopkins Hospital, UMMC surgeons are performing lung volume reductions on patients. A lung volume reduction involves removing parts of the lung that are no longer functional. Hogan said, "My staff and I have a great opportunity to grow professionally by caring for these [emphysema] patients. The technology is amazing and it's always changing."
The Medical/Oncology ICU
Workman is the medical/oncology ICU patient care services manager. A nurse since 1978, she was drawn to oncology nursing by her desire to care for cancer patients. She and her staff are focused on helping their patients through crisis situations. "Nurses need to be compassionate and try to understand what the patients and their families are going through," says Workman. Besides caring for critically ill cancer patients, her ICU staff also cares for patients awaiting organ transplants. Workman says, "Our hospital is one of the largest solid organ transplant centers in the country."
The Neurocare ICU
Judy Slide is the patient care services manager for the neurocare ICU. Slide's patients are critically ill patients that require specialized neurological monitoring and care. A nurse for 22 years, Slide said she's amazed by the changes in technology since entering the nursing field.
One piece of equipment used in neurocare not commonly found in other intensive care units is a device that measures intracranial pressure. Using a fiberoptic probe, Slide's staff can constantly monitor a patient's condition. However, she added, "A neuro ICU nurse has to be able to pick up slight changes in a patient's condition even before they register on a monitor." Physicians rely on a nurse's keen ability to observe minute changes in level of consciousness. Without it, patient care may be jeopardized.
The Common Threads of Intensive Care Nursing
One way that nurses can learn more about intensive care nursing is through a program at UMMC called the Critical Care Nurse Fellowship Program. This program provides the opportunity for nurses from other specialties, as well as new graduates, to learn more about ICU nursing. When talking about the program Hogan says, "every new grad I've brought in the ICU has succeeded. They are wonderful critical care nurses. I'm proud of that." Slide and Workman also agree - if given the chance, nurses will rise to the challenge.
Teamwork is another common thread that runs throughout the units. When discussing the teamwork displayed by ICU nurses, Workman says, "nurses are each others' back up and support. When you see a patient in crisis, everyone's concern is to make sure they get the best chance possible of making it."
Slide and Hogan have had similar experiences on their units. Each told stories about how their nurses work together in times of crisis to help each other out. When you have to work so closely with one another, comaraderie naturally develops. Because "ICU nurses work closely with the physicians, teamwork makes it a rewarding experience," says Workman.
Meeting Challenges was Never This Fun
Like anything else, there is a downside to working in an ICU. Working long hours and dealing with life and death situations everyday can take it's toll even on the best of us. "When people are really sick, you feel like you want to be in two places at once," said Hogan. Financially, nurse managers face the challenge of balancing a unit budget. Hogan says, "without sacrificing the quality of care patients receive, a nurse manager is responsible for keeping the unit financially viable." Addressing staffing issues and the high acuity of their patients can also be a daunting task for ICU nurses. Nevertheless, all three managers enjoy what they do. "My job is to serve my staff. By meeting their needs, they can better meet the needs of the patients," says Hogan.
There is diversity and common ground in ICU nursing. The nurses at University of Maryland Medical Center strive to meet today's healthcare challenges, helping to serve the needs of their community. Next time someone asks you what you do, say it and say it proud, "I'm a nurse and I'm everywhere."

Source : http://include.nurse.com/apps/pbcs.dll/article?AID=20007100310