Secrets of an ICU nurse

ICU nurse

I recently had the opportunity to be a guest blogger for Stephen at Page the PA – he is a rock star on Instagram sharing his experiences as he goes through PA school. He is doing his ICU rotation soon, so I thought I would tell him a few secrets from this veteran ICU nurse! Please connect with him on IG @PagethePA and tell him I sent you!!

When most students, rotate through the ICU, they literally enter another world in health care. Whether they are new residents on service for the month, PA students, medical students or nursing students, the ICU experience is like no other rotation.  Sure, you may have seen a few sick folks, but ICU patients take that to a whole new level. It’s a smorgasbord of problems – all in one human fighting to survive. It’s the land with more devices, tubes and drains than any human should have to endure.  But, there is nothing like caring for a patient with multiple, often competing problems. The challenges are endless and the environment is often fast paced and demanding. But for a visiting student, it is certainly intimidating.

So, here’s a few tips from this 20-year ICU nurse that will hopefully make your experience a smooth one and ultimately make you want to come back for more!

Nurses shedding light on the ugly side of the flu


The 2017-2018 flu season is breaking all records. The Centers for Disease Control and Prevention (CDC) noted that the “overall hospitalization rate is higher than the overall hospitalization rate reported during the same week of the 2014-2015 season; the most severe season in recent years.” The most recent CDC report showed an additional 17 flu-related pediatric deaths, bringing the total to 53 this season with little relief in sight.

What is measles?

What is measles?

Well, here I go again…. another highly contagious health scare hits the headlines and I find myself doing research on different health advice blogs to find out more. Yup, talking about measles this time.

No, I am not paranoid, but as a nurse, I feel its my obligation to stay abreast of current health care concerns – I find it even more important as a nursing instructor. So, I am sharing what I know with all of you!

Now, what’s the big deal about measles? Well, considering it was virtually eradicated in the US due to vigilant vaccination programs, most are not familiar with this highly contagious disease. In fact, in 2000 the CDC declared measles eradicated from the US. Unlike the flu, pneumonia or heart disease, we are just not familiar and need to re-educate ourselves on a disease we don’t deal with on a daily basis. (On a more personal note, I do not titer for measles, so that just makes my concern level a little higher…and personal!)

What Respiratory Therapists Wish Nurses Would Understand

When I was a new nurse working in the hospital, I quickly learned who one of my best allies was – the respiratory therapist! As I moved into the ICU, they were invaluable as we weaned patients from the vent and rescued them from death. My second ICU job was at a large metropolitan teaching hospital in NYC. I was working nights in the NeuroSurgical ICU and almost fainted when during my orientation, I was informed that there really was no RT support at night. In fact, the nurses did the vent checks, blood gases, retaping ET tubes (this is where I learned NO pink tape!) and even the weaning and extubation! Say what!! I was grateful for the great RT’s that trained me – I would have been so lost without their valuable insight and knowledge that they instilled in me (and I am pretty sure the patients are thankful also… I still remember my first extubation – not pretty!) Lessons learned and I truly discovered the value of the RT on my team during my shift when I moved on to another hospital.

So, you could say, I had a new found respect for the masters of the lungs, wizards of the vents and providers of smoke pipes! But, one thing in my journey as a nurse I have discovered, they find us pretty annoying…. and rightly so! I often come across nurses who lack respect for their discipline and yet want them to rescue their patient they have let go down the tubes. So what do they wish we knew about them? What do respiratory therapists wish nurses would understand? Well, I asked one of them and here is what he said….

Respiratory Therapy

The Best Stethoscope

So as a clinical instructor I am often asked what type of stethoscope should the students invest in? Personally, this comes down to budget constraints, especially as a student. However, keep in mind that picking out your stethoscope is a pretty important decision. No doubt everyone, from the new doctors to those who have worked with a Cardiovascular Group for many years, will take their time making a decision on this matter. This will be one of your go-to tools in assessing your patients. I hate to sound cliche, but a patient’s life may depend on it. So chose wisely and carefully! Here are the one’s I personally have tried and the one that has been my work horse for over 15 years.

The Best Stethoscope

Nursing School Survival Series – Acute Confusion

It starts out as a nice day at clinicals. Your nurse is happy to be working with you – bonus. You were prepared, organized and your morning is going nice and smooth. You go in to check on your previously alert and oriented patient…. and they are no longer very alert and no longer oriented. NOW WHAT? …although you will need to get your nurse and/ or instructor, what should you be thinking about in a patient with new onset of acute confusion? And in reality, one day you will be that nurse, so let’s learn what to do now!

Acute Confusion

What is MERS?

What is MERS?

What is M.E.R.S?

When the first case of Middle East Respiratory Syndrome (MERS) showed up in the United States recently, it got my attention. Don’t get me wrong, I am not usually reactionary or an alarmist, but I know these little viruses can be pretty dangerous. I also know we don’t have a lot in our medical arsenal to fight against the thing. So, when a virus makes the national news for being the first case, I pay attention. I was mildly comforted when I realized in was in Indiana, a few thousand miles away from my home. That comfort was shaken shortly after when another case showed up on Orlando, just a few hours from home. OK, now it has my attention.

Again, I usually watch these things get blown out of proportion on the news, and really don’t give it much thought. Maybe it was the unusually early and virulent flu season we just had or the recent EBOLA outbreak (that no one seems to be talking about). But, what I think really got my attention today, all healthcare workers who were exposed to the patient were placed in “home isolation”, however, two were being watched closely due to possible new onset of symptoms. Yup, you got my attention.

The latest outbreak that has plunged the world into a pandemic, COVID-19, has led to many thousands of cases of the disease around the globe and, unfortunately, deaths too. Washing your hands with soap and killing the bacteria that are living on your body has never been so vital to an individual’s health. There are other things you should be doing, including coughing into your elbow (not your hands) and social distancing. You should also not be seeing anyone from outside of your household, including people you are dating. For anyone unclear, here are the Dos and Don’t in COVID19 time for those in relationships. It has also sent businesses and industries into disarray thanks to social and movement restrictions imposed by governments of the world. Many businesses have closed and others have had to make drastic cuts. Any businesses that have been able to remain open have had to follow government guidance which has limited their freedom and will have certainly dented their profits. If you are a business owner whos business is currently still open or is looking to reopen soon, you might want to visit Versare to see the range of sneeze guards and the other health protection items available. Whilst keeping a business afloat is important, the health and safety of staff and the general public must come first. All the restrictions and guidance in place has led many companies to seek coronavirus small business assistance to help them through this difficult time, which will inevitably have a negative impact on many of their finances.