Nursing is a profession that requires competence on many levels: mental, physical, emotional, and interpersonal. Thus it seems a good nurse must be a well-rounded, exceptional person.
If this seems like a tall order to fill, it gets even taller for the ICU nurse, who must excel in each competency because of the nature of critical care work. Critical care patients suffer from life-threatening conditions, so their nurses must be knowledgeable, strong, quick, considerate, and wise, at the least.
But nurses aren’t just born that way. They gain these excellent qualities through education, training, hard work, and experience. If your goal is to become an ICU nurse, it’s not as unattainable as it might sound.
Let us guide you into a deeper understanding of the ICU nursing profession — what it takes and how to get there — so that you can begin the journey toward a career that will save lives and help you maximize your potential.
Table of Contents
- What Does an ICU Nurse DO?
- 10 Responsibilities of an ICU Nurse
- Important Qualities of an ICU Nurse
- How To Become an ICU Nurse
- Let Trusted Nurse Staffing Help You Land a Travel ICU Nurse Contract
What Does an ICU Nurse Do?
All ICU nurses are responsible for the following:
- Assessing and treating patients
- Ordering diagnostic tests
- Monitoring medical equipment
- Being the patient’s advocate
- Recording developments in the patient’s status
- Informing family members of the patient’s status
An ICU nurse’s place of work depends on the specific certification earned. You can be certified to work with cardiac patients, trauma patients, and surgical patients, or in the NICU or PICU.
History of Critical Care Nursing
The development of critical care nursing and the first ICUs happened gradually, beginning in the 1850s when Florence Nightingale demanded that sicker patients be placed in beds closer to the nurse’s station for closer observation.
In 1923 Dr. Walter Dandy opened a three-bed unit at Johns Hopkins Hospital for the sickest post-operative neurosurgical patients, cared for by a team of specially trained nurses.
In 1930 Dr. Martin Kirschner designed and built an ICU for post-operative patients at the University of Tubingen in Germany.
Following the examples set by Walter and Dandy, most hospitals had built recovery units near their operating rooms by 1960. Throughout the next several decades more ICUs were added to serve critically ill patients for other reasons. The first multidisciplinary ICU was in the Baltimore City Hospital in 1958.
Initially, patients in the ICU were attended by different physicians, until it became clear that a specialized team of doctors and nurses could provide more effective patient care.
Advances in technology have allowed less invasive monitoring and assessment of ICU patients, and the relatively new focus on evidence-based practice has led to a reconsideration of protocols for intervention.
Critical care nursing has always involved working closely with doctors and other healthcare providers to provide advanced care for critically ill patients. It also involves learning about the patients’ needs and wishes so that they fully understand the care offered/provided to them.
10 Responsibilities of an ICU Nurse
So what does an ICU nurse do? Specific responsibilities will depend on the type of critical care nursing:
- Pediatric – A pediatric ICU nurse cares for critically ill or injured children.
- Surgical/trauma – This involves care for unstable patients in need of surgery as well as post-operative patients.
- Neuroscience – This involves care for patients who’ve had a stroke, brain injury, seizures, or sudden change in baseline neurological status.
- Neonatal – A neonatal ICU nurse cares for newborns with a life-threatening disease or condition.
- Cardiothoracic or cardiac care – A nurse in this specialty will care for no more than two patients with severe heart conditions at a time.
- Medical – This involves care for patients with a disease process unrelated to surgery.
Each type has its specific set of challenges, but all ICU nurses share certain responsibilities.
#1: Assess and Treat Patients
The nurse commonly sees the patient before the doctor does, so it is the nurse’s responsibility to assess the patient and initiate care. Assessment includes:
- Monitoring vitals
- Identifying changes in the patient’s condition
- Evaluating patient progress
- Observing diet, fluid intake, and physical activity levels
- Providing updates to doctors and families
Treatment might include:
- Administering medications
- Assisting in intubation
- Changing wound dressings
#2: Order and Perform Diagnostic Tests
An ICU nurse will likely need to send orders for diagnostic tests to determine the location and extent of an injury or illness. The nurse must decide which of the following tests are clinically necessary:
- X-rays
- CT scans
- Fluoroscopy
- Colonoscopy
- ECG
- ABG
As you would expect, the ability to make these decisions requires strong, ongoing education.
#3: Manage Wounds
The ICU nurse is responsible for management of wounds, such as:
- Pressure ulcers caused by immobility
- Unhealing or infected surgical or traumatic wounds
- Diabetic food ulcers
- Ischemic ulcers, etc.
Besides caring for the wound itself, the nurse must maintain clean bedding and keep a germ-free environment conducive to healing.
#4: Act as a Patient Advocate
Patients, especially those in critical condition, need help making informed decisions about their health. They need nurses who can translate medical jargon to them and their families in a way that makes sense. A nurse must be empathetic and have excellent interpersonal skills to do this effectively.
Besides explaining the medical side to patients and their families, the nurse should be the patient’s advocate to the doctors and other caregivers. This requires getting to know the patient’s wishes and beliefs about the care he/she is receiving or might receive.
#5: Monitor Medical Equipment
An ICU nurse must ensure that medical equipment is working properly and is in good condition. If a malfunction is identified, the nurse must arrange for repair or replacements. Proper maintenance of the medical equipment requires cleaning and storing it correctly.
Medical equipment found in the ICU includes:
- Ventilators
- Monitors
- Defibrillators
- Arterial lines
- Central venous catheters
- Endotracheal tubes
- Feeding tubes
- Pulse oximeters
- Cervical braces
- Shunts
- Test tubes
Although most equipment in the ICU is standardized, older devices may need to be used at times. This means paying close attention to the variations between devices to avoid errors in operation.
All equipment must be checked daily to ensure patient safety.
#6: Provide Pre-Operative Care
ICU nurses prepare patients for surgery, mentally and physically. It is important to keep calm so that the patient – already ill at ease – will not feel more insecure or uncomfortable. Before surgery, the nurse should:
- Note any concerns the patient might have.
- Note any complications or elements of the health history that would affect surgery
- Verify the type and site of surgery.
- Administer necessary medications or ascertain that any contraindicated medication has not been taken.
- Have the patient or the patient’s guardian sign their consent for operation.
#7: Assist With Procedures
The nurse will help prepare any equipment needed for procedures and might even assist doctors with things like:
- Bronchoscopy
- Endoscopy
- Intubations
- Elective cardioversion
- Bone marrow transplant
- Drain insertion
- Ventilations
During surgery, an ICU nurse might act as:
- The scrub nurse, passing instruments and supplies for the operation
- The circulating nurse, helping other team members monitor the patient’s status, help reposition the patient, or provide additional supplies and sterile instruments as needed.
#8: Provide Post-Operative Care
In the recovery room, an ICU nurse oversees the patient’s mental state and monitors the effects of surgery. The nurse peforms the following tasks:
- Watch for complications
- Encourage and assist patient with mobilization
- Assess and manage the patient’s pain level
- Non-pharmocologic methods of pain management include:
- Massage therapy
- Cold therapy
- Music and sound
- Relaxation therapy
- Pharmacological methods should be implemented only in a gradated fashion based on pain scores.
- Non-pharmocologic methods of pain management include:
#9: Document and Report
Documentation is on a level with treatment in terms of importance. An ICU nurse must record precise, detailed reports that include:
- Symptoms
- Changes in patient condition
- Medical history
- Findings or test results
The nurse will report all these in consultation with the healthcare team and work with the team to plan interventions to achieve desired outcomes. These interventions must be recorded, along with their effect on the patient’s condition.
#10: Coordinate Discharge Plans
An ICU nurse helps to plan discharge and coordinate referrals to ensure that the patient receives continuity of care. All must be carefully documented.
The nurse makes sure that the patient understands discharge instructions.
Important Qualities of an ICU Nurse
As mentioned above, an ICU nurse is a person of high caliber. Developing the following qualities is imperative for someone to perform the functions of an ICU nurse:
- Attention to detail – Observational skills help a nurse detect changes in the condition of patients who are unable to speak and differentiate between what is normal and what is abnormal.
- High critical thinking – The ability to analyze and solve problems to quickly and efficiently decide how to resolve challenges in a stressful environment
- Great social skills – The ability to listen effectively in order to respond with relevant information and deliver it appropriately
- High emotional intelligence – The ability to manage the stress of operating continuously in emergency situations and to patiently communicate with the patients’ family members who are frightened and confused
- Resilience – The ability to handle post-traumatic stress and the temptation to burnout
- Resourcefulness – Intuitive problem-solving for handling challenging situations
- Compassion – Nurses must always treat patients with respect and consideration. They have the opportunity to be for patients a positive, life-giving, tangible connection to reality in times of immense distress and uncertainty.
- Organizational skills
- Humanity
- Focus for complex tasks
- The ability to deliver high quality patient care
If you possess these qualities and are interested in travel nursing as an ICU nurse, Trusted Nurse Staffing is the right fit for you.
How To Become an ICU Nurse
These are the steps toecoming an ICU nurse:
- 1. Become an RN by earning a BSN or an ADN followed by an RN-to-BSN program.
- 2. Pass the NCLEX-RN exam to earn your nursing licensure.
- 3. Obtain the CCRN certification to be a critical care nurse. To be eligible to take the exam:
- a. Work 1,750 hours as an RN or APRN caring directly for critically ill patients during the past two years. 875 of these hours must be in the year prior to examination.
- b. Work five years as an RN or APRN, at least 2,000 hours caring directly for critically ill patients, 144 of these hours in the year prior to examination.
- 4. Extend your education by getting an MSN or earn further certifications, such as:
- a. CMC – Cardiac Medicine Certification
- b. CSC – Cardiac Surgery Certification
- c. ACNPC-AG – Acute Care Nurse Practitioner Certification – Adult Gerontology
Let Trusted Nurse Staffing Help You Land a Travel ICU Nurse Contract
Once you have accomplished the first three steps outlined above, you can potentially work anywhere you want as an ICU nurse. To work as a traveling ICU nurse, you need at least one year of experience in an acute care facility.
If this applies to you and you are a licensed RN or LPN, complete an application through Trusted Nurse Staffing to get started finding a placement in the place of your choice.
Trusted Nurse Staffing understands how important it is to balance work and life, and that where you work is one of the main factors in how you achieve that balance.
Trusted Nurse Staffing will help you find the ideal place to continue your professional career. Create a free profile through Pronto to find travel nursing jobs that match your preferences.