EP 159: Pros & Cons of Being an ICU Nurse

EP 159: Pros & Cons of Being an ICU Nurse

EP 159: Pros & Cons of Being an ICU Nurse

Being an ICU nurse is not for the weak. Nurses are witnesses to a patient’s most vulnerable time of their life. And for us nurses, it is a blessing to be a part of that. Working as an ICU nurse taught us many things workwise and experiencing the negative and positive impacts of being one. 

In this episode, we will talk about the pros and cons of being an ICU nurse, share our experiences and inspire those interested in becoming one in the future.

Pros & Cons of Being an ICU nurse

Is it worth being an Intensive care unit (ICU) nurse? As an ICU nurse, you will be working with patients experiencing life-threatening health problems, and now, the pandemic. The complexity of care in the ICU requires critical thinking as the central core of all responsibilities.

What inspired us to become ICU nurses?

How we became ICU nurses started at the hospital when we were still new nurses ourselves. In Matt’s case, becoming an ICU nurse was easy – he was inspired by an ICU nurse who showed him what’s it like to handle a situation, which left him with a good impression. Moments like this are rare because when you are a new grad nurse, you often get assigned to one area where you get to work for a year or so and not be able to explore other areas in nursing. 

Being an ICU nurse is interesting because we get involved in the littlest thing with our patients. Every orifice, drop, whatever comes in or out – we know it all. It’s like doing science and history at work. We all get to see where our patient came from, their present condition, and working ways to help them be better in the future. 

Nurses as Role Models

Imagine if Matt’s interaction with that ICU nurse was a negative one? Perhaps he wouldn’t even try exploring the ICU or being an ICU nurse. As nurses, we have to be a good example to people because our actions can either impress or distress others who have the potential to be good nurses someday. That said, here are the pros and cons of being an intensive care unit nurse: 

Pros of Being an ICU Nurse

  • Collaboration with other healthcare professionals to help the patient as a team – you get to see the whole picture of the situation.
  • Easy access to the medical team. Intensivists vs hospitalists.
  • Larger autonomy and scope of practice – nurses can practice using their critical thinking skills to help the patients.
  • Great career progression to reach CCRN or even management. 
  • 2:1 and 1:1 patient ratios.
  • Learning curve – learning to prioritize/critical thinking.

Cons of Being an ICU Nurse

  • We get the worst of the worst like ETOH withdrawals – you want to help but sometimes the situation can be stressful because of unruly patients. 
  • Crashing patients a lot of drip management – is the opposite of the “worst of the worst”. Your patient keeps crashing no matter how much you try to help them. 
  • High stress – we don’t respond stressed out all the time but the tasks/care we give is a constant level of stress. It can be exhausting by the end of the day. 
  • Difficult dealing with family, decision making & family drama. – an emotional strain that can put you in a tough spot. You are the response team.
  • Physical labor – this is not just ICU, we are in charge of full care usually because patients in our unit don’t participate in our care. There’s a possibility of workplace injury. 
  • Nasty wounds and messy patients – you get to clean up the body fluids that come out of your patients like sputum, drool, urine, feces, etc. If you are easily squeamish, this is not the place for you. 
  • Loss of patient care – higher mortality in the ICU. dealing with the hardships. How to cope. 
  • No extra pay – some healthcare facilities don’t pay ICU nurses much given all the responsibilities that they have.

How did C19 affect the ICU as far as workload?

Usually, an intensive care unit is limited only to two patients, but hospitals have been flooded with critical patients since the pandemic broke out. More patients are sent to the ICU nowadays, and nurses’ role has tripled over time. From monitoring patients to dealing with the loss, and helping families, it’s a tough job, to be honest. 

The idea that nurses are navigating new territories adds to the emotional stress of your work, more critically ill patients, dying patients, and dealing with the emotions of the families who just lost a loved one. It is a stressful time to be an ICU nurse. But then again, it is something worth taking because of how rewarding our job is. 

How to know if ICU Nursing is right for you?

Being an ICU nurse is not for everyone. It’s a tough job, to be honest. But as you grow with the job, your perspective in life changes too. There’s no specific personality or knowledge to being an ICU nurse. You don’t need to be perfect for the job because you will never know if it is the right job for you unless you give it a try. 

As you go, you learn with experience. We all learned from experience in nursing school and now in real life. Nursing school was hard, but you made it. The same goes with ICU nursing, it may be hard from the beginning, but that doesn’t mean it won’t help you grow in your career. 

Of course, you have an option to give it a try and see where it goes. As a nurse, there are so many fields of nursing that you can explore. Maybe ICU nursing is your thing, maybe not. And that’s fine too. The important thing is that you know where your heart is in this profession, so you can excel at the work you have chosen. 

In Closing

There are so many ways being a nurse can take you. It would be best if you didn’t waste your time doing something you are not happy with. Our time as ICU nurses have been a real blessing. It taught us wisdom and humbled us in many ways. We wouldn’t want to change that.

Of course, we enjoy being travel nurses, but the lessons we have learned as ICU nurses will always have a special place in our lives. Hopefully, you can also find that as you embrace being an ICU nurse in the future. 

To watch the full Episode 159, click here for more and other Cup of Nurses episodes:

TIMESTAMP

00:00:00 Intro
00:55 Plugs
02:36 Episode Introduction
07:06 Pro: Health Care Team Collaboration
10:38 Pro: Access to other medical teams
12:40 Pro: Larger autonomy and scope of practice
15:03 Pro: Great career progression
15:52 Pro: Patient ratio
18:36 Pro: More on the critical task
19:59 Con: ETOH or unruly patients
21:20 Con: Crashing patients
23:51 Con: High stress
27:12 Con: Physical Labor
30:59 Con: Dealing with nasty wounds, blood, sputum, etc.
32:16 Con: Compensation
34:16 ICU is for you if…
36:08 Wrapping up the episode

EP 141: 4 Problems in Nursing

EP 141: 4 Problems in Nursing

Top 4 Problems in Nursing We Are Currently Facing

Nursing is the nation’s largest healthcare profession, with over 4 million registered nurses nationwide. Yet it feels like nurses have no voice, no say in what goes on in healthcare.

The struggles nurses face seem to be a nationwide occurrence. Nurses are plagued with the same revolving problems in nursing nationwide. Management in nursing seems to be driven by politics, the idea of healthcare is centered around patient care it looks more as if hospitals are centered around money.

Slowly nursing and healthcare are becoming more of a business. Patient ratios, nurse retention and recruitment, burnout, and patient satisfaction are the current nationwide issues that nurse managers are facing.

Patient Ratios

Currently, California is leading with the best and most complete nursing union. The whole state is union-based, meaning that every hospital in the state is required to have a nursing union. Some people are anti-union and it is understandable why but as nurses who have worked in both union and non-union hospitals we see some major differences. 

The main difference is patient ratios. California has the best nurse-to-patient ratios because its nursing union sets strict guidelines on how many patients a nurse has. It also states that based on a certain level of acuity a patient might need closer monitoring. These guidelines are clear-cut and strictly adhered to. 

When there are good patient ratios this increases nurse satisfaction. It is hard to understand that nurse managers don’t seem to address this issue. If you were to ask nurses what would make their job less stressful and empowering they would all say better staffing ratios.

This shouldn’t come as a surprise. With appropriate nurse ratios, care would be more personal to the patient and patient-centered, let’s face the facts, nurses are overworked and the amount of tasks they have to do decreases the nurse-patient experience.

It means nurses have less time to get to know the patient, the concept of holistic care fades because we only have time to treat the body, leaving out the mind and the soul. This has become one of the most common problems in nursing – the lack of self-care when nurses need it most.

Nurse Retention and Recruitment

Retention and recruitment are something managers struggle with all the time. It has also become one of the problems in nursing. Especially during a pandemic with an increase in demand for nurses finding them and keeping them is tough. If your hospital was already short prior to the pandemic it is most likely in an even worse state.

Trying to keep a nurse is always a struggle because there is endless opportunity for the nurse. They don/t have to be tied down long-term to one area because almost every staff position has openings, meaning nurses can almost come and go as they please. 

The struggle with nurse retention is related to job satisfaction. Nurses don’t just leave because they feel like it. There is a reason for them wanting to work somewhere else.

Job satisfaction seems to be the biggest motivator for a change in employment. This means that many nurses are unhappy, it can be due to many things such as unit politics, working conditions, stress, workload, and pay. 

There shouldn’t be a surprise why nurses are leaving a unit to pursue travel jobs. They pay more, allow you to travel, and explore different units. If you can’t pay your nurses fairly don’t expect them to pass up opportunities. 

Recruitment is also tough on managers. Finding nurses to hire onto your unit is a mission in itself. New grad nurses are easier to hire but usually more expensive and use up more resources upfront because they are fresh out of school and need a lot of training. It makes new nurses an investment.

Nurses that are coming from other positions need to be sold on the new job because they don’t want to leave their current job and get stuck with a worse one.

The best way to maintain nurse retention and increase recruitment is higher pay and a better working environment. It may seem impossible to provide those but as we’ve seen during the pandemic, there is money for nurses in healthcare.

Burnout

One of the most common problems in nursing that plague nurse managers are the burnout of their nurses. Being burnt out leads to less productivity and a weaker work environment. There are 2 culprits to nurse burnout, one is related to the work environment and the second is related to overtime,

Stressful Work Environment

Nurse get burnt out because of poor work environments, this means an environment where the nurse is overworked mentally or physically. Unit politics plays a big part in this because no one wants to work at a job where there is constant negativity.

Nurses talking about other nurses, day shift vs night shift mentality, and a lack of teamwork a deafly to a unit. It is important to foster cohesin on the unit to promote a better work experience.

A lot of this also has to do with ratios and proper staffing. It is hard to be happy in a career where the expectation is to always do more because there is a lack of support. 

Too Much Overtime

Some nurses work a ton of overtime. For whatever reason, a lot of nurses pick up too much overtime. This leads straight into burnout because many times the reason why nurses pick up is to help their coworkers due to staffing issues. It’s great to help out your peers but there comes a point where you start to forget to help yourself.

You lose touch with yourself and your emotions, you get stuck in a fog and slowly start to fade from your true self. You start feeling tired every day and in s slump that you cannot get out of, that’s how burnout feels.

Nurses also pick up overtime for financial benefit because they can earn a greater amount of money. This can be due to college debt that many nurses suffer through. It’s always good to make more money but money isn’t always the root of happiness.

Many nurses that pick up overtime to make more money don’t even get to enjoy that money because they don’t even put aside the time to spend it on themselves and take care of themselves. It’s just more numbers in the bank. 

Patient Satisfaction

We hear about patient satisfaction scores during our huddles and monthly meetings, are we hitting the quota for the month? The medical industry puts continuous emphasis and patient satisfaction and positive care experience. 

Nurses have proven essential for driving patient satisfaction. It’s ironic because if you’d like to increase patient experience, we would need more time to deliver holistic care which does not happen in our current system of healthcare?

Making time for patients, listening, and having empathy take time and our time is only so finite in work. Nurses are currently busy charting on the cash registers instead of giving that empathy to patients. 

Topics Covered in HCAHPS Survey:

  • Nurse Communication
  • Doctor Communication 
  • Responsiveness of Hospital Staff 
  • Pain Management
  • Communication About Medicines 
  • Discharge Information 
  • Cleanliness of Hospital Environment
  • The quietness of Hospital Environment

SHOW NOTES:

0:00 Introduction
0:49 Sponsor Ads
2:34 Episode Introduction
2:58 Issues in Nursing We are Facing
6:48 Patient Ratios
11:17 Nurse Retention and Recruitment
20:00 Burnout
20:24 Stressful Work Environment
23:16 Too Much Overtime
27:24 Patient Satisfaction
28:02 Topics covered in HCAHPS Survey

 

 

Benefits of Patient Ratios for Nurses

Benefits of Patient Ratios for Nurses

Benefits of Patient Ratios for Nurses

Nurses are the backbone of our healthcare system, and they should enjoy the benefits of patient ratios. It is essential to ensure that nurses have enough time to perform their critical duties without being overworked by too many patients at a time. According to studies, nurses with a patient ratio of 1:4 or less can perform their duties well. They can also spend time with patients, which results in better care and outcome for them.

To make sure hospitals meet these standards, California has passed legislation requiring them to maintain staffing ratios with newly established benchmarks from the Joint Commission (TJC). It will help protect public health by ensuring sufficient nurse staffing levels for all settings, including hospitals, nursing homes, home health agencies, and other health care facilities. But does this affect the work of a nurse? 

What is the Nurse-to-Patient Ratio

Working as a nurse is one of the best jobs in the world. It can open a ton of possibilities for many nurses, and at the same time, help people. It’s also one of the reasons why many students sign up for nursing school. However, when you are working in an actual hospital setting, things can get tricky. One of the many issues nurses face these days is the increasing number of patients handled for each shift. 

We defined the nurse-to-patient ratio as the number described to the number of patients assigned to individual nurses on a particular floor, unit, or ward. Nurses working in general care units have a higher patient ratio. For example, a nurse can care for five to eight patients on her shift in regular wards while nurses in the ICU can care for one or two patients at a time. Depending on how critical a patient’s condition is, ICU nurses can also work 1:1. 

Why are Nurse-to-Patient Ratios Important?

Providing safe and quality care to patients is the goal of nurses. It is why assigning the correct number of patients for each nurse is crucial in achieving this goal. [1]

It’s Important to Nurses

The current problem of nursing shortages is seen in many hospitals these days. As a result of the pandemic, nurses work longer hours and with more patients. This situation can cause extreme exhaustion, injury, and even job dissatisfaction to many nurses. It can also lead to medical errors or mistakes on the nurse’s part as they start to feel overwhelmed with the workload as they deal with stress while supporting their families.

Nurses who have fewer patients under their belt are happier with their jobs. A study published by labor union AFL-CIO showed that nurses in California feel they have a reasonable workload and can provide better care to patients than their New Jersey or Pennsylvania counterparts. Nurses also reported receiving adequate support services, such as nursing assistants, having time for quick breaks on their shifts, leading them to be more productive in their areas. 

It’s Important for Patients

Patients are the main characters in a nurse’s job and center of care for nurses. But if the nurse has too many patients under her, they can’t execute proper care to their patients. A new study published in the New England Journal of Medicine found that unsafe staffing levels were associated with increased mortality for patients. 

Besides the risks to the patients, patient satisfaction is also a concern. When the ratio between nurses and patients is not balanced, patients may view the nursing staff and the facilities as performing poorly.

It’s Important for Hospitals

When nurses have the correct ratio of patients under their care, they use the full benefits of patient ratios. Meaning, it shortens patients’ time at hospitals. More nurses mean shorter time for patients, which can also help the hospitals to save medical costs. 

The better the quality of nursing care in a hospital facility, the more likely patients will have positive perceptions about their overall experience. According to research by Kaplan-Meier, “the higher perception was associated with greater satisfaction on all assessed measures including functional status at discharge; control over activities of daily living; participation in decision making regarding treatment plans or life support decisions.” 

Pros and Cons and Benefits of Patient Ratios

Nurses working with patients always have their upsides and downsides. Some nurses have no problem working with many patients, while some can’t. That said, having the proper nurse-to-patient ratio comes in handy, and here’s why. [2]

PROS:

  • It decreases fatigue and burnout among nurses. Working as a nurse can be a tiresome profession. A proper nurse-to-patient ratio reduces the chances of developing irritability, depression, insomnia, weight gain, and other health risks from exhausted nurses and stressful workplaces. 
  • Recruitment and retention rates improve with minimum nurse-to-patient ratios. It means nurses will most likely stay in their company, and hiring new nurses is not a problem for hospitals. 
  • The number of preventable mistakes, including patient falls and pressure ulcers, are proven to decrease if the nurse-to-patient ratios are correct. Patient mortality also decreases as a result of nurses that can do their job accordingly. It means more patient recoveries, fewer sick patients, and fewer patients suffer from post-treatment infections. 

CONS:

  • Under the proposed plan, hospitals would have to expand their nursing staff and pay them more. It will be a challenge for some hospitals with limited funding or strict budgets that restrict hiring new employees who don’t already work there.
  • Nurses will not be able to give proper care for patients all at once. Patients will have to wait longer even if there are available beds for admission. 
  • Can cause nurses to burn out, develop anxieties, depression, sleep deprivation, and may even quit jobs. 

Should Nurses Have Patient Ratios?

The question now is, should nurses have more patients than they can handle? The debate about whether or not to turn nursing-to-patient ratios into law will never go away. Since healthcare practices are constantly changing, finding ways to provide better care for nurses and patients will always be relevant. This way, both can use the benefits of patient ratios. Giving nurses the minimum ratio of patients under their care can make a difference in their work performance and general well-being. 

 

 

 

Benefits of Reduced Nurse Ratio to Patients and Nurses

Benefits of Reduced Nurse Ratio to Patients and Nurses

The benefits of a reduced nurse ratio play a vital role in a nurse’s career and constantly changing positions. With a significant increase in nurse-to-patient ratios across the United States in the past ten years, nurses’ quality of time with their patients improves patient satisfaction and comfort.

So why is it important to practice the correct nurse ratio? 

Benefits of Reduced Nurse Ratio to Patients

The patients will always be the nurses’ priority. They are also the reason why practicing the proper nurse ratio must be done [1]. How can patients benefit from this? 

  1. Quality care is given to patients when nurses have the correct number of patients under their supervision. All patients under their care receive the attention needed. No one is left out or forgotten. 
  2. The chances of writing the wrong information in the patient’s chart are small. When a nurse is too busy taking care of other patients, it is possible to write the incorrect information given to all of their patients. No matter how experienced a nurse is, errors happen if they take care of too many patients. The proper nurse ratio can help avoid these situations. 
  3. Readmission is less when nurses take care of the patients correctly. According to studies, nurses in a good work environment versus nurses in a poor working environment (ex., too many patients under their care) have fewer readmitted patients than many patients under them. 
  4. Meeting patient satisfaction is easy when nurses have a reduced number of patients under their supervision. Patients are happier with the quality of care they deliver. 

Benefits of Reduced Nurse Ratio to Nurses and Hospitals

Studies show that nurses can benefit significantly if healthcare facilities follow the proper nurse ratio. Not only will it affect their patients, but the quality of health care they deliver as well [2]. 

  1. The benefits of reduced nurse ratio help in decreasing the chances of nursing burnout. It also relieves insomnia, fatigue, depression, irritability, weight gain, and other health risks from being overworked and stressed. Studies of nurses in California say that they experience more burnout and dissatisfaction with their jobs than nurses working with minimum nurse ratios in other states. That said, regulated nurse-to-patient ratios allow nurses to perform better while also maintaining their health. 
  2. Work retention and recruitment of nurses improve when there are minimum nurse ratios. Nurses will stay with their job when stress is less at work. Recruiting new nurses is more accessible when the hospital’s minimum nurse ratios reflect quality care towards their patients. 
  3. Patient mortality and preventable mistakes like patient falls, ulcerations and hospital-related infections decrease to a minimum when there are higher nurse-to-patient ratios. Some fewer patients get sick while in recovery, and post-operation treatment complications are lesser. Medical errors, as well as patient and family complaints, are also avoided in this situation. 
  4. The performance of nurses reflects their work environment. Nurses work better with their co-nurses and doctors. They also participate actively in improving patient care and making decisions in their workplace. In short, nurses become better members of the entire healthcare facility in quality patient care programs. 

Why Should Reduced Nursing Ratio Be Applied to all HealthCare Facilities?

Nurses are amazing people! They work hard to help the sick and dying, especially now that we are experiencing the pandemic. And with the increasing number of ill patients, many nurses are caught between taking care of their patients and maintaining their health. 

The influx of patients with the new Covid variant had nurses working for long hours with few rest periods. Because of this, nurses give less quality care to patients. They are also exhausted from the different roles they carry out. Among these roles include acquiring knowledge from non-nursing disciples to treat patients. 

If hospitals want their nurses to stay in their jobs and hire new ones, they must find a way to implement minimum nurse-to-patient ratios. Nurses are not robots; they feel exhausted too, and we cannot replace them with robots either!

As exhausting as their jobs can be, nurses will continue to give their best. Providing them with better options and opportunities will surely change their perspective. Hopefully, healthcare facilities will consider the benefits of a reduced nurse ratio. It will be helpful to their nurses and the patients, and the entire hospital as well.