Critical Care Nurses make sure all critically ill patients get optimal care for their illnesses

and injuries. To do that, they use their specialized skills as well as their in-depth knowledge of the human body and the latest technology in the field. Most Critical Care Nurses work in hospitals, but they can work out of nursing homes, outpatient facilities and flight units, too. As a Critical Care Nurse, you can specialize in treating adults, children, or babies.

As long as you have good critical thinking skills then you can handle critical care. From my own experience when I transitioned from med/surg to ICU the biggest change was going from an environment where my main goal was time management to make sure I completed all of my tasks to an environment where critical thinking is paramount. Time management and prioritization is still important but you have to critically think about what is happening with your patients so you can anticipate needed interventions and fix acute problems. Med/surg is more of an observation environment simply due to nurse to patient ratio.

The technology is a little more advanced. You have bedside monitors, a-lines, swan-ganz catheters, balloon pumps, crrt machines, ventilators, etc... But you should receive training on these things during your orientation.

The drugs are a little different as well. You will be titrating vasoactive medications, sedation, etc... based on your patients' response. This isn't a cut and dry subject, you get good at it by doing it a lot and developing a feel for it.

Another big change between floor nursing and ICU nursing is autonomy. As a critical care nurse you'll be expected to have the knowledge to make certain decisions you might not make on the floor and carry out interventions you may feel like you need an order for. This comes with getting to know your intensevist and what they expect you to do in certain situations. You also need to be comfortable with being a team member in a code and may have to run a code. For instance, my hospital is a smaller one and we only have one in house MD available for codes, if there are two codes at the same time an ICU nurse may have to run one of them.

Don't let all this scare you off. Most ICU's have an orientation period during which you will learn what you need to know. Larger hospitals even have internships you can do to gain experience in a few different critical care areas before deciding which one you want to practice in. Preparing for you CCRN is a good way to gain the knowledge you'll need for critical care and a good book for that is "PASS CCRN." A good book regarding hemodynamics that is easy to understand for a new learner is "Hemodynamics Made Incredibly Visual." Realize that if you go into critical care and you don't feel comfortable with a situation you have a charge nurse and colleagues that you can collaborate with. It's a learning process but you shouldn't be afraid of going for it.

That is pretty much what we do too...

I am currently working in a SICU and somedays it is very overwhelming. Every 4 hours we have to do a full head to toe assessment. Every 4 hours we have to print off EKG strips and analyze them. Every 2 hours we have to assess our patients for pain. Every 2 hours you have to do treatments such as suctioning, repositioning, etc. We have to do strict I/O, and we have to calculate those either every 4 or every 8 hours. Depending on our patient we have to do neuro checks anywhere from every 1-4 hours. We have to do vitals every 1-2 hours. Every time you move a patient, you have to rezero all their equipment such as ventriculostomies, Alines, or whatever else they have.

On our floor we get a lot of different things such as ventriculostomies, A-lines, SWAN lines, Internal temp. monitors, ICP monitors, central lines, etc. We also deal with a lot of meds that are not usually found on other floors such as Neo, Pentobarbitol, Levophed, Dopamine, Insulin, TPN, etc.

Just like the person above me said, the patients you deal with in the ICU are a lot sicker and even simple things like turning them could cause serious issues. I had a patient bottom out one time because they couldn't tolerate being turned. I personally really like working in the SICU, because I really enjoy the challenge of it.