After my 8 week stint in A&E and a short period back in the School of Nursing, I went to my next placement which was the Intensive Care Unit (ICU). After the hustle and bustle in A&E, which in the end I had quite enjoyed, the relative stillness of the ITU patients was quite daunting. Suddenly the two-way chat had gone, to be replaced by the hushed shunts of ventilators and the quiet blips and peeps of life-saving machinery.
The pace of work in ITU was completely different. It was a small 6 bedded unit, very unsophisticated by today’s standards but still daunting to an inexperienced student. With only a few patients to concentrate on and 'afternoon only' visiting times strictly observed, there were fewer people in the Unit and everything seemed much calmer than in A&E. With a controlled entry system, everyone who entered the Unit had to have a reason for being there. If a patient hit a crisis the team would swarm around them, like bees in a hive, each person seeming to know their individual role. As students we were assigned to a member of staff who usually worked with just one patient throughout their shift; occasionally two if their dependency was slightly lower. Our patients were wholly dependent on the staff and the machines that surrounded them. Everything had to be monitored and recorded from urine output, to oxygen saturation to cardiac rhythm. We still had oxygen in tanks in those days and even the supply display had to be checked regularly to ensure the porters replaced the tank before it emptied completely. No running supply of air or oxygen from a valve in the wall!
The pace of work in ITU was completely different. It was a small 6 bedded unit, very unsophisticated by today’s standards but still daunting to an inexperienced student. With only a few patients to concentrate on and 'afternoon only' visiting times strictly observed, there were fewer people in the Unit and everything seemed much calmer than in A&E. With a controlled entry system, everyone who entered the Unit had to have a reason for being there. If a patient hit a crisis the team would swarm around them, like bees in a hive, each person seeming to know their individual role. As students we were assigned to a member of staff who usually worked with just one patient throughout their shift; occasionally two if their dependency was slightly lower. Our patients were wholly dependent on the staff and the machines that surrounded them. Everything had to be monitored and recorded from urine output, to oxygen saturation to cardiac rhythm. We still had oxygen in tanks in those days and even the supply display had to be checked regularly to ensure the porters replaced the tank before it emptied completely. No running supply of air or oxygen from a valve in the wall!
Nursing ITU patients felt like a very one-way kind of nursing, much more technical and far less patient-nurse interaction than in the wards. Lots of communication through other means though and for many nurses the relationships with patients and family through these very intense periods of illness were very rewarding. For me though, the ITU experience was less than satisfying and I couldn’t wait to go back to the hustle of a ward placement area, not least because I could stop worrying about what was coming through the doors next. It was not until years later, as a Tissue Viability Nurse visiting ITU regularly, that I suddenly understood why some people enjoyed ITU nursing so much. What had seemed so daunting as a student became fascinating as an experienced qualified nurse and as is often the way with nursing, I started learning all over again.
Next week: Compassion - a dying art.
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