Posted: March 27th, 2023

Roles of ICU Nurses in Medical Surgery

Roles of ICU Nurses in Medical Surgery

Intensive care unit (ICU) nurses are essential members of the health care team who provide specialized care to critically ill patients. They work in various settings, such as hospitals, trauma centers, and surgical units, where they monitor vital signs, administer medications, perform interventions, and communicate with other professionals. ICU nurses also play a key role in supporting the patients’ families and educating them about the condition and treatment of their loved ones.

In this blog post, we will explore the roles and responsibilities of ICU nurses in medical surgery, the challenges they face, and the skills and qualifications they need to succeed in this demanding field.

Roles and Responsibilities of ICU Nurses in Medical Surgery

ICU nurses in medical surgery are responsible for caring for patients who have undergone major surgical procedures that require intensive monitoring and treatment. Some of the common types of surgeries that ICU nurses deal with are:

– Cardiovascular surgery: This involves operations on the heart and blood vessels, such as coronary artery bypass grafting (CABG), valve replacement, or repair, and heart transplant.
– Neurosurgery: This involves operations on the brain and spinal cord, such as craniotomy, aneurysm clipping, or tumor removal.
– Thoracic surgery: This involves operations on the chest cavity and lungs, such as lobectomy, pneumonectomy, or lung transplant.
– Abdominal surgery: This involves operations on the abdominal organs and structures, such as liver resection, pancreaticoduodenectomy (Whipple procedure), or bowel resection.

ICU nurses in medical surgery have to perform various tasks to ensure the safety and recovery of their patients. Some of these tasks are:

– Assessing the patient’s condition and identifying potential complications or changes in status.
– Implementing the care plan and following the orders of the surgeon and other specialists.
– Administering medications, fluids, blood products, and nutrition through intravenous (IV) lines or feeding tubes.
– Managing the patient’s pain and sedation levels using analgesics, opioids, or sedatives.
– Monitoring the patient’s vital signs, such as blood pressure, heart rate, oxygen saturation, and temperature.
– Operating and maintaining advanced equipment, such as ventilators, cardiac monitors, intra-aortic balloon pumps (IABPs), or extracorporeal membrane oxygenation (ECMO) machines.
– Performing invasive procedures, such as inserting central venous catheters (CVCs), arterial lines, chest tubes, or drainage tubes.
– Providing wound care and dressing changes for surgical incisions or infections.
– Collaborating with other health care professionals, such as surgeons, anesthesiologists, pharmacists, respiratory therapists, physiotherapists, or social workers.
– Documenting the patient’s progress and interventions in electronic health records (EHRs) or charts.
– Educating the patient and family about the diagnosis, prognosis, treatment options, discharge plan, and follow-up care.

Challenges Faced by ICU Nurses in Medical Surgery

ICU nurses in medical surgery face many challenges that can affect their physical, mental, and emotional well-being. Some of these challenges are:

– High workload and stress: ICU nurses have to deal with multiple patients with complex and life-threatening conditions that require constant attention and intervention. They also have to cope with frequent emergencies, ethical dilemmas, end-of-life decisions, and death.
– Shift work and long hours: ICU nurses often work 12-hour shifts that can disrupt their circadian rhythms and sleep patterns. They also have to work on weekends, holidays, nights, or overtime to meet the demand for critical care services.
– Exposure to hazards: ICU nurses are exposed to various hazards that can pose risks to their health and safety. These include infectious diseases (such as COVID-19), needlestick injuries (from contaminated sharps), radiation (from X-rays or CT scans), chemicals (from medications or disinfectants), or violence (from agitated or delirious patients).
– Burnout and compassion fatigue: ICU nurses can experience burnout and compassion fatigue due to the high level of emotional involvement and empathy they have for their patients. Burnout is characterized by exhaustion, cynicism,
and reduced personal accomplishment. Compassion fatigue is characterized by secondary traumatic stress,
diminished compassion,
and reduced ability to cope.

Skills and Qualifications Needed by ICU Nurses in Medical Surgery

ICU nurses in medical surgery need to have various skills and qualifications to perform their roles effectively. Some of these are:

– Education: ICU nurses need to have a bachelor’s degree in nursing (BSN) or an associate degree in nursing (ADN) from an accredited program. They also need to pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to obtain their license. Additionally,
they need to complete a postgraduate certificate or diploma program in critical care nursing that covers topics such as pathophysiology,
pharmacology,
hemodynamics,
ventilation,
and shock.
– Certification: ICU nurses need to obtain certification from a recognized organization, such as the American Association of Critical-Care Nurses (AACN) or the American Nurses Credentialing Center (ANCC). Certification demonstrates the nurse’s competence and knowledge in critical care nursing and can enhance their career opportunities and salary. Some of the common certifications for ICU nurses are:
– CCRN: Critical Care Registered Nurse
– CMC: Cardiac Medicine Certification
– CSC: Cardiac Surgery Certification
– CNRN: Certified Neuroscience Registered Nurse
– Experience: ICU nurses need to have at least one year of experience in a general medical-surgical unit before applying for a position in an ICU. They also need to undergo orientation and training in the specific ICU they will work in, such as cardiac, neuro, thoracic, or abdominal. They need to learn the policies, protocols, and procedures of the unit, as well as the equipment, devices, and medications used.
– Skills: ICU nurses need to have various skills to provide quality care to their patients. Some of these skills are:
– Clinical skills: ICU nurses need to have strong clinical skills to assess, diagnose, treat, and monitor their patients. They need to be proficient in performing physical examinations, interpreting laboratory tests and imaging results, administering medications and fluids, operating and troubleshooting equipment, and performing invasive procedures.
– Communication skills: ICU nurses need to have excellent communication skills to interact with their patients, families, and colleagues. They need to be able to explain complex medical information in simple terms, listen actively and empathetically, provide emotional support and education, and collaborate effectively with other health care professionals.
– Critical thinking skills: ICU nurses need to have sharp critical thinking skills to make quick and accurate decisions in emergency situations. They need to be able to analyze data, evaluate outcomes, identify problems, prioritize interventions, and apply evidence-based practice.
– Organizational skills: ICU nurses need to have good organizational skills to manage their time, resources, and tasks efficiently. They need to be able to multitask, delegate, document, and coordinate care for multiple patients with different needs and goals.
– Leadership skills: ICU nurses need to have strong leadership skills to lead and mentor other nurses, students, or assistants. They need to be able to motivate, inspire,
and empower others,
as well as provide feedback,
resolve conflicts,
and advocate for their patients.

Conclusion

ICU nurses in medical surgery are vital members of the health care team who provide specialized care to critically ill patients who have undergone major surgical procedures. They have various roles and responsibilities that require advanced education,
certification,
experience,
and skills. They also face many challenges that can affect their well-being and performance. Therefore,
they need to take care of themselves and seek support from their peers,
managers,
or counselors when needed.

Bibliography

– AACN (2021) ‘AACN Certification Corporation’, accessed 27 October 2023.
– ANCC (2021) ‘ANCC Certification Center’, accessed 27 October 2023.
– BLS (2020) ‘Registered Nurses : Occupational Outlook Handbook’, accessed 27 October 2023.
– Cimiotti JP et al (2012) ‘Burnout syndrome among critical care nurses in North America’, Journal of Nursing Scholarship vol. 44 no. 4 pp. 349-356.
– Figley CR (1995) Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized New York: Brunner/Mazel.
– Maslach C et al (2001) ‘Job burnout’, Annual Review of Psychology vol. 52 pp. 397-422.
– McHugh MD et al (2011) ‘Nurses’ widespread job dissatisfaction’, Health Affairs vol. 30 no. 2 pp. 202-210.