Why are ICU nurses such a pain to work with

January 14, 2018, 02:43 AM

2000Z-71

Yes, ICU nurses have a reputation for being bitchy and difficult to work with. I found out it's not just at work. My mom's currently in the ICU and I had to basically tell her nurse how to do his job tonight.

Granted, I work in a different world in the ER that moves at a much greater speed but what I saw tonight was just inexcusable. I go in to visit and she can't talk because she can't breathe. Literally gasping and using accessory muscles in the rib cage to breathe. I'm looking at the monitor and her heart rate is at 155, respiratory rate at 45, pressure at 110/70, but yet her O2 level is at 99% on 2L O2.

I told her to hit the call button and get a nurse in. First ICU nurse walks in, I explain that she's had a serious change in condition since yesterday, she's tachycardic and tachypnic. Nurse's response, "She's at 99%, she's fine." My response, "Look at your patient, not the monitor."

Long story short; after 2 different nurses, 4 ass chewings administered by me; 3 hours later with no change in condition, there was finally a doc in the room who ordered an EKG, chest x-ray, and dose of lasix which I had asked for in the beginning. An hour later she was finally put on a bipap machine to ease her breathing. Her vitals and condition are gradually improving but it was just unacceptable to take so long to try and reverse the situation. It's really scary to think what the outcome may have been if I wasn't there to advocate for her.

January 14, 2018, 05:30 AM

Elk Hunter

quote:
Originally posted by 2000Z-71:
Yes, ICU nurses have a reputation for being bitchy and difficult to work with. I found out it's not just at work. My mom's currently in the ICU and I had to basically tell her nurse how to do his job tonight.

Granted, I work in a different world in the ER that moves at a much greater speed but what I saw tonight was just inexcusable. I go in to visit and she can't talk because she can't breathe. Literally gasping and using accessory muscles in the rib cage to breathe. I'm looking at the monitor and her heart rate is at 155, respiratory rate at 45, pressure at 110/70, but yet her O2 level is at 99% on 2L O2.

I told her to hit the call button and get a nurse in. First ICU nurse walks in, I explain that she's had a serious change in condition since yesterday, she's tachycardic and tachypnic. Nurse's response, "She's at 99%, she's fine." My response, "Look at your patient, not the monitor."

Long story short; after 2 different nurses, 4 ass chewings administered by me; 3 hours later with no change in condition, there was finally a doc in the room who ordered an EKG, chest x-ray, and dose of lasix which I had asked for in the beginning. An hour later she was finally put on a bipap machine to ease her breathing. Her vitals and condition are gradually improving but it was just unacceptable to take so long to try and reverse the situation. It's really scary to think what the outcome may have been if I wasn't there to advocate for her.

First, let me say how sorry I am for your mom and you for having to go through that MCF.

Many years ago our daughter was in a car wreck where she got hit head on by a drunk driver. She was in emergency room and was slowly dying of lack of oxygen, and internal bleeding. Her "doctor" was doing NOTHING. Fortunately for us, the ER head nurse called in another doctor who checked, then he and the nurse came to see us in the waiting room. Essentially, they asked for our permission to treat our daughter. We agreed and they jumped in and saved her life.

Turns out the first "doctor" was from one of those middle eastern countries and was up on charges from a previous MCF in which the patient had died.

Not to mention some of the "care" my grandson received when he was at Walter Reed! Both times!! The work done by those "experts" when he was shot in the face had to be completely removed and redone by the real doctors at Ft Bragg.

January 14, 2018, 06:23 AM

Oz_Shadow

I think it is often a matter of perspective. What the public, including non-ICU/CCU nurses, perceive as a serious issue is just not as serious to someone that sees it everyday and knows when to get concerned. When in the unit, it's all about getting the person stable and keeping them alive.

On the flip side, when it is their family member in the bed, they will react just like you. Most of them know they are doing it though.

Best wishes for a quick recovery!

January 14, 2018, 07:57 AM

Dusty78

Sounds like she’s at a shitty hospital. I have worked with plenty of ICU nurses who were world class. I have also worked with terrible ER nurses. It’s all a roll of the dice. Every profession has it’s duds. ICU vs ER is a tale as old as time.

I have worked at some world class hospitals and some not so much. A change in condition like that at a place like UPMC Presby would have had a resident in the room within 5 min and and ABG drawn within 10.

This message has been edited. Last edited by: Dusty78,

January 14, 2018, 08:01 AM

Fusternc

As a prior ICU nurse, you sir did the correct thing by using your medical knowledge, assesment of the situation, and advocating for your mom.

ICU tends to attract the more controlling, OCD personalities overall. There are exceptions of course. Some of the nicest nurses Ive ever worked with worked along side me in the ICU, and I’ve also met some of the most toxic personalities there as well.

Best wishes for a speedy recovery for your mom!

January 14, 2018, 08:23 AM

12131

quote:
Why are ICU nurses such a pain to work with.
Yes, ICU nurses have a reputation for being bitchy and difficult to work with.

Sorry about your mother. But, don't generalize. I've worked with many of the most caring ICU nurses.

January 14, 2018, 08:49 AM

selogic

My daughter in law was a Pediatric ICU Nurse and now is a Hospice Nurse . I watched her in action when two close family members passed . Don't generalize .

January 14, 2018, 11:44 AM

dewhorse

My 18yo was in ICU this last week due to DKA, he has T1D. The nurses were great, my ex knows at least one of them due to her brother going to school with her.

Anyway....... 2000 you did the right thing but not all are bad

January 14, 2018, 01:24 PM

Gustofer

You should feel lucky you even have ICU nurses.

Our "ICU" consists of one room and is only designated that because it is directly across from the nurses station. Our "ICU nurses" are mostly inept floor nurses who are scared shitless when I bring them a patient with an A-line.

Ah...the joys of a small town rural hospital. Count your blessings.

I generally agree though that most ICU nurses are a bit uppity and difficult to deal with. Most, however, are very good at their jobs.

January 14, 2018, 02:46 PM

PowerSurge

I was married to an ICU nurse. She was always right. I’m glad you got them straightened out.

January 14, 2018, 03:24 PM

sjtill

quote:
Literally gasping and using accessory muscles in the rib cage to breathe. I'm looking at the monitor and her heart rate is at 155, respiratory rate at 45, pressure at 110/70, but yet her O2 level is at 99% on 2L O2.

In my experience of many years and many hospitals, for a nurse not to look at the overall state of the patient but just to rely on the 99% oxygen sat--achieved at the cost of working her body to near death--would be extremely unusual.
Was this the night shift by any chance? Inexperienced nurses start there, nurses work out of night shift work as soon as they can if they're any good, IMO.

January 14, 2018, 07:22 PM

striperkid

I'm going through this now with my Mom. Only difference is I have NO medical experience so I'm behind the eight ball.

January 14, 2018, 08:30 PM

mrbill345

quote:
Originally posted by sjtill:

Was this the night shift by any chance? Inexperienced nurses start there, nurses work out of night shift work as soon as they can if they're any good, IMO.

Some prefer the night shift to avoid administrative types who care more about looking good than providing good care.

January 14, 2018, 09:05 PM

Dusty78

quote:
Originally posted by sjtill:
quote:
Literally gasping and using accessory muscles in the rib cage to breathe. I'm looking at the monitor and her heart rate is at 155, respiratory rate at 45, pressure at 110/70, but yet her O2 level is at 99% on 2L O2.

In my experience of many years and many hospitals, for a nurse not to look at the overall state of the patient but just to rely on the 99% oxygen sat--achieved at the cost of working her body to near death--would be extremely unusual.
Was this the night shift by any chance? Inexperienced nurses start there, nurses work out of night shift work as soon as they can if they're any good, IMO.

It’s the opposite in my experience. The smart nurses work nights, no admin, no rounds, less families messing with patients, less procedures, did I mention less admin?

January 14, 2018, 10:15 PM

MagicHorse

In Aug my sister had a brain aneurysm & was in a special ICU for brain trauma patients. We were told she'd have to be there for over a month. Her usual night time nurse was literally a life saver. All the others seemed clueless. Honestly believe it was that 1, caring & knowledgeable nurse that kept my sister alive. We owe her everything. We could tell, just by how my sister looked & acted if she had been the one caring for her.

January 15, 2018, 01:40 PM

Sevo1967

I’m sorry about your Mom, and you certainly did the right thing advocating for her. Sounds like her nurse was a bit of a moron. Actually, it sounds like IQ’s aren’t really much above room temp in that ICU. I hope she’s better and out of there soon.
Sean

January 15, 2018, 02:34 PM

Georgeair

An elderly patient with serious and compounding issues alone in a hospital is doomed in many cases. We experienced more than one instance where had we not been advocating for my 80+ mother she'd have ended up in much worse shape, or dead.

Last time was when she very suddenly started talking all crazy a day or so after admit, couldn't focus or stay awake. After repeated attempts to get nurses to investigate beyond their assessment of it's just the med and she's just tired, finally got ahold of her doctor explained the situation and that I was calling 911 for a response to her room if he couldn't get some eyes on the situation. One CT later found that she had a massive intracranial bleed that nearly killed her and resulted in her being in ICU for a week post-surgery.

Not cool.

I know they are busy, but don't dismiss everybody else as an idiot so readily perhaps?

January 21, 2018, 06:40 AM

choang3

I pray that your mother is doing better. You’re absolutely right to advocate for her, and based on everything you said, the nurse missed the mark seemingly because she relied only on values rather than assessing your mother.

I’d be mindful of painting with such a broad brush, though. It’s obvious from your posts that you work in the ED, perhaps in a nursing capacity? It’s a rivalry as old as modern medicine: ED vs. ICU nurses; ED docs vs. internists; night shift vs. day shift; etc.

Some of the best nurses I’ve ever worked with are ICU nurses: very intelligent, compassionate, and absolute advocates for their patients. Some of the worst nurses I’ve worked with were ICU nurses, as well: arrogant, entitled, gossipy, would rather manage their Air BnB than look at their patients. But I see that whole spectrum in all fields, whether it is on the Med/Surg Ward, Telemtry, PACU, or ED.

Again, I hope your mother is doing better. I’ll be sure to pray for her and your family when I go to church this morning.