I began my nursing career back in 1994 at the tender age of 20, soon after graduating from St. Clare’s Mercy Hospital School of Nursing in St. John’s. Jobs were scarce at that time, and a large majority of my classmates ventured on to the United States in search of employment.
I started out in a casual nursing position in acute care and medicine at St. Clare’s Mercy Hospital, and in 1998, I became a full time registered nurse in the Intensive Care Unit (ICU) at the Salvation Army Grace General Hospital.
I had two years at “the Grace” to get my feet wet, before the hospital closed in June 2000. I then entered the exciting, yet intimidating, world at the Medical Surgical Intensive Care Unit (MSICU) at the newly built Health Sciences Centre.
I thoroughly enjoyed my introduction to critical care at the old Grace hospital and decided I would “stick with it” for a while … that “while” has now turned into 17 years!
“It seemed that ICU had chosen me, more than I had chosen it …”
The Health Sciences Centre at that time was going through many changes to absorb the patients and staff of the Salvation Army Grace General Hospital. At this point in my career, I had six years of nursing experience, with only two being in critical care. This meant that in some ways, I still felt very “green,” and that the new MSICU at the Health Sciences Centre was overwhelming for me, to say the least.
This new unit was bigger, busier, noisier and sadder than what I was used to – but it seemed to be a controlled chaos. I do remember being instantly impressed by how smoothly things ran at the MSICU, and how well everyone worked together as a team.
Since my time at the MSICU, I saw many types of patients coming through the doors. Patients varied in age, ranging from 16 to 90. I was exposed for the first time to trauma and burn patients.
Fast forward to 2015: although many things are the same, change is constant in such a fast-paced environment. Under the umbrella of the MSICU, there are many types of patients critical care nurses care for with each day.
Nurses become a “jack of all trades,” so to speak, as we care for a wide-ranging group of patients who require care from obstetrics to oncology, and almost everything in between. Each patient requires different procedures, individualized treatments and assessments.
Occasionally, we care for the high-risk pregnant or post-partum patient. We deal with tremendously difficult situations where the mother, the baby, or both for example, have not survived. But, then, after all those heartbreaking cases, some of us are fortunate enough to take part of some of the most wonderful, joyous moments in patients’ lives.
We also learn from our patients. Sometimes we attend to trauma patients as young as 16 years old, which gives us experience with the pediatric demographic. These young people teach us how to communicate with them and their parents.
We have had patients of all ages who have had life altering traumatic brain or spinal cord injuries. Paraplegics, quadriplegics, amputations, sensory losses, skin grafting for burn patients, and the list goes on.
“You can never predict what you might be facing when you go in for your shift.”
We have also had a large number of cancer patients come through our doors, who have been in varying stages of their disease, whether it be after a complicated surgery, a reaction to treatment, or a change in their status. In conjunction with the oncology team, we administer chemotherapy when it is appropriate, and we support them though the most difficult task of battling both cancer and critical illness.
There are many times when the critical care areas have palliative patients. We often have to change gears from critical, lifesaving measures, to that of comfort care. End-of-life care is a painful, and often a daily reality of working in critical care. The focus changes from analyzing rhythms, mixing infusions and trips to diagnostic tests, to that of providing comfort to the patient, and as much support and privacy as possible to the family during the most difficult time.
“The emotional side of critical care nursing can be far more stressful than the physical care at times … thoughts of these patients stay with us long after our shift is over.”
Organ donation is one area that is closely tied to critical care. When a family is faced with the devastating news that their loved one is brain dead, for example, we support them as they make their decision to donate. The organ procurement team is a vital part of critical care, and together with their oversight, the bedside nurse plays a critical role in the many procedures that are required to ensure that a patient is a suitable donor.
We are very fortunate to live in a place of wonderfully generous people. The vast majority of families faced with this rare circumstance choose to donate, and the loss of their love one, gives life to so many other Canadians. The emotional component of caring for organ donors is one of the most bittersweet experiences I have ever known. I don’t think anything has made me more proud as a registered nurse or as a Newfoundlander, than to know how many families choose to donate just so another can live.
I have witnessed many aspects of critical care evolve over the past two decades, some of which are consistent with changes in modern-day society. Take, for example, mental health issues, a facet of critical care nursing that may not typically be associated with our group. We see a much higher number of mental health and addictions-related admissions compared to earlier times. In more recent years, I personally, have seen more overdoses, attempted suicides and crime-related injuries than ever before in my career, and dealing with these sensitive issues requires a lot of empathy. We also see increasing levels of delirium, where patients can be agitated and sometimes aggressive.
Another societal change that is affecting critical care, is the increased number of morbidly obese patients. With half of the population being either overweight or obese, naturally, many of our patients fall within this category. There have been many changes made over the years to accommodate this shift, such as an increase in specialized beds, lifts and diagnostic equipment.
Also in recent years has been the addition of long-term care beds for ventilated patients. Now, these patients can receive long-term care in a more appropriate and home-like setting. We also see ventilated patients who live out in the community, who are admitted back to the ICU from time to time – these patients are like part of our family. Critical care is more physically demanding than many people can even begin to understand. All of our staff who provide direct patient care are registered nurses. There is a great sense of teamwork and we always have each other’s back! Nobody is ever on their own, and we do our best to take care of each other, as much as we do for our patients.
There is something to be said for the type of bond that develops from sharing some of the most sacred, tragic and touching moments of peoples’ lives. We spend so much time side by side with our colleagues, and we support and counsel each other through both our professional and personal challenges. I can honestly say that some of my closest friendships have been built from time spent working together in the ICU.
Although the outcomes are not always happy in the critical care setting, I do have a feeling of pride in our department, and knowing that we provide the best care possible to those we serve, provides me with great satisfaction. There are times when patients come back to visit us after they recover, or we see them and family members years later in the mall and they remember us, hug us and call us “mighty mouse.” That makes it all worth it for me! ■
This story was written by Lisa Power, a critical care nurse with Eastern Health.
Excellent job Lisa – you have certainly captured what it means to be a critical care nurse. Thankyou for sharing your story !
Great story from one of the best! You are certainly an enormous asset to our MSICU and our profession!
Such a wonderful article Lisa! The care that each one of you provide to your patients is astounding as I know it firsthand. Those long days I spent waiting in the unit were made bearable only because each and everyone of your team gave me the strength to face each day! The dual balance of taking care of your patients while providing direction, comfort and information to the families during these horrific times does not go unnoticed! And yes……ICU chose you, it was a perfect fit!
When I was a patient in the ICU I was taken care of by from some of the most amazing and caring people I have ever met. All the nurses hold a very dear place in my heart. Great job on the article Lisa!
Great article, LIsa! The services you nurses provide is amazing and very difficult. May God Bless you and all the ICU Nurses!
What a fanastic article, so well written and obviously heartfelt. Well done Lisa! Keep up all the great work!
Wow Lisa! You put into words what we all feel as critical care nurses! An incredibly rewarding yet difficult job both emotionally and physically. Thanks!!
Lisa, wonderful article of what you do every shift as a critical care nurse! Your dedication to your patients’ care is inspiring. Eastern Health is lucky to have such amazing nursing staff!
GREAT ARTICLE LISA, VERY INSPIRING TO ALL OF US, NO MATTER WHAT CAREER WE CHOSE OR CHOSE US. WORKING IN HEALTH CARE IN GOOD DAYS AND BAD I TRY TO ALWAYS REMEMBER THAT THERE IS A PATIENT BEHIND EVERY THING I DO, WHO IS DEPENDING ON ME TO DO MY VERY BEST. THANKS FOR THE REMINDER TO US ALL THAT WE ALL HAVE AN IMPORTANT ROLE AND WE SHOULD BE PROUD OF WHAT WE DO. NURSES ARE VERY IMPORTANT AS FRONTLINE STAFF.
I CAN SEE YOU SERVE BOTH THE PATIENT AND THEIR FAMILIES. KEEP UP THE GREAT WORK
yuo ahev writen a wonderful, heartfelt story about your career in criitcal care nursing.
Lisa, very articulate and thoughtful article. You obviously chose well, your area of expertise.
Lisa, I remember working with you at the Grace before it closed. You are a fantastic nurse, as were all of our team. Glad to see you are still working in critical care and making an impact on so many. Shout out to Kim Parsons as well…. it’s a very difficult role in a stressful setting. God Bless!\
The comment above (jennifer reid barrett) was actullly written by Shelley Drover! (technical difficulities!!)
Such a wonderful well written and true story Lisa…. although you feel as the ICU chose you… it certainly is a relationship that is of mutual passion and professionalism as you were made to be an ICU nurse! I miss working with you and all the team – a true mix of dedication, experience, knowledge, kindness and warmth!!!