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Career Story: Registered Nurse In An ICU Stepdown Unit

Registered Nurse In An ICU Stepdown Unit

Job Title: Registered Nurse- ICU Stepdown

Education: Associate Degree in Science - Nursing, RN

Previous Experience: I worked as a nursing assistant in a nursing home, and also as a medical office assistant for a GI practice before and during nursing school.

Job Tasks: I am a Registered Nurse currently employed in the Intensive Care Unit (ICU)- Stepdown at a local hospital. It is an intense position that requires a great level of clinical knowledge. Typically our nurse to patient ratio is 1:3 because we are responsible for total patient care. These patient's acuity level is high therefore the ordering physician places them on our unit for monitoring and more personalized care.

On our unit, we have numerous nurses stations strategically placed in order to view our patient in their private room. The patient is continuously on a cardiac monitor to determine their heart rhythm, rate, breaths per minute, an oxygen saturation monitor, and an automatic blood pressure cuff that can be set for repeat intervals. On our floor is a monitor room staffed with a trained cardiac rhythm specialist that is a valuable resource. They can identify problems and assist in early interventions.

We see a variety of patients, including those with short term, acute onset illnesses who fully recover, to those with long-term, chronic illnesses and needs who often lose function and require assistance after discharge. We also have post-op surgical patients requiring full care. These patients are often immobilized for up to eight hours and require vascular checks for pulses in the operative extremity. In addition, patients who are upgraded from the Intensive Care Unit (such as those previously on ventilators) or who become more ill on a medical/surgical floor may be transferred to ICU Stepdown for closer monitoring, and more specialized care.

Our total patient care approach requires that I am 100% responsible for my patient during my shift. This includes (but is not limited to) assessment of the patient's current health status, medicine administration, hygiene and elimination needs, social and spiritual needs, role performance and rehabilitation referrals as appropriate, patient advocate, and as a liason between the patient, their family, and the physician.

Our philosophy is that healthcare must be handled with a team approach. This is true in all areas of our hospital which makes the collaboration between doctors, nurses, physical and occupational therapists, as well as social workers, etc. an integrative and essential part to our success.

Best and Worst Parts of the Job: The best part of my job is that I have an integral role in helping patients get better and regain their function. In addition, I am also the one patients and family turn to in time of need and despair and can assist them in navigating through concerns, fear, loss and grief.

The worst part of my job is that I spend a significant amount of time charting what I did to help, instead of hands-on helping. It is a rewarding position that I take seriously, but I always want to do more.

Job Tips: I suggest that anyone considering a nursing career should work in a healthcare environment so they are immersed in the "culture" of healthcare. Starting as a certified nursing assistant is often helpful because it teaches you basic care skills you wiil always use. Choosing to be a unit clerk in a hospital can also be very beneficial as you learn the paperwork, computer system, and general processes of the floor.

Additional Thoughts: Nursing is for anyone - male, female, young, old - anyone with a heart of compassion for the ill. In my nursing program we had everything from very young adults who went straight to college from high school, men with families, single mothers, professionals looking for a change of pace, to retirees who wanted to help others.

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