Current Events > I worked in the ICU as a nurse for the last two years, this is what I did.

(+) Yeah! (+)

A hospital floor can't permanently be a COVID ICU, but the ones I worked in basically were since March of 2020. Most patients were older men (50+) that just simply couldn't breathe. After a day or two of trying to put them on BiPAP or Airvo (heated high flow nasal cannula), they would still start to get hypoxic and confused, ripping off their oxygen, trying to stand up and leave saying there's things in the room when there weren't, they NEED water, then eventually trying to throw punches (sometimes succeeding) until intubation was necessary.

Once intubated they were usually very difficult to keep sedated with fentanyl, versed, ketamine, propofol, the works, so they would have be put on a chemical Paralytic so they would stop overbreathing the vent and let it do the work for them. You have to monitor their brainwave form using a BIS monitor to make sure they weren't conscious. It's a terrible fate to have every muscle paralyzed and be aware of it but unable to do anything about it, they need to be VERY sedated.

We would prone them because being on your stomach helps your lungs expand further. At the facility I worked at the longest they didn't have functional hoyer lifts on the ceiling so we would gather a group of 7 people, roll them up into a sheet and physically flip them from their back to stomach. Most of these people weighed over 250lbs, some as high as 400, 500lbs. Their oxygen sat and ABG would improve on their stomachs but would usually go back to being crappy on their back. You had to flip them at least every 12 hours.

They would have a central venous line usually running a minimum of 4 different IV drugs or fluids, the ventilator in their throat, and an oral pharyngeal tube going to their stomach to give them nutrition and oral meds, a foley catheter for their urine and if they weren't constipated for days and days, a tube up their butt to collect their feces.

Eventually blood clots start to become a real problem, then their kidneys start to fail and it all starts to go downhill until they are on CRRT but it usually isn't enough. Their lungs are scarred beyond repair after weeks of being on the vent and COVID wrecking their lungs that even if they do survive, it's months and months of recovery just to be able to walk a few feet with supplemental oxygen.

The average stay for a patient was about 2-3 weeks until they either died, got off the ventilator and could be downgraded, or they got a tracheostomy and a PEG tube (feeding tube going directly to their stomach) and sent to a LTAC where they may be living on vent support the rest of their lives.

I've had to counsel a guys son in his 30s on how we will transition his father to comfort care (removing the vent and stopping all meds other than morphine) with the phone wedged between my shoulder and cheek as I am putting a 32 year old former EMT into a body bag after he got put on comfort care earlier that day too.

I did this for over two years. I decided if I was going to go through this much emotional punishment I should get paid the big bucks and travel nurse. I went to Maine in the dead of winter (January of this year) after being in Texas and it SUCKED. I made a lot of money but even though I was on an ICU contract, they had too much ICU staff most days so I usually got put into the IMC, or progressive care unit; people too sick for the regular floor but not sick enough for the ICU. Basically every patient I had was going through alcohol or opiate withdrawal with COVID on top of some other conditions, constantly on the border of getting intubated but constantly belligerent and I had more punches thrown at me there than I had my entire time working as a nurse. I finished my contract miserably, the winter was brutal as hell and the place I was staying cost over $2k a month.

I haven't worked since March 1st and I don't know what I'll do now. I do not want to go back to a hospital floor, I am terrified of it. I watched over 60 people die in front of me, some violently some peacefully, and usually it was just me in the room holding an iPad so their family could say their final goodbyes through a screen.

99% of them were not vaccinated. 99% of them still would never get the vaccination and would tell me that with their dying breath if they were able to.

Can you do nursing not in the ICU?
What were your patient to nurse ratios at your jobs?

I do med-surge/Neuro, and its terrible but the patients aren't near ICU level most of the time.

FLAMING EVIL HOMER posted...

Can you do nursing not in the ICU?
What were your patient to nurse ratios at your jobs?

I do med-surge/Neuro, and its terrible but the patients aren't near ICU level most of the time.

I'd rather not go back to med-surg ever again. When I was doing med-surg it was usually between 5-7 patients a shift, not counting discharges and new admits. It felt like adult daycare most of the time and I was just constantly busy. In the ICU I just had my two patients and while it was a lot to manage, I liked that they didn't talk or pull of their IVs and complain about everything. I'd take a sedated vented patient over someone hitting the call light every 5 minutes to tell me their water is too cold or is missing a single ice chip. We never had techs or CNAs, nobody wants to do that awful work for less than they would make at Target.

Lol yup that's about right with medsurge. Taking care of 7 adult babies fml.
I work PRN 2 days a week now so its more bearable.

Just do some same day surgery or procedure stuff.

I also never got COVID after working with the sickest of the sick for two years. I don't plan on ever getting it, thus I am now a hermit.

That's all pretty rough. The emotional burden is why I could never work in a medical field.

I dont blame you for stepping back. Its good to take a mental health break in that career every now and then. You basically saw the same things a soldier in a combat zone would in the span of 2 years. People dont realize that when they think of nurses. I saw it working nursing homes, but not to the extent of what you did since we couldnt provide the same treatment as a hospital. Its why I dont work full time anymore and just doing the traveling gig now and then.