A Critical Day in the Life of a Student Nurse

By Elizabeth Hermann

After completing an 8-week critical care course required by my nursing school, I knew I had found the nursing specialty for me. Although every day of this course was memorable, I will never forget the opportunity I had to help care for an organ donor and one of the organ recipients.

The 22-year-old donor, John, had been transferred to my hospital on life support to undergo organ donation. He had been pronounced brain dead at a nearby hospital from a self-inflicted gunshot wound to the head. His family had already said their goodbyes prior to his transfer, but the absence of family made his last few hours seem remarkably lonely.

The nurse who was directing John’s care quickly recruited my help in preparing John for surgery. The opportunity to use some of the skills I had learned in class made me feel that I was truly contributing. For example, I calculated the medication dose in micrograms per kilogram per minute, manipulated the arterial line stopcocks to obtain blood samples for lab work and, for the first time, obtained a sputum culture.

I also assisted a resident in starting a subclavian line; then applied the dressing. An echocardiogram was performed to assess John’s heart for donation, and a bronchoscopy was performed to assess his lungs.

We placed John on a warming blanket to maintain his body temperature, and administered four units of packed, red blood cells. When the time came to take John to surgery, I placed him on the transport monitor and accompanied him to the operating room.

After the two recipients for the heart and the lungs arrived, I eagerly accepted an invitation to watch the organ transplantation. The transplant team had a good working relationship and recognized the value of teaching others.

The surgeons and nurses allowed me to get in close and observe their work. By the time I left that evening, both recipients of the organs had completed their surgeries successfully, and were en route to the cardiovascular surgical ICU.

The next day, my instructor let me take an assignment in the cardiovascular ICU, so that I could follow the progress of the heart and lung recipients. I selected the lung transplant patient for my assignment, and I was sad that he was not doing well.

Carol, the nurse with whom I was working, was a great role model for me as she brilliantly coordinated the care of this patient. The intensity of his care was incredibly challenging; yet, Carol maintained a supportive and nurturing relationship with him and his wife, while taking the time to explain things and involve me in his care.

Although his condition was critical when I left, he was alert and communicating with his wife when I returned the next day. The team was already planning to extubate him within the next 12 hours.

It was wonderful to know that, despite the sad circumstances of John’s death, the donation of his organs saved and improved the life of someone else.

As I look back on this experience, I reflect on many things: the sadness of John’s situation, the loneliness that I felt in providing care for him, my amazement with the surgical procedures, the challenge of providing high-intensity physical and psychosocial and spiritual care and the joy of knowing that the generosity of John’s family brought life and hope to others.

The nurses with whom I worked were awesome role models. Their ability to impart knowledge in a nonthreatening and supportive way indicated that they remember what it is like to be a nursing student.

The collaborative environment of the ICU truly exemplified healthcare at its finest, and inspired me to pursue a career as a critical care nurse. I hope someday that I can inspire someone else to make a similar career choice.

What Nursing Students Say

Do you remember why you chose to become a critical care nurse? Read on to find out some of the reasons why today’s nursing students are attracted to your specialty. The following comments were collected at the 1999 National Student Nurses Association meeting.

"I have seen first-hand how helpless these patients are. They need qualified, skilled nurses to give care and advocate for them." — Eileen Hermance

"Although advanced in technology, critical care nursing provides a broad-based background in dealing with all illness and various modes of treatment, which would be limited in other areas of nursing." — Olive M. Brown

"While working in a nonmedical hospital position for five years, I saw critical care up close on countless occasions. I believe I can make a positive impact on the lives of patients." — Rob Black

"A career in this field provides an excellent opportunity to enhance my nursing skills." — Melissa Fleist

"Every day, the work is new, different and exciting." — Julie Win

"I like the fast pace of nursing the critically injured patient. It definitely keeps you on your toes." — Amy Owen

"The acute care setting provides the thrill of being an RN and the opportunities to grow in knowledge. You are never bored because of a lack of work." — Kellene Fisher

"Critical care patients are the most important and most in need of care. They are desperately in need of patient advocacy." — Steve Maxwell

"I enjoy the holistic approach. Critical care nurses are involved in all aspects of patient care, and are able to give attention to each patient." — Denise Pisacone

"Critical care nurses are highly respected and are given a great deal of autonomy." — Patricia Baldwin

"Critical care nursing draws on your knowledge and intuitive thinking to provide the best possible care." — Janey Chu

"The daily challenges, continual learning and teamwork with other healthcare experts will help me obtain my goal of becoming an expert nurse clinician."

Randy S. Oyster

"I like the aspect of critical thinking and looking at the whole picture of care for one to two patients instead of skimming the surface for five or six patients. I have also noted the respect CCRNs receive from other healthcare professionals." — Alison Kaestren

"I like knowing that I can help my patients through the most difficult times." — Carolyn Sieveking

"Critical care is exciting and challenging every day. I want to keep learning and expanding my horizons." — Betsy Ploeger

"Critical care allows me to spend more time with each patient and to maximize the use of the assessment skills I have learned." — Stacy L. Succop

"Critical care nursing is extremely challenging and allows nurses to use and build on the skills they have learned." — Edgardo Gomez

"I like working under pressure and constantly learning new techniques and procedures." — Kim Henry

"It’s challenging, dynamic and rewarding." — Dawn Callanan

"Critical care encompasses everything I enjoy about nursing. It also is a gateway to expanding your career." — Candice Beer

"I enjoy being able to think on my feet, be autonomous and provide holistic care for critically ill patients and their families." — Jill M. Saycor

"Your patients are never textbook, and I love the challenge of learning more every day as my patients’ diseases progress." — Marie DeLeon

"I can spend more one-on-one time with my patients." — Kimberly Bonts

"The nurses were so compassionate when my son was in the NICU. I want to be one of those compassionate nurses." — Jessica Bradigan

"The critically ill patient is dependent on your knowledge, advocacy and compassion more than other patients." — Allison Haritan

"Critical care nursing requires you to use all of your skills as a nurse." — Tracie Giannini

"It takes a special kind of person to dedicate themselves to patients who are experiencing a life-threatening condition. I love my work for being a nurse, not just a job." — Rebecca Hall

"It is a foundation or stepping stone to many specialty careers." — Natalie Adams

"It incorporates all fields of nursing and gives the RN the opportunity to practice many skills and increases one’s competence and critical thinking."

Elizabeth Clements

"I love the multisystem approach in ICUs." — Dawn Spivey

"This field is much more specific to the patient’s needs." — Christina Capers

"Critical care challenges me to stay current on all areas and continue my education in nursing." — Regina McBride

"I want to be the person who delivers the care that people will never forget." — Marissa Sparks