Intensive Care Unit, Ana Campos, Redlands Community Hospital

What brought you to the ICU?

I feel strongly that critical care is what I was truly destined to do. My transition into the ICU was smooth: The night shift helped me ease into learning everything (for example, medications and titrations). I had to be very intuitive and pay attention to how the patient was reacting to medications or any interventions, and night shift made it easier to focus without the distractions that are common during the day.

What do you most love about working in critical care?

What an incredible gift it is to work in the ICU, where life continues or ends and life decisions happen every day as we care for critically ill patients and their families. What we accomplish as a team for our critically ill patients is extraordinary. I am so grateful and proud to work with all of the nurses in our ICU.

We’ve built a strong culture of collaboration and high standards of patient care delivery. We always stand together, even when going beyond the walls of the ICU as rapid response team nurses. We know critical care is a need everywhere, not just in a specific setting.

How has critical care made you the nurse you are?

The ICU is a very rewarding area where you not only help someone return to a healthy state, but also provide education on the disease process. We are sometimes also in the position of helping patients to let go in peace and ensuring their comfort in their final moments.

This is a multigenerational community hospital: People bring their aging parents here for care; they have their babies here; and they return again and again in a variety of circumstances, including the end of life.

What is it like to be with patients and families in the process of death?

You try to be strong and at your best; even so, I sometimes cry with patients and their families. Several times, I have had the experience of running into some of those families over a decade later, and they still remember how I was a comfort to their family member. It is such a beautiful thing when someone remembers you after so long because it reminds you of the impact you’re capable of having on others.

What does it mean to you to be a nurse leader?

A sense of collaboration and teamwork is central to how I approach my work. As a leader, I like to mentor, inspire and guide newer nurses, even as I also focus, by necessity, on schedules, quality of care, audits and other administrative functions.

To me, transformational leadership means focusing on patient outcomes and quality of care, but also being present with the nurses who provide direct patient care and ensuring that they have all the necessary support to be successful.

Has COVID-19 changed the way critical care is approached?

The pandemic completely shifted our approach. The unknown has been a big part of it, and we have to continue to pivot when needed. It’s been a very labor-intensive process, with the adoption of manual proning, the arrival of the new variants and the evolution of evidence-based practices. Many situations require a great deal of teamwork, encouragement and huddles every morning to get everyone on the same page.

Our interdisciplinary (IDT) rounds, which our ICU implemented in 2004, have been a very powerful process for patient- and family-centered care. Before the restrictions on family visitation imposed due to the pandemic, our ICU was open to family members. It was a great way to involve the family in the plan of care and to answer their questions.

We continue to do IDT rounds every day, but in order to ensure the safety and privacy of everyone on the unit, we have implemented the use of iPads to connect families with their loved ones.

What characteristics make an exceptional ICU nurse?

A few years ago, we adopted Jean Watson’s Caring Science theory, and that is how I think about nursing. I can teach someone everything they need to know about the ICU, but I can’t teach someone how to alleviate suffering, be present and exercise compassion.

We also must learn to take care of ourselves; we need some time for our own needs, and nurses need to be willing to put this into practice. Of course, we also look for solid clinical experience, skills and the curiosity that leads to learning and professional growth.

KEITH CARLSON, RN, BSN, CPC, NC-BC, has worked as a nurse since 1996 and has hosted the popular nursing blog Digital Doorway since 2005. He offers expert professional coaching for nurses and nursing students at www.nursekeith.com.

In this Article: Critical Care