[id_ocad]

This forum is created to address the psychological stress disorders of ICU /ER workers. Please state whether you think the doctor or the nurses are under more pressure and stress and feel free to give any comment questions or advices that can change the nature of the ICU/ER to make it less stressful. Please state the hospital you work at, and the department you work or worked in. Thanks~

[cougarnurse]

I may not work ER, but a few of my classmates did after graduation. From what I gather, they are more stressed than the ICU's; why? Things tend to come in 'clumps', and restocking, etc. is a bear.

[Ricu]

In my experience, I perceive that stress might be equally shared but possibly experienced differently by nurses and physicians. The physician is called upon to do procedures and make determinations; weightly responsibility indeed, but generally experienced over short periods of time. The doctor comes in, explains the thing, does the thing, completes the follow up brief and then leaves. He or she then checks in and then checks out. The nurse must be present throughout, assist in those procedures, be present for the patient and family, help them process all of the information and finally work through the decision making process. This usually requires interfacing with assorted family members and dealing with complex social dynamics, facilitating the involvement of other physicians, clergy and so on. It can be enormously taxing especially when the decision is difficult for example, when it is time to let a loved one go. Because of the trust relationship that inevitably develops, frequently the nurse more than the doctor, is relied upon through those challenging times. I do this on a regular basis and usually find it very rewarding. Sometimes it can be draining especially when many patients die in a short period of time. It would be nice if there was a more accessible support network when burn out happens, but nurses are expected to shoulder this strain and then shrug it off when it's done. How many senseless deaths and organ doner kids does a nurse have to shrug off before it's too much. I'm not there yet and have my faith to thank for that but at the same time, I see an end for me in the not too distant future. I have no doubt however, that somebody else will step up to the plate when that time comes.

R

[RockinRobynRN]

I am currently an ICU nurse & was previously an ER nurse. I can definitely say that I had more stress in the ED than in currently do in the ICU. True, the patients that I take care of now are "sicker", but it is a much more controlled atmosphere than the ED. I don't have families in my face for every second of every day for every conceivable reason. Even if someone is crashing, I have a wealth of support & teamwork. That's not something I could count on in the ED because my fellow nurses were often drowning just like me. ER is my first love, but the chaos can often be overwhelming. I work in a 18-bed Surgical-Trauma ICU in Columbia, SC. It is a 649-bed teaching facility.

[denna rn]

I know from personal experience that you can suffer from burn out, the anxiety disorders even if you don't work in the ER or ICU. I have had patients that should have been in the ICU and sometimes it is just overwhelming, plus that guy had his oil checked this morning and he's gonna get at least 4 units to start with, she aspirated and has to be suctioned often, the other heman wants his morphine every hr for non cardiac cp, CE have been neg. sinceyesterday, and don't even think about offering him nitro, OMgoodness, here I go again. One of the days I'm gonna tell ya one of the stories of one of the many wonderful patients that I have been blessed to have taken care of. Really, I will Denna

[Mom-n-More]

I just did a year in ED and I really think it is the most stressful type of nursing there is. You never know what is coming through that door. It is not controlled, the patients aren't stable, nothing is bandaged or cleaned. You see the true blood and guts of nursing. I had to leave after a year and go back to pediatrics where I had spent the prior 6 years because I was starting to feel the stress personally. I thought I was developing some post-traumatic stress or something. Since I left ER, my own nightmares have gone away and my own stress level has completely resolved.