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Apr 18, 2014 · A Day in the Life of a Medical ICU Nurse in Rochester, MN

Picture of Ann Ballard

Ann Ballard, RN
Medical ICU Nurse

I arrive and check for my assignment. Today I’ll be with a new patient. Our unit huddles at 7 a.m., and we are briefed about staff and patients. My patient is a direct admission from an outside hospital and preliminary diagnoses are sepsis and pneumonia- that’s our specialty. She’s coming by helicopter and they are landing in 10 minutes. I am going to be busy! My room is ready and I grab a couple IV pumps and set up a couple of pressure bags with IV fluids. The report is that the patient’s blood pressure is low, she’s tachycardic, she’s on BiPAP, has a urinary catheter, and she has a couple small gauge peripheral IVs.

The admitted patient arrives, and the medical team swarms the room — I have lots of help to get her settled in bed and hooked up to the monitor. Blood pressure is still low despite 4 Liters of IV fluids and the patient is breathing too fast and hard with the BiPAP — she’ll need to be intubated first before a central line can be placed. One of my co-workers has pulled out the medications I’ll need to administer for intubation. The doctor tells me what to give just prior to intubation and after the procedural pause, we begin. Medications are in and the doctor intubates the patient. While the doctor places the central line next, I watch the monitor and report any ectopy.

Whew! The procedures are done and X-rays are ordered to verify placement. Once those are done and placement looks good, I can run the medications to help the patient’s blood pressure through her central line. I have many antibiotics and sedation to administer so the more IV access, the better! My co-workers keep checking on me to see if I need any help. I catch up on charting and signing off orders.

My patient is waking up and getting restless — time to increase the sedation a little.  Is it lunch time already? I report off to the nurse covering me for lunch. Back from lunch and I see there’s an order for a chest CT. I call the respiratory therapist to let him know that we’re going to need to take a trip to radiology.  Blood pressures are low again when we get back so I call the physicians to see if they want to give more IV fluids or add another medication.

 

 

Mar 14, 2014 · Great place for a new grad, varied and complex with all the resources to support you in your career!

Hi! I’m Ann, a medical ICU nurse here at Mayo. I’ve been working for Mayo for almost 14 years now. I first came to Mayo as a nursing student — we had some of our clinicals here. I was so impressed with the variety of specialties and resources at hand that I thought I’d apply after I graduated. When I was hired, I started on a general medical floor, since I didn’t have my heart set on any particular specialty. What a great place to start as a new grad! Medical patients are so varied and complex that you have to know a little about a lot of different diseases and conditions. And then you have to know where the resources are to look up what you don’t know!

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One of the specialties that my medical floor had was diabetes. With my nurse manager’s encouragement, after a year, I started a job share position with the Diabetes Consulting Service. I rotated two months on the service and then two months on the floor. I learned a lot about diabetes management and also did a lot of patient education regarding home management of diabetes. That also helped hone my teaching skills for discharge education on the floor. I did the job share for three years and then rotated off.  There are so many different opportunities for your nursing career here.

I’ve had a chance to precept new RNs and Summer 3s. That has been a great opportunity, too — it reinforces what I know and why.  I felt very comfortable and experienced — I like sharing what I know. When I felt I needed more a challenge after 10 years, I decided to apply for the medical ICU.  It was a welcome change and challenge — we get some very sick patients. It has enhanced my critical thinking skills, and I have that great experience from working on the medical floor.

And have I mentioned the teamwork? No? Silly me! The teamwork is fabulous! I never feel alone when I’m having a really busy admission or my patient is crashing. My co-workers are right there helping, often without being asked. We just do it because we are there for the patient and for each other. That always makes my day.

 

Ann Ballad, RN

Medical ICU Nurse

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