Are you Smart Enough to be an ICU Nurse?

If you’re a nursing student or new grad nurse interested in pursuing a career in critical care, I’m nearly certain you’ve been told to start in Med Surg. While there are valid reasons to do so, it’s not the right decision for every nurse. That leaves many with the burning question of whether or not they are smart enough to be an ICU nurse or start in the ICU as a new grad. In this article, I want to explore the necessary attributes required of an ICU nurse and address the question of whether you’re intelligent enough to be an ICU nurse. Then, I want to give you some tips on how you can increase your chances of success in the ICU setting.

First and foremost, you are the best judge of your character, intelligence, aptitude, and determination. To be a great and (more than) competent ICU nurse, you’ll need to have a strong foundation of knowledge in pharmacology and pathophysiology. This means you’ll need to understand the conditions your patients are diagnosed with, the underlying complications and health implications related to those conditions, what medications are required to manage their condition, and anticipate necessary treatments. In the ICU setting, there are so many medications that are not used on other floors in the hospital and, sometimes, not even in the emergency department. You’ll need to understand what these meds are, how they work, when they are used or discontinued, parameters for titrating the dosage (if applicable), and how they may affect your patient’s hemodynamic stability. If you’ve taken pharm and patho seriously in nursing school, your odds for success in critical care are much higher.

In the ICU setting, skills are also a major component for managing patient care and stability. The good news here is that nursing school prepares you with the knowledge and basic skills to be a competent and safe nurse on any floor. Critical care specific interventions and skills will be learned on the job during your orientation and preceptorship as a new grad in the ICU. You will learn the skills you will be required to know and utilize and you will have repeated exposure to these interventions. The best thing you can do to set yourself up for success in the ICU as a new grad would be to master those basic skills in nursing school so you can build upon them and expand your clinical knowledge on the job.

So are you smart enough to be an ICU nurse? Have a solid foundation and understanding of pharmacology, pathophysiology, and basic clinical skills as a new grad. Yes, you read that right. In my opinion, those are the “book smarts” that will help you excel and it is perfectly attainable! Aside from “book smarts,” there are also a few other key points of alternative intelligence that I believe you should have if you are going to be a smart ICU nurse. For example, great ICU nurses are resourceful and know how to utilize tools and personnel available to them in order to better their nursing care and knowledge. Additionally, successful ICU nurses have a willingness to learn, motivation with self-study and learning on the job, are detail and task oriented, and admit when they have limited knowledge. They ask questions when uncertain and aren’t overconfident. They’re team players with uncanny critical thinking skills. This means they have the ability to think quickly on their feet and trend data so intervention can occur before an emergency situation arises.

Many times, especially in my experience as an ICU nurse who has worked with new grads and nursing students, those non-book smart types of intelligence far outweigh having extensive knowledge of pharmacology and pathophysiology. So how can you increase your chances of success in the critical care setting if you are doubting your abilities? There are plenty of ways to set yourself up to excel in the ICU environment!

Seek out a mentor. All great ICU nurses have had a mentor who shaped them and their career trajectory (whether the mentor was good or bad…you learn more from them than you’ll realize). Take initiative and help other nurses and healthcare professionals; you never know who has the capacity to teach you something beneficial to your practice. Similarly, ask for help in advance and admit when you have reached the limitations of your comfort and/or knowledge and expertise. Work as a team, because it’s the only way ICU nursing is successful for nurses and their patients. Take feedback and criticism seriously and without offense. Be organized in your report, care, interventions, and medications. Organization can make the difference for your patient’s life in an emergency situation.

Take advantage of critical care classes offered to you by your facility/department: ACLS, PALS, ECG interpretation, transplants, hemodialysis and CRRT, CABG and recovering other surgical patients, hemodynamics and specialty equipment management, etc. The opportunities are there to improve your knowledge and skills if you only take advantage of them. In addition to this, motivate yourself to engage in self-learning whether at work or in your downtime. Utilize educational resources such as the American Association of Critical Care Nurses, Nicole Kupchik, Cardiac Nursing Education Associates, etc. to continue your critical care education on your own.

Don’t let equipment overwhelm you! In the ICU setting we have ventilators, balloon pumps, sheaths, arterial and central lines, IV pumps, dialysis machines, etc. Learn how to use these pieces of equipment, work to understand their modes and settings, understand how to extract data from it, change settings, and troubleshoot the equipment. These are tools not only to sustain and care for your patient, but also to help you excel in providing patient-centered evidence-based care for them. Learn your different alarms and what each means. Figure out how to change and set alarm parameters to the specifics set forth by MD orders and your own understanding of their hemodynamic trends.

Lastly, don’t be cocky and overconfident! That can be dangerous for your patient and your nursing license. It takes time to feel comfortable in the ICU setting…typically at least a year to feel like you have a routine established. Then, when you’re finally feeling comfortable, things change and you’re outside of your comfort zone again. Never let yourself get too comfortable or become complacent in this setting, because again, that’s not only dangerous for your patient but also your nursing license.

So, let’s revisit the original question…Are you smart enough to be an ICU nurse? Only you know the extent of your book knowledge with pharmacology and pathophysiology. However, nearly just as important is the ability to be resourceful in finding data related to medications, surgical procedures, medical conditions, nursing interventions, etc. If you can be resourceful, it can make up for a perceived lack of “book smarts.” While in nursing school or working as a new grad, work on developing those other characteristics of successful critical care nurses. In this setting, motivation and hard work account for a majority of the success you’ll experience in developing a thorough ICU-specific nursing knowledge base. Do I think you’re smart enough to be an ICU nurse? In short, yes! You can definitely excel in the ICU without a 4.0 GPA or without having passed your NCLEX with the minimum number of questions. Put yourself out there and go after your dream career! Until next time, happy studying!

Andra Alyse