Three nurses share their passion for working in critical care

By Robin Hocevar

For Renelle Staus, MSN, RN, recently hired manager of emergency services at Aurora Health Care's newest medical center in Summit (opening March 1, 2010) it's her weekend hobby that keeps her sharp for her 9-to-5 job. She is a volunteer with the state of Wisconsin emergency response team and gleans lots of perspective in those "off hours."

"If you want to be a good nurse, be an EMT. It's a whole different world in the field than in a hospital. It'll prepare you more than anything," she said.

Staus' 20+ year nursing career included stints in the ICU and step-down units, but she finds the most satisfaction applying her critical care skills in the emergency department.

"You have to be good critical thinker. If you get a bad trauma case, you must think quickly thru processes. You have to be one step ahead at all times. When patients are admitted you have some information on them and a diagnosis. When patients present to the ED, this is not always the case.

Whether you hone the skills as an EMT or in another fashion, Staus can't overemphasize the importance of the assessment.

"Don't be afraid to look up everything and really, really zone down on assessment skills. Once you can do a rapid assessment, you can treat almost every patient who comes through," she said.

Those accurate assessments provide comfort at some of life's most vulnerable moments and thinking about that gives Staus immense job satisfaction.

"When people are frightened and anxious, you are the one person they can turn to in an emergency, she said. "That's what excites me about being a nurse."

The Best Stomping Ground

Grace Hooker, BSN, RN, CCRN, started in the trauma surgical ICU in 1989 as a student nurse and has never left. At Loyola University Medical Center, Maywood, IL, she's no exception.

"A lot of people have strong opinions on where you should start. People think new grads shouldn't start in the ED or the ICU. You have to pay attention in clinical, but lots of Loyola nurses take their first job in critical care," she said.

Part of the reason Hooker has stayed as long as she has on the unit is that she likes the equal playing field. The technical aspect of the job is a perk, but it's the camaraderie that keeps her clocking in every day.

"We work closely with the doctors and residents. Being in a teaching hospital means it's a constant learning experience on all sides. There's a lot of give-and-take between doctors and nurses here. All opinions are relevant and counted," she said.

All About the Science

For some nurses, keeping up to date on the new medications released into the market is something to put up with. For Natalie Bonner, BSN, PNS, ENPC, ACLS, co-manager on the cardiac intervention unit and staff nurse in the ICU at MacNeal Hospital, Berwyn, IL, it's the best part of the job.

"There are so many new drugs out there. It's nice to master when to use each of them," she said.

Prior to her current position, Bonner worked in a hospice setting.

"You use the same skill set in critical care that you do in hospice. In hospice, you might assess how their lungs sound but the patients are bedridden so you might put them on morphine. One area has a more palliative response and the other addresses their pain in a more acute way."

Bonner left hospice when she was looking for a job with a broader application of critical thinking. Watching the patients respond to meds is a highlight in her current work, as is the forethought involved in initiating a cardiovascular drug.

"Even though you can be a nurse in any area, I love how the higher critical-thinking skills are mixed with everything I've learned. I think this is one of the most wonderful jobs besides being a mom. You need to be very well-organized, understand anatomy and physiology, and pharmaceuticals. Remember that nursing is a noble profession and to treat the spirit as well as the body. If you give [patients] hope or dignity, it makes a big difference," Bonner said.

Robin Hocevar is senior regional editor at ADVANCE.