Resilient ICU Nurse Practitioners Share Common Rewards for Intense Work
by Jennifer Walker
It was a normal case for the Neurocritical Intensive Care Unit: a man in his eighties arrived with a devastating bleed in his brain. Filissa Caserta, MSN ’03, CRNP-AC, CNRN, senior nurse practitioner, had to explain the injury to his wife of sixty years and ask about his end-of-life wishes. “As sad as it was, by the end of that meeting the wife was smiling, the daughter was smiling, and they were even laughing as they shared memories,” Caserta says.
Hopkins nurse practitioners who work in Intensive Care Units (ICU) across specialties say that comforting and educating patients’ families is one of the most rewarding aspects of their work, which can be intense. A typical twelve- to fourteen-hour shift involves assessing and developing plans with multi-disciplinary teams for up to eight critical care patients during rounds. Not only does the nurse practitioner develop the plan, he or she then carries out specific parts of the plan including performing invasive procedures such as inserting central and arterial lines, ordering treatments and medications, coordinating care with other medical specialists and consultants, and adjusting the plans when needed. He or she also must quickly assess the status of new patients who arrive.
“There can be multiple patients having multiple issues at once, and you really need to prioritize to help very quickly,” says Tammy Slater, DNP ’11, ACNP, lead nurse practitioner for the Cardiac Surgery Intensive Care Unit. “The nursing staff is also looking to you as the expert. You’re making the assessments and you’re making decisions. You may not always have the answers, but you need to find out how to get them.”
“You have to be very level-headed and think on your feet when a patient is coding and crashing,” says Cathy Barenski, MSN ’03, BS ’98, ACNP, lead nurse practitioner in the Weinberg Intensive Care Unit. But in the end, “you’re working with patients and family members during one of the most difficult times they’ll ever face. Being there to support them is a privilege.”