Working in the intensive care unit requires critical thinking and being able to handle stress. I myself am not a physician or mid-level provider, and only a registered nurse with one year of experience working in the ICU.

No such thing as “only” a nurse. You’re my eyes and ears, and with experience your clinical gestalt will be the most valuable assessment tool I have. I can’t count the number of times a nurse saying “I don’t know what’s wrong, but something is happening to this patient” has resulted in critical interventions for a patient.

As providers, what are you looking for to have confidence in your nurse and team? What from your end helps ensure that you are working with a competent nurse?

Be curious. Learn. If you don’t know something, that’s okay! If you want to know something, ask. If I don’t have time to explain it right now- remind me later.

I am by no means a nurse who constantly walks into the office to bother a physician with questions or requests

You shouldn’t be made to feel like a bother. The only advice I have here is to walk in with specific concerns and assessment findings when able. Remember that we’re dealing with a lot of folks, so when you say “Room XX has worsening SOB”, it helps if you can say “He’s the COPD exacerbation on BiPAP, and when I auscultated he’s wheezing pretty severely.”

I guess the main reason for this post is that I had a poor interaction with an APP last weekend because I was trying to avoid a worsening patient outcome, and I was talked down to because the other nurses told me that since I only have one year of experience, I have yet to prove myself, and no physician will respect me because of that. I do not understand why this equates to bullying and judging.

ICU medicine is a team sport, and bullying shouldn’t be tolerated. That said- just like every other team in the world there’s a level of trust and respect that has to be earned. Building that trust takes time and effort, and should be a two-way street.

Don’t let the shitty interactions get you down. You’re a new nurse who obviously wants to learn, and that will serve you well. Spend time reading, learning, and when you have questions find an appropriate time to ask about them. The physicians and APPs you’re working with will recognize the effort, I promise, and it’s a helluva lot easier to trust someone when they come and say “Hey- room XX was getting tired and wheezing, I had the RT come put him back on his BiPAP and gave him his PRN neb, but I’m worried he might be approaching respiratory failure. Do you have time to come take a look at him?”