Critical Care Nursing: Interview with Deborah Michiko Fried, RN

My Specialty

Critical Care Nursing: Interview with Deborah Michiko Fried, RN

By Working Nurse
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WORKING NURSE: What is your nursing specialty and where do you work?

DEBORAH MICHIKO FRIED, RN: I work in the general ICU at Glendale Adventist Medical Center (GAMC), and occasionally float to the SICU (surgical ICU) and CCU (cardiac critical unit). I consider critical care my specialty.

Tell us about your career path and how you chose that specialty.
I have been interested in the healthcare profession since childhood, but for many personal reasons received my bachelor’s degree in English literature and became a high school English teacher. I always planned to return to school someday and pursue a career in nursing. The opportunity arose a few years ago, and I was finally able to achieve my goal.

What special training did your specialty require?
Through GAMC, I was given an orientation with experienced ICU RN preceptors, during which they assessed my capability to perform in this environment. I also attended critical care classes taught by the GAMC nursing educator and was required to pass a final examination. I passed exams in Advanced Cardiovascular Life Support (ACLS) and fundamental electrocardiogram interpretation.

What is a typical day?
The only “typical” thing about each shift is that each one is unique and never predictable! ICU nurses have a maximum of two patients, but transfers and admissions happen frequently, so the patients with whom I begin a shift may not be the patients with whom I end one. Each patient requires a thorough assessment at the beginning of each shift, but assessments are always continual. Due to the instability of many of our patients, status can change from one moment to the next and interventions are adjusted accordingly.

Documentation is complex, and requires diligent and thorough attention to detail. ICU nurses provide complete care, so bed baths and linen changes occur regularly, because many of our patients are incontinent; have limited mobility; or are obtunded, stuporous or sedated because they’re on ventilators and “fight” the machine. Patients who are alert and oriented often require a great deal of emotional support, so frequent interaction and reassurance must be provided. Medication lists are usually long, and change with changes in patient status. We interact a great deal with family. We must help patients and family members cope with death more often here than on other units.

What are your favorite aspects of the job?
My favorite aspect of nursing is, without question or hesitation, direct patient care in all its forms.

Least favorite?
My least favorite task is sitting at a computer making certain I’ve documented everything completely and accurately. It takes me away from the bedside!

What are some aspects of your specialty that make it unique compared to other specialties?
Since I am newer to this profession than many of the nurses reading this magazine, I am not as familiar with other specialties and consequently do not feel qualified to make comparisons. I feel comfortable saying that I chose to work in the ICU because I have a focused interest in pathophysiology and its associated medical conditions and treatments. I also have a desire to assist patients in critical situations toward optimizing their health, at least to make end-of-life a gentler process for all involved.

In your opinion, what personality type is best suited toward this specialty?
One must be open-minded, nonjudgmental and have deep reserves of compassion and patience. An ethic of hard work and integrity is absolutely is necessary, as is humility. I work to develop these characteristics constantly. “Type A personality with a big, honest heart” could possibly sum it up.

What is it that attracted you to nursing in the first place?
Since childhood, I’ve been fascinated by the human body: How does it work? Why does it break down? How does it recover? As I’ve grown older (I’m 44 now), I’ve also developed an interest in how the physical condition affects the emotional and psychological condition. I've come to understand how they are inextricably intertwined, thus leading me to place emphasis on treating patients holistically.

What advice would you give to a nurse looking to enter your field of nursing?
Please be honest about your motivation for going into nursing. In order to provide excellent care and to find satisfaction in your profession, you must truly care about the patient and be willing to perform all the duties responsibly. That is not to say that one may never feel dissatisfied, or that there cannot be aspects you dislike. However, overall one must be able to see each patient as a unique and beautiful individual in need of care and kindness. The knowledge and skills can be learned and developed, but the perspective must come from within.


Critical Care Nurse (journal)

Critical Care Nursing Quarterly

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