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'Always pushing yourself' - life on the cutting-edge of critical care

A critical nurse talks about working on the frontl
Photo: 'Always pushing yourself' - life on the cutting-edge of critical care
For Will Jones*, trying to decide which nursing area to specialise in was no easy task – until he realised he could experience them all as a critical care nurse. From neurology, cardiology to emergency caesareans, he says the autonomy and adrenaline of the field has kept him there for 35 years.

“As a critical care nurse, you get to do a lot more than you do in other parts of nursing. You titrate the medications yourself, you do something and you see the physiology change immediately.”

“There's a lot more autonomy and you have to know a lot more, and I guess it’s a little bit more academic and physiology based", he told HealthTimes.

“In critical care, we’re at the forefront of changes - things change week by week and there's always new knowledge, new technology coming through. And we get to be on the cutting edge of that and you're always pushing yourself, which is lovely.”
Mr Jones says there’s one moment in his career in critical care that he often reflects on.

“There was one day in 2009, just after the swine flu came here and had swept right across the country.”

“It wasn't in the papers as much, but that was a terribly busy time – in NSW, for example, we had to find an extra 115 beds and it just didn't make the news.”

“I remember there was a pregnant woman who came in one night looking quite sick.”

“When I came back in the morning, she was really struggling, struggling to be oxygenated. I was actually supposed to work at the university that day and they called me to come in because I was quite knowledgeable about the ventilators.”

“So I came in and a whole team of us had to rush this mother into surgery and it was an emergency caesarean for the baby.”

“The teamwork and the urgency we all had to save the mother and her baby was incredible. I was right in the middle of that and people were asking me what to do, and that was exhilarating.”

“It was very intense and emotional because there was a baby and a mother involved - and the outcome was immediate and that was really rewarding.”

“That's when I thought ‘working in IT is fun, working in universities is fun, but this is something where we really make a difference’”.

Mr Jones said nursing had attracted him early on as a potential career.

“When I was about 17, I had to try and decide what to do with my life. Numbers or money didn't appeal to me. If I was going to spend that amount of time doing something it should be to help people and nursing seemed like a good job for that.”

“There was also the aspect of stability in terms of employment. In the 1970s, my father struggled for work and that always stuck with me.”

He said that initially, a permanent switch to critical care nursing wasn’t planned – but he had been feeling restless.

“I was working in children's nursing and I really liked that, but I felt a bit inadequate in my experience and that I needed to go and get more adult experience before I committed to that as a specialty.”

“And I wasn't sure what to do - respiratory or neuro - and then I noticed that with intensive care, you actually do everything like that. You work in the extremes of all those areas.”

“So, I went back to get a year's experience in critical care, and I just loved it and stayed there for the next 35 years.”

He says that while some of the challenges of critical care nursing can be applied to all forms of the profession, there are some unique difficulties – which are only beginning to be fully recognised

“There used to be this idea that if you're involved in stress and trauma on a day to day basis, then you don't need support because it's just part of your job.”

“They’d say that if a lay person comes across a massive accident, which is outside of their normal world, then they get extremely affected by it.”

“However , the research has been shown to be wrong. For nurses, it’s a  cumulative trauma that occurs and it's a compassionate trauma, where if you're constantly exposed to other people experiencing trauma then you take up a bit of that and then it builds up over the years, and this is under-recognized.”

“But I know about it now and I worry about the new nurses coming in because they're so excited to experience critical care nursing, but don't realise the cumulative effect of being exposed to this kind of stress.”

“There's really not a lot being done about it because this idea is really new and people are just starting to identify it now as we all start to talk more about wellness.

“Right now, though, there's nothing that’s really tangible.”

He said that a starting point would be to increase awareness among new nurses.

“I think during nurses' induction into the areas, there should be a component to this –  just letting people know that this is a real phenomenon to be aware of”, he said.

“I don't know the exact answer from there. I would think there could be some ongoing access to a clinical psychologist to perhaps provide strategies early on about how to deal with this.”

*name changed to protect the privacy of the nurse

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Charlotte Mitchell

Charlotte is a published journalist and editor, with 10 years of experience in developing high-quality content for national and international publications.

With an academic background in both science and communications, she specialises in medical and science writing. Charlotte is passionate about creating engaging, evidence-based content that equips the community with important information on issues around healthcare, medicine and research.

Over the years, she has partnered with organisations including the Medical Journal of Australia, Cancer Council NSW, Bupa, the Australasian Medical Publishing Company, Dementia Australia, MDA National, pharmaceutical companies, and state and federal government agencies, to produce high-impact news and clinical content  for different audiences.