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Marcie Ludwig, RN[/caption] Marcie Ludwig, BSN, RN, CPEN, wouldn't say her career as a critical care nurse in the pediatric ICU is stress free, but she said she's developed skills that help her keep the focus on helping her patients. For more than a decade and a half, Ludwig has worked as a critical care nurse in pediatric care units, first in Las Vegas, and for the last decade, at Children's Hospital Colorado in Denver. Her time at Children's Hospital has included work in the cardiac ICU and the hospital's ED and Level 1 trauma center. For the last three years, Ludwig has complemented her bedside work with service to her nursing colleagues as a clinical nursing educator, helping new and experienced nurses transition to critical care. In this role, Ludwig helped develop an orientation program to assist dozens of healthcare professionals transition to work at the hospital's new South Campus, a freestanding community-based hospital south of Denver. For her efforts, Ludwig was chosen by American Sentinel University and the Colorado Hospital Association to receive the November 2015 Colorado Health Care Stars Award. Here Ludwig shares some tips to help other critical care nurses improve their practice.
Collaborate
Few can understand what a nurse experiences better than fellow nurses, Ludwig said. "Your nursing peers are most often your closest friends," she said. "They understand the intricacies of critical care nursing and the challenges it presents." To create the kind of environment nurses desire and need -- one in which patients, families, nurses and all healthcare professionals receive the support they deserve -- nurses need to collaborate. "Nurses make the biggest difference with their attention to detail, assessment skills and facilitating care coordination," Ludwig said.
Reach out
Today's nurses have many resources to help them succeed professionally and thrive personally, but they will find those resources far more readily if they ask for help. "I would have never made it through my career in critical care without the support of my peers," Ludwig said. She recommends nurses find a mentor and then mentor someone else. "Having a mentor to reach out to is essential," she said. "In turn, having the satisfaction of being a mentor to others also helps you cope with stressful situations." Nurses should also seek out training to develop stress-management skills, she said. At Children's Hospital Colorado, for instance, staff employ techniques developed by the HeartMath Institute, incorporating breathing exercises, positive thinking and mental imagery, to remain calm, coherent and focused in stressful situations and to avoid compassion fatigue. "[The HeartMath Institute offers] great tools to decrease stress in the moment and for the long term, as well," Ludwig said. "The most essential thing for me personally is my family and my faith. They both fill me up when I am drained."
Listen
A key to managing stressful environments is remaining keenly aware of the environment. In nursing, this could mean honing an awareness of deficits in the nursing unit and in patient care. To identify those deficits, active listening is essential, Ludwig said. "Although nursing is continuously evolving, nurses remain the subject matter experts," Ludwig said. "They continue to prevent patient harm by taking action on the near misses that they witness every day. This is done through active listening, connecting with patients and advocating for improvements in care delivery."
Speak up
Too often, nurses let complacency and pride interfere with the chance to improve the situations and environments in which they find themselves, according to Ludwig. "[Often, this can be remedied by] keeping the patient at the center of our focus," Ludwig said. To combat this tendency, Ludwig encouraged nurses to maintain "a personal drive to become the expert" in all they do. "Nursing is not just a job, but a profession," she said. "We must never stop learning, asking why or searching for best evidence-based practices." From there, she said critical care nurses, particularly, should constantly work to hone how they share and deliver what they have learned and to advocate for the implementation of those evidence-based practices to help patients. "Speaking your mind in a respectful, heartfelt way is an art developed over time," Ludwig said.
