Then vs. Now in the ICU: Seasoned ICU Staff Share Insights into Changes Over the Decades

About the Guests
Michael, NP -cardiac ICU nurse practitioner whose career spans nearly four decades in cardiac critical care. Beginning as a bedside nurse in 1988 and later returning as an advanced practice provider, he brings a rare longitudinal perspective on how ICU medicine (and teamwork) has evolved over time.
Ava - cardiac ICU nurse with nearly 20 years of experience and a deep commitment to patient-centered care and mentorship. Known for her bedside leadership and calm presence in high-acuity moments, she shares how personal experience as a pediatric patient shaped her lifelong dedication to nursing.

Key Takeaways
- Technology has transformed ICU care—but strong relationships and communication remain the foundation of safe practice.
- Earlier ICU environments relied heavily on face-to-face collaboration, cross-unit teamwork, and creative problem-solving with fewer in-house resources.
- Understanding **physiology—not just protocols—**is one of the most important skills clinicians can develop.
- Senior nurses and team members play a critical role in shaping the confidence and competence of the next generation.
- Long careers in healthcare are sustained not by recognition or metrics—but by the meaning found in helping people on their hardest days.


Timestamps
03:30 – Why this conversation matters: how healthcare has changed over time
11:15 – The legendary “toilet paper memo” story
14:30 – Communication before electronic charting
23:15 – The culture (and myths) of cardiac ICU teams
33:00 – Learning to listen across the interprofessional team
38:00 – Why they stayed in healthcare for decades
41:15 – A childhood patient experience that inspired a nursing career
51:00 – Advice for younger clinicians entering the ICU
57:30 – Night shift stories and unit camaraderie
1:01:00 – If we had a magic wand: what we would change about healthcare systems today