Interview Summary
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Christopher Carlstrom is a registered nurse who has worked in a broad range of medical settings, including the adult ICU, the pediatric ICU, the ER, and flight nursing.
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Christopher explains that nursing is a very holistic practice as it looks at every need a patient has in order for them to achieve well-being. While a doctor typically looks at identifying and treating medical conditions, nurses aim to see the patient as a whole by considering their physical, emotional, and spiritual needs.
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To become a registered nurse, you can either get an associate’s degree (two years), a bachelor’s degree (four years), or a master’s degree (six years). After graduating, you must pass the NCLEX exam to become licensed to practice medicine.
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Christopher emphasized that nursing gives him a lot of flexibility in terms of his work-life balance. Most of his jobs involve 12-hour shifts, which means that he typically works three days a week. Because of how his shifts are organized, Christopher sometimes has up to a week off of work without needing to use vacation time. However, he sometimes needs to work nights and weekends, which can be challenging.
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With there being so many specialties within healthcare, Christopher recommends that students interested in medicine explore all of their options. He also emphasizes the importance of building connections with healthcare workers, shadowing, and working hard in school.
Registered Nurse Interview With Christopher Carlstrom
What does a day in your life as a registered nurse look like?
I’ve worked a few different jobs as a nurse, and each job is a little bit different. I’ll go in order of how I worked the jobs.
Adult ICU:
The first job that I had as a nurse was in the adult ICU. In that setting, we mostly worked 12-hour shifts. My shifts would either be from 7 a.m. to 7 p.m. or from 7 p.m. to 7 a.m. Although these shifts are long, they help to minimize the number of times patients are handed off to a different nurse. This is important because transitions of care are the highest-risk time for mistakes to happen.
To start these shifts, I would look at the patient’s chart and use the system on the computers to see all of the information I needed to know about them. During this time, I would learn about what was wrong with the patient, why they were in the hospital, and what orders (such as medication or blood draw orders) were in for the patient. Afterwards, I would get a report from the nurse previously caring for the patient where they would summarize everything I needed to know about the patient in order to care for them. Typically, this is a general explanation of why the patient is in the hospital and a description of the assessments done on each category of the patient’s organ systems. This is definitely one of the busiest parts of the shift as you need to figure out exactly what is going on with the patient.
Throughout the course of the shift, everything else tends to be scheduled and routine. The idea is to be very proactive in the ICU. Every four hours, we would complete assessments on patients where we go head-to-toe and do a comprehensive look at all of the patient’s organ systems by checking neuro exams, lung sounds, etc. During this time, I would also be keeping up with all of the patient’s medications and completing any lab tests as needed.
Typically, I would see one or two patients during my shifts. If I had a really sick patient, then they would usually be the only patient for that shift. Otherwise, I would normally have two patients during my shift.
Emergency Department (ER):
The emergency department is much different than the ICU because you are seeing a much broader span of acuities. What I mean by acuity is how sick the patient is, and in the ER, I would see anything from the sickest patient all the way down to people who have the common cold.
Throughout the day, I would see patients as they came in and out, meaning that I was admitting and discharging a lot of patients. In the ER, you are really cycling through a lot of patients, and I would typically see anywhere from 10 to 30 patients in a day depending on how they were flowing through the ER. As a result, the ER is sometimes a faster-paced environment than the ICU depending on the amount of patients coming in.
In the ER, I was doing emergency-related interventions, which focused on making sure there were no life-threatening issues with the patient. However, there are many different settings that you can work in within the emergency department, with each one looking a little bit different. Sometimes nurses work in general rooms with the more basic patients who are less sick. However, nurses also work in the stabilization room, which is usually where the larger trauma cases are. In this setting, there are typically two nurses assigned to one patient, and the patient will oftentimes be suffering from something serious like severe trauma, cardiac arrest, a stroke, or a heart attack. Nurses can also work in triage, which is where they check patients in and complete their initial assessment.
Flight Nursing:
Flight nursing is very different from working hospital jobs because you are not constantly caring for a patient. It is like working at a firehouse where you work a 12-hour shift, but you are at an airport with the aircraft. We have a dispatch center that is responsible for taking emergency calls and determining which base is the closest to an emergency at which an aircraft is being requested. Essentially, I am waiting during my shift until an emergency happens and the dispatch center calls us on the radio.
Flight nursing is a role where you get to be more independent than if you were to work in a hospital. When we would fly out to emergencies, it would only be myself, the flight paramedic, and a pilot on board. After getting a call from the dispatch center, we would fly out to where the patient was, pick them up, and address all of the immediate life threats that we could during the transport to the hospital. The flights would usually be between 30 minutes to an hour. We would be with the patient the entire time before dropping them off at the hospital and giving the hospital staff a report on the patient.
Our crew was also responsible for everything at the base. This means that we would restock our aircraft after going on flights, clean the aircraft, and keep the base clean by sweeping the floors, cleaning the toilets, etc.
What does being a registered nurse mean to you?
The best way for me to describe nursing is by comparing it to other healthcare disciplines. I consider nursing to be a very holistic practice, meaning that it looks at all of the needs of a patient for them to achieve wellbeing. For example, a doctor might specifically be looking at diseases the patient has and trying to find treatments for those diseases. On the other hand, nurses tend to look at the patient as a whole as opposed to looking at a disease. This means that nurses evaluate the patient's ability to do all of the necessary activities in the course of a day, such as walking around, eating, and going to the bathroom. They also consider the emotional and spiritual aspects of the patient’s life. Being able to look at patients as a whole is one of the things that I really enjoy about nursing.
Nurses are also the providers that typically spend the most time with patients. For example, when I would work a shift at the hospital in the ICU setting, I would usually have the same patient for eight-to-twelve hours at a time. This allowed me to work closely with the patient whereas the doctors would be coming in and out.
Nursing is also a very broad profession. For example, there are nurses who work in hospice, aesthetics, clinical settings, and medical technology companies. Overall, there are a tremendous number of specialties and pathways you can pursue in a nursing career.
Can you tell us about yourself?
After I graduated from high school, I completed a three-month EMT course during the summer to become certified. That fall, I started my nursing program in college. During college, I worked as an EMT and graduated with my nursing degree.
Since graduating from college, I have worked in the adult ICU, the adult and pediatric emergency department, flight nursing, and most recently the pediatric ICU. I have also worked a couple of part-time jobs in addition to my full-time roles. For example, I have worked as an ECMO specialist, a ketamine infusion nurse at an integrative psychiatry clinic, and I’ve also worked as an EMS educator.
Full Q&A With Christopher Carlstrom
What is the career outlook for a registered nurse?
Currently, there is a high demand for nurses. Of course, certain factors can affect the need for nurses. For example, the COVID-19 pandemic created a lot of shifting in the workplace for nurses that resulted in a lot of open jobs. However, this has settled down and the job market is currently not as robust. The need for nurses also varies between different regions in the country and depends on what is happening in different communities.
Overall, the need for nurses fluctuates from year-to-year, but it is generally a profession where most people find work shortly after graduation. It is also a job that pays quite nicely.
When did you realize that you wanted to be a registered nurse?
I knew from a very young age that I wanted to go into medicine, but I had not figured out exactly what field in healthcare I wanted to pursue. I was primarily considering either going to medical school or nursing school. Because I did not want to spend eight years going to medical school, I decided to go to nursing school, which took four years. After graduating nursing school, I was able to work, earn some money, and enjoy my twenties without being in school the whole time.
As a nurse, I have a good work-life balance, which has given me the flexibility to be able to travel a lot and have more free time than people who work five days a week. Typically I only work three days a week, because I work 12 hours at a time. Also, because my shifts are clustered together multiple days in a row, I sometimes end up having an entire week off from work without needing to take vacation time. This is a unique aspect of my work-life balance as a registered nurse. However, I am sometimes required to work nights and weekends, which can be challenging.
How much education is required to become a registered nurse?
You can become eligible to take the RN licensing exam (NCLEX) after completing either an associate’s degree (two years), bachelor’s degree (four years), or master’s degree (six years). If you decide to get a master’s degree, you would typically earn a bachelor’s degree in some other discipline and then apply for a two year master’s program to learn all of the nursing skills. After you complete the required education and pass the NCLEX exam, you can practice medicine as a nurse.
There is no residency to become a registered nurse, and you can start practicing as soon as you earn your nursing license. In order to become trained to practice as a nurse, you will complete a series of clinicals during your schooling. This means that part of your coursework is to go into the hospital and work alongside a nurse to learn in a hands-on environment. Additionally, once you become licensed to practice as a nurse, the first job you work often has a fairly long training process where you will work alongside other nurses to learn the specifics of caring for patients in that environment.
What advice would you give to someone who is interested in the healthcare field and is trying to figure out what profession is best for them?
Explore all of your options. I think that most people are aware of doctors and nurses who work in healthcare, but there are so many other careers like medicine such as physical therapists, occupational therapists, radiology technicians, ultrasounds technicians, anesthesia technicians, etc. There are also so many different educational pathways that you can take to achieve a career in medicine. As a result, I think it is important to look broadly at everything that is an option to you.
I would also say that building connections with others is really valuable. A lot of people who work in healthcare are really passionate about building connections and enjoy talking to younger people who are interested in their profession. I would suggest that you have conversations with people you know and see if you can shadow them. It is important to start getting these experiences as early as possible to begin conceptualizing where your interest lies within healthcare.
My final suggestion would be to do well in your science classes and just work hard in general.
What is your favorite part of being a registered nurse?
My favorite job in my career so far has been flight nursing because it is very autonomous. Flight nursing is a unique role because there is no doctor that is giving you direct orders. Instead, there is a set of guidelines that essentially instructs you on how to manage various situations. As a flight nurse, you then get to independently decide which of those guidelines to utilize and what interventions to provide to the patient. This can be a little more stressful because you are responsible for everything related to the patient’s care. However, it is also extremely rewarding because I truly felt like I owned the work that I was doing to help the patient.
Oftentimes, I would be helping people in some of the scariest and worst moments of their lives. Being able to apply my skills to help and provide comfort to patients in these moments is amazing. It’s also a privilege to be invited into these people’s lives at such a sensitive time.
It is also fascinating to be able to fly around and see the world from that perspective.
What are the biggest challenges of being a registered nurse?
Being a registered nurse is definitely challenging. However, I would say that the level of difficulty also depends on what setting you work in. For example, working in a clinic might not be as emotionally challenging as working in an emergency department where you see difficult situations with patients who have been in bad accidents. Personally, working in critical care (the ICU and ER) can definitely be exhausting because of night shifts and the accumulated emotion that comes about with certain cases. The emotional toll that this can take on a nurse can be challenging at times. That is why it is really important to know how to care for yourself and process the emotions related to caring for these patients.
Being a healthcare worker is also a big responsibility. In modern medicine, there are very complex interventions that healthcare providers are responsible for monitoring and implementing, which can definitely produce stress. However, I think you can remain competent using complex skills as long as you continue to educate yourself and train at a high level.