D-H Nursing Blog

Why Critical Care is Essential with Jen Lyon, Associate Clinical Nurse Manager Medical ICU

Medical ICU

Jennifer Lyon, Dartmouth-Hitchcock’s Associate Clinical Nurse Manager for the Medical Critical Care Unit (MICU) is about to celebrate 10 years with us this spring. She has worked other places and she lives further away than your average nurse, but there are many reasons why she chose to join D-H and continues to stay with our team. 

The Reasons

Like we said, Jen commutes quite far to be a part of our team. She said, “I drive an hour and a half to get to D-H every day. It’s good because it gives me time to reflect and when I leave, I am able to remove myself from the environment and refresh. I drive past three different hospitals to get here and I choose to come here.” 

Jen made the choice to work for Dartmouth-Hitchcock mainly because of the opportunities it offered her initially and continues to provide for her career. She said, “There are many opportunities here. I came from a critical access hospital where there were traumas and we were always sending our patients to places like D-H. I wanted to take care of those patients rather than sending them out. The process of working here has provided me with so much more than I could’ve thought about when I was first applying. For instance, right after the earthquake in Haiti, I was part of a team that got sent there to take care of patients right in Port Au Prince. That would’ve never happened anywhere else! I’ve also been given the opportunity to go to conferences and give presentations talking about our ICU and I’ve been promoted to leadership. I never thought I wanted that, but now I realize that I can take care of patients while helping others learn how to do the same.”

The Past and Current Times in D-H Critical Care

At the heart of things, Jen is a puzzle-solver. And that’s a great thing because her daily work and the work her team does every day requires her to find solutions that are less than obvious.

It should be noted that the original critical care experience at D-H was entirely different than the current state of affairs. “When I first started at D-H, we were one large mixed ICU that cared for medical, surgical, neuro, and trauma patients. That was the initial draw, but then about 4 years ago we added on an additional 14 beds to critical care and at that point, we started to split them because of the staffing needs. Some had previous experience that was specific to trauma surgery and the medical patients had their own intricacies to them. 

Patients that are medically ill can actually be more complex because of hidden comorbidities versus a person in surgery that comes in with a clear pathway or a trauma patient. Our patients in the MICU can present with one illness, but may have six others contributing to that since they haven’t seen by a primary care doctor in years,” said Jen.

What the Team is Like

The D-H MICU team is a multi-disciplinary group. They have team members who are secretaries, support techs for logistics, LNAs to help turn and mobilize patients, nursing staff and specialty-trained nurses for therapies like Continuous Renal Replacement Therapy (CRRT). There is also a resource nurse who is there to help the nursing staff as a second set of hands or step in to alleviate stress on nurses so that they can continue to give quality care. There is a charge nurse who is typically running the unit flow. There are two teams assigned to the unit; one of NPs and PAs, and another with interns, students, and residents, both over seen by a fellow and attending. It’s a small group of attendings so it’s a close-knit group who all know each other’s skills sets and ways they like to work which keeps things moving fluidly.

Jen noted, “I’m drawn to D-H’s critical care in general. The team approach and atmosphere on the unit is strong. The staff work well with physicians and each other and we have a lot of resources here that you don’t see in other institutions.”

She went on to say that prospective MICU nurses looking to join her team should consider their situational, and emotional awareness. “You need to learn what the environment really means so that you will know how it will affect you. It’s high stress and there is a lot of mortality, not from lack of care, but due to the many comorbidities or different patient wishes. The work can really affect you in the long-term. You have to be the type of person who can learn from it and not let it take you down. If you can do that, it can teach you,” said Jen. Essentially, Jen recommends a strategy of taking experiences and transforming them into actionable results. 

Nurses who join Jen’s unit have to be self-directed and calm. “The #1 quality I want to see in a nurse is that they are self-driven. They need to be constantly looking for opportunities to continue learning and to provide the best care to the patients. Our unit in particular is a constantly evolving environment. If you want your job to be the same forever, that is not realistic on this unit. We will teach you what you need to know, but you have to want to learn and you must be able to remain calm throughout,” said Jen.

Nurses who are currently working in other specialties and want to transition to MICU are welcome on Jen’s unit! She said, “Reach out to leadership and shadow in the environment to find out if you’re truly interested. Thinking about and actually being in critical care is totally different. I’m always happy to have med-surg nurses come shadow even just to understand the environment to see what others are dealing with.”


Jen’s unit is often times a launching pad for a lifetime in medicine because the area of expertise is filled with opportunities for everything for all kinds of nurses. She said, “you can do a little bit of a lot! Surgical procedures and therapies at bedside and so much more!”

One of the biggest advantages to practicing critical care medicine is that it gives you critical thinking and time management skills. Jen said, “You could apply those skills to anywhere else you want to go. We see the sickest patients in the hospital and help them get better. In doing so, it prepares you for other specialties…becoming a CRNA or NP, flying on our helicopter…it’s critical that you have this experience. We are truly a career ladder-oriented department. I would love for people to come and stay here long-term, but that’s not realistic.”

Time Outside of Work 

When she isn’t working, Jen is either with her family or working on her career in another way! She said, “My family and I have a camp and we spend time there and outdoors. Right now I’m working on my Masters, so I don’t have a lot of time actually.”


Clearly, Jen is a bright star in the nursing world. We are so grateful that she spends her time with us. 

Want to join her team? 

Contact a Nurse Recruiter for MICU!

By Miriam A. Benson | November 14th, 2018 | Categories: Insider, nursing careers, nurse managers, MICU

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