Considering ICU/CCu

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    Hi .I have been on a cardiac stepdown unit for a few years. I need a change- would really like to get out of nursing period, but that isn't going to happen soon,so I am stuck.

    Where I work, the micu/ccu seems to have high turnovers. I also work with a gal who actually came to pcu from icu- she said she hated it.

    I think I do better with more complicated/less patients, especially since sometimes we have to hang onto icu transfers due to no beds.

    What's holding me back is that I hate codes. I do wonder if it's because I just really don't have enough experience with them. I am not an adrenalin junkie-quite the opposite. I do realize that some pts are futile cares,but family wants all things done. I am not judgemental in that sense; it just makes me sad sometimes too see the patient's that way when they are close to death.

    I do have attention to detail- I try to catch things with my own patient's when I see that they may be heading south.

    So , do I sound like a candidate for ICU? Funny ,it fascinated me in NS, but now scares me , which is why I never actually have transferred.

    Any input? thanks
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  3. 10 Comments so far...

  4. 1
    Codes in the ICU are different than on the floor. You've got the equipment and drugs practically right at your finger tips, and if you're not an adrenaline junky, chances that the person working next to you is! If it's your patient, once you get the code started, then you just stand back and let them at it. You talk to the docs, the pharmacist, the family. Let the other nurses do the heavy work. If it's not your patient, then jump in. Push some drugs, run the defib. Learn by doing.

    What's fun about the ICU is that you'll know your patient inside and out, every little detail, because you actually have time to do so.

    Give it a try. What have you got to loose?
    jrwest likes this.
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    Another thing is codes don't happen as much as people think. The number of ICU codes is nothing compared to the number in the ED. Sometimes, we will have 3 codes in a day or 3 codes in a 6 month period. In ICU, you hopefully get to intervene before a code happens. Many codes are an airway or resp issues, and in the ICU, we can quickly intubate someone before things go bad. Codes on the floor are mainly either v-vib or PEA and one of the main sources of PEA in the hospital is hypoxia related. You will get your share codes in the ICU and you will become more comfortable as time goes on. Codes actually run very smooth in the unit.

    Unrealistic family members...it's sad. There's nothing that can really change that.
    jrwest likes this.
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    Talk to the nurse manager in the icu and let them know you are interested. Try and see if you can set up a shadow experience with an experienced nurse if you're hesitant to transfer.

    You sound like you would be a good fit and it's normal to be nervous of codes. In the icu everyone is acls so codes run smoothly and everyone falls into their role with ease.
    jrwest likes this.
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    You said "would really like to get out of nursing period, but that isn't going to happen soon,so I am stuck". Why would you then consider working in a unit where, at least in my experience, the nurses who do work there are committed to their patients, and they are not afraid of challenges. Just because you may have one or two patients does not mean its easy, it takes experience, commitment, and a strong nurse to be able to apply critical thinking in an ICU. In my opinion, its not just a place to pass the time until you find your calling. The learning curve of switching from a step down unit to an ICU will take some time as well. If it were me in your position, I would not inflict my dissatisfaction with the nursing profession on critically ill patients who are counting on you for quality care.
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    I think changing areas can have a large impact on whether someone loves or hates nursing. I think most nurses are afraid of codes due to the lack of knowledge and exposure. while codes probably happen with an increased frequency they aren't as frequent as people think. while I respect floor nurses immensely ...I am NOT a floor nurse. I would rather triage a bus load of elderly leaf peepers on a field trip then work the floor. I admire floor nurses......They have a difficult job..... the shear volume of patients and no time to really be a nurse, chasing your tail all day...so frustrating....it is not my thing. I'd rather be a bartender and at least receive tips!

    I've worked cardiac step down and that is another tough area starting with 4-6 patients, transferring 4 of them to get 4 more. I learned alot but had to move on.

    I say try the ICU ...you'll learn about codes but for me...the total care of the head to toe patient and the pathophysiology was my thing....Good luck!
    celclt and jrwest like this.
  9. 1
    Quote from MBunny
    You said "would really like to get out of nursing period, but that isn't going to happen soon,so I am stuck". Why would you then consider working in a unit where, at least in my experience, the nurses who do work there are committed to their patients, and they are not afraid of challenges. Just because you may have one or two patients does not mean its easy, it takes experience, commitment, and a strong nurse to be able to apply critical thinking in an ICU. In my opinion, its not just a place to pass the time until you find your calling. The learning curve of switching from a step down unit to an ICU will take some time as well. If it were me in your position, I would not inflict my dissatisfaction with the nursing profession on critically ill patients who are counting on you for quality care.
    Don't get me wrong- I do care for my pts- it's my downfall. In my efforts to be on top of things( ie. pts heading south) and too much attention to detail, I suppose, that this is what is most frustrating about the job. For example, I had a very nice elderly pt who, come to find out , has RSV. I believe I spent 80 % of my shift in his room, or eyeballing him, etc. because I knew he could turn in an instant( he was full code, wanted everything). When I left, he was stable.I know some of my co- workers don't do this.They sit on their butts unless someone actually puts on a call light. This guy was ill, and didnt want to bother anyone- by the the time he says anything might be too late to do anything about it. The frustrating part is the other 4-5 pts I have won't be seeing me too much, and then we ( or I ) get dinged on our scores.It's the customer service thing that makes me want to change professions.That's another rant addressed profusely in other areas of the forum.

    And where I am , they don't take acuity into account- you should have heard the night nurse I gave report to last night night- she was so angry at me for not complaining about that assignment( which she was getting) I know better- it doesn't do any good to complain. This is why I get so conflicted. I feel bad for the guy; they are angry they can't surf the net and eat all night( I've worked nights with them- that IS what they do sometimes)

    I am serious about my job- I just want to be able to do it right, but the Studor Joke crap is what will have me leave eventually- I can't do my job right with all that horse bleep that takes me away from doing my job right.

    Maybe, as I realize what I am writing, is the fact that there is NO teamwork anymore where I am, and everyone is stressed out ( at least the day/eve people)
    JetBlitz likes this.
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    If codes are the reason the move is holding you back, I wouldn't worry about to much. In my experience you can be as involved or un-involved in a code as you please. Most of the time we have a ton of people respond regardless of what side of the unit the code is taking place. If it's actually your pt coding, your main job most of the time is to give the history to the responding physician and recording what is actually happening. Other team-mates will be handling the drugs, compressions, monitors etc....so don't let codes hold you back.
    JetBlitz and jrwest like this.
  11. 0
    Thanks for all the inputs. Gave this some more thought.Maybe it wouldn't be such a good idea to move to icu. I understand ours has a very high turnover and is hard to staff. I'm sure there is a reason for this

    I guess I will continue to evaluate other options, despite not seeing any other options at this time.
  12. 0
    Have you considered med/surg floors? I know you hate codes but the stat team can always help with the code and you can call rapid response before you sense a code is going to happen.


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