Big decision: what unit to transfer from after ICU. Help!

  1. Hello!

    I will share a very summarized version of my experiences and hope to get opinions as soon as possible.

    I graduated May 2016 and began in an ICU at a level one trauma center. It was nearing end of my orientation (total: 4months) and I did not feel competent or comfortable in an ICU with only four months under my belt. I felt I was drowning each shift. I let management know and they were happy to transfer me to a different unit.

    I have been offered jobs on the step down unit to my ICU, as well as an advanced telemetry floor. I will share some info on each floor:

    -step down: Extubated (very rarely will get stable chronic vents), 1-2 pressors maximum, only sedation: Precedex; very rarely see a-lines, vcaths. A HUGE difference from the ICU. Nurses here say they never felt anything was over their head or assignment not manageable. 2-3 patients per shift. ICU nurses claim this is a glorified med surg floor because recently many privileges have been taken from step down.

    -Telemetry: 3-4 patient assignments. More advanced than a typical med surg/tele floor (conscious sedation, certain drips) and supposedly looking to soon become a cardiac step down. My experience here seemed extremely lax compared to my ICU shifts. Nurses there say that is typical for their shifts.

    My thoughts: I would rather step down because I am familiar with these type of patients. It seems that I would still have two patients but they are much less critical. I hope to one day get back to the ICU and do what I love. My only fear is that I realize these patients are still unstable and that I could fail again.
    I feel that telemetry would be good for time management, but not for learning. Patients here don't have many medical needs. I've noticed most busy shifts are caused by call bells to use the bathroom/food. I am more motivated to be a nurse for two unstable sick patients than four kind of sick cardiac patients. I should also note that I love learning about trauma/sepsis/medical ICU stuff and do not feel the same about cardiac. I feel this could be an easier floor to start on, but I feel I should be challenged for my first years of nursing.

    Please se share your own experiences and nursing wisdom. Thanks so much!
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  2. Poll: Medical step down or telemetry unit?

    • Step down unit

      50.00% 1
    • Telemetry

      50.00% 1
    2 Votes
  3. 6 Comments

  4. by   Lev <3
    I think that given than ICU was not a good fit, maybe telemetry would work out better for you at this point. I think you are too quick to say that telemetry won't be good "for learning." You are a new nurse so any floor will have lots to teach you. Tele back to ICU won't be an unmanageable transition.
  5. by   Ruby Vee
    I think either position would be a great learning experience and an easy transition back to ICU when you're ready. Something to think about: maybe that particular ICU wasn't a great fit for you. In larger urban hospitals, there can be as many as a dozen different ICUs. Each one has a different focus and a different culture. Maybe CCU or MICU would be a better fit for you than a SICU.

    As a new nurse, you have SO much to learn. I started out in telemetry and it provided a very good foundation for me when I transferred to CCU/MICU.

    Pick the position that feels like the better "fit" for you at this time. You're looking for supportive colleagues, a good orientation and a manager who has your back.
  6. by   CCRN_CSC_0710
    I'm not sure that telemetry would be bad for learning. I started on tele and learned a TON then went to the ICU, where I was comfortable after a 12 week orientation. I can't say which would be better but you will learn a lot on tele. If you do go to the tele unit PLEASE lose the "not good for learning" attitude. That's a dangerous attitude for any unit and disrespectful to those nurses.
  7. by   futureNPmomof2
    You will learn no matter what floor/job you take. You just graduated this year. I went to a rural hospital straight out of nursing school and was thrown all over the place. BEST experience ever. I learned a lot about everything and it helped me become more well rounded. Don't discount an experience because you already have a pre-existing bias.

    My advice is to shadow each department and pick the one with the best management, support and team camaraderie. That will make or break your experiences and development.
  8. by   BSN1234
    Thanks for your input!!!
  9. by   BSN1234
    Quote from Lev <3
    I think that given than ICU was not a good fit, maybe telemetry would work out better for you at this point. I think you are too quick to say that telemetry won't be good "for learning." You are a new nurse so any floor will have lots to teach you. Tele back to ICU won't be an unmanageable transition.
    Thanks for sharing Maybe one day I'll be back

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