Move from Medsurg to ICU?

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I am thinking about moving from medsurg to ICU after 9 months of a small, slow night shift women's care medsurg, and one year of a slamming, stuff them in, shot out of a rocket every day progressive care medsurg unit.

I took courses introducing PCU nurses to ICU material to further education for step downs. The material made me thirsty for new things. And then a more experienced charge nurse told me the other day that my reports are so detailed yet focused, it makes it easy for people to know exactly how to care for a patient. I told her I wasn't sure I was ready, but she said she thought I was. I like the idea of cardiovascular or trauma ICU.

So I have two questions: what makes someone ready? And other than the obvious, what differentiates trauma and cardiovascular ICU populations?

Specializes in Critical Care, Capacity/Bed Management.

The only person who truly knows if they are ready to move on to a different specialty is yourself.

Trauma ICU is exactly what it sounds like, trauma. MVA's, falls, GSW's, etc. These patients are usually young and healthy and had a bad accident.

CCU/CTICU/CVICU is all things cardiac related, here you get STEMI's, NSTEMI's, CHF, balloon pumps, LVAD's, CABG, these patients are usually chronically sick and had some sort of exacerbation.

The only person who truly knows if they are ready to move on to a different specialty is yourself.

Trauma ICU is exactly what it sounds like, trauma. MVA's, falls, GSW's, etc. These patients are usually young and healthy and had a bad accident.

CCU/CTICU/CVICU is all things cardiac related, here you get STEMI's, NSTEMI's, CHF, balloon pumps, LVAD's, CABG, these patients are usually chronically sick and had some sort of exacerbation.

Agree with the second paragraph, although its important to note that CCUs are medical units and CVICU/CTICU/CSICU are surgical units. You can get some very sick patients on CCU but the acuity is much more variable than in a cardiac surgery unit where people are very acute, at least in the initial post-op period (if not longer, in which case they get dumped on cardiac medicine - CCU).

What makes someone ready this is YOU. YOU are ready to go for it. You have taken it on yourself prepare for this. :up:

Trauma and cardiovascular ICU patients are not comparable. Choose where you want to go. You've got this.

Best of luck, let us know how it's going.

Specializes in Med-Tele; ED; ICU.

What makes somebody ready is primarily attitude.

Don't think for a second that trauma patients don't end up in cardiothoracic nor that cardiac patients don't end up in trauma. When they're in the ED and need to be in the unit, they go to an open ICU bed, even if it's not the specialty unit.

Don't think for a second that trauma patients don't end up in cardiothoracic nor that cardiac patients don't end up in trauma. When they're in the ED and need to be in the unit, they go to an open ICU bed, even if it's not the specialty unit.

In well-run hospitals, they don't.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Moved to the Critical Care Nursing forum for more feedback.

Specializes in Med-Tele; ED; ICU.
In well-run hospitals, they don't.
Perhaps in hospitals with excess capacity. How do these well-run hospitals cope with incoming patients if they're already at capacity in the specialty unit?
Perhaps in hospitals with excess capacity. How do these well-run hospitals cope with incoming patients if they're already at capacity in the specialty unit?

They move patients that are lower acuity and/or have more general ICU needs to off-service ICUs to admit the more critical patients to the specialty ICU.

Specializes in Cardiac/Transplant ICU, Critical Care.

The biggest indicators that a person is ready for The Units is A) They are hungry to learn more and want to continue to challenge themselves and grow B) They have shown they can very competently care for their floor/step-down patients C) Their experienced coworkers feel that they are ready. I don't know about you, but it seems to me that you have achieved all three! :yes:

Trauma ICU populations include MVAs, GSWs, falls, crushing injuries, broken bones etc. It is very focused and more often than not their problem lists are very low. Cardiac is broken up into Coronary Care Unit (medicine) and Cardiac Surgery (Surgical). These patients can be vastly different. CCU takes care of but is not limited to MIs, CHF, Cardiogenic shock, and other kinds of heart failure.

Cardiac surgery will take care of but is not limited to Open heart surgery CABG, MVR, TVR, Maze, Type A dissections, Congenital heart defects, and where it really gets exciting is when you get into LVADs, IABPs, Impella, ECMO, Tandems and open chests and many times a mix of those devices. These patients can be extremely complex and will have to take into account many different things when managing the patient. My CTICU (Cardiac/Transplant) can take any other patient from the other ICUs but not vice versa.

It really just depends on how intense you want to go and what tickles your fancy! Let us know how it goes

The biggest indicators that a person is ready for The Units is A) They are hungry to learn more and want to continue to challenge themselves and grow B) They have shown they can very competently care for their floor/step-down patients C) Their experienced coworkers feel that they are ready. I don't know about you, but it seems to me that you have achieved all three! :yes:

Trauma ICU populations include MVAs, GSWs, falls, crushing injuries, broken bones etc. It is very focused and more often than not their problem lists are very low. Cardiac is broken up into Coronary Care Unit (medicine) and Cardiac Surgery (Surgical). These patients can be vastly different. CCU takes care of but is not limited to MIs, CHF, Cardiogenic shock, and other kinds of heart failure.

Cardiac surgery will take care of but is not limited to Open heart surgery CABG, MVR, TVR, Maze, Type A dissections, Congenital heart defects, and where it really gets exciting is when you get into LVADs, IABPs, Impella, ECMO, Tandems and open chests and many times a mix of those devices. These patients can be extremely complex and will have to take into account many different things when managing the patient. My CTICU (Cardiac/Transplant) can take any other patient from the other ICUs but not vice versa.

It really just depends on how intense you want to go and what tickles your fancy! Let us know how it goes

Your ICU can take other ICU patients primarily because nurses in other ICUs are not given competency on CVICU devices not because CVICU is some special snowflake unit.

Specializes in Cardiac/Transplant ICU, Critical Care.
Your ICU can take other ICU patients primarily because nurses in other ICUs are not given competency on CVICU devices not because CVICU is some special snowflake unit.

Actually, because we have advanced competencies and can take every other ICU patient from MICU, SICU, CCU, and NICU, that does make us a specialized unit not necessarily a "special snowflake unit". When the other units are full, and we have beds open, we become the ICU dumping grounds and can take everything under the sun.

It's just like the CVT stepdown that I worked in before my CTICU switch. They could take every other floor patient in the hospital but not vice versa, so that makes it a specialized floor since they can take care of all floor patient populations competently.

Specialized training, in anything that you do in life, will challenge you, help you grow, and make you better. To say that it doesn't make you better is either ignorance, arrogance, or denial.

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