Why do Critical Care nurses look down their noses at Med-Surg nurses? - page 3

I'm a med-surg nurse and proud to be one. I routinely care for 5-7 patients on day shift, who present with a variety of complex, acute conditions. Whenever I transfer a patient to a critical care... Read More

  1. Visit  EtherFever profile page
    6
    Craymond +1.

    As an icu nurse, and a former stepdown nurse, I will say that floor nursing is not easy. But it's on a whole different level of hard when compared to "hard" in the icu. In the ICU, the bar is set high as far as nursing expectations, critical thinking, & pathophysiology, and any momentary lapse has grave consequences. I felt like a hard day on stepdown was related more to difficulty with multiple tasks and completing them... honestly some days I felt like a glorified waiter. Nowadays, I feel like a hard day in the ICU is both physically and mentally draining, as there is no time for a "mental break," and you are constantly problem solving and trying to stay 2 steps ahead.

    I know that many of the floor nurses where I work do look at ICU nurses as snobby, standoffish, elitist, & aggressive. However, just know, most of the time it's nothing personal. I think part of the aggressive attitude has to do with the type of personality needed in the ICU. Additionally, 99% of the time, ICU nurses are under crazy time constraints, especially when it comes to transferring patients out to admit crashing or fresh post-op patients. That's why we always seem in a rush & why we are ancy to get to the nitty gritty.. again nothing personal, but just a little insight from someone who's been on both sides.
    lidleanjel, nurseguyjosh, Stalirris, and 3 others like this.
  2. Visit  maryray profile page
    1
    Quote from EtherFever
    Craymond +1.

    As an icu nurse, and a former stepdown nurse, I will say that floor nursing is not easy. But it's on a whole different level of hard when compared to "hard" in the icu. In the ICU, the bar is set high as far as nursing expectations, critical thinking, & pathophysiology, and any momentary lapse has grave consequences. I felt like a hard day on stepdown was related more to difficulty with multiple tasks and completing them... honestly some days I felt like a glorified waiter. Nowadays, I feel like a hard day in the ICU is both physically and mentally draining, as there is no time for a "mental break," and you are constantly problem solving and trying to stay 2 steps ahead.

    I know that many of the floor nurses where I work do look at ICU nurses as snobby, standoffish, elitist, & aggressive. However, just know, most of the time it's nothing personal. I think part of the aggressive attitude has to do with the type of personality needed in the ICU. Additionally, 99% of the time, ICU nurses are under crazy time constraints, especially when it comes to transferring patients out to admit crashing or fresh post-op patients. That's why we always seem in a rush & why we are ancy to get to the nitty gritty.. again nothing personal, but just a little insight from someone who's been on both sides.
    This describes ICU nurses as loosing the ability to converse tactfully. You indirectly described floor nurses as glorified waiters. Medical floor nurses where I work routinely get unstable patients. Otherwise they would be discharged and get outpatient treatment.
    littlepeopleRNICU likes this.
  3. Visit  DoeRN profile page
    3
    The funny thing is from my experience floor nurses and ICU nurses are paid the same rate.

    We all went to nursing school and learned the same thing. Some choose to take additional training in order to specialize. It doesn't matter if you work in the ICU, floor or clinic we are there to do one thing. Take care of the patients. And yes, I have worked in the ICU and the floors.
  4. Visit  EtherFever profile page
    5
    Quote from maryray
    This describes ICU nurses as loosing the ability to converse tactfully. You indirectly described floor nurses as glorified waiters. Medical floor nurses where I work routinely get unstable patients. Otherwise they would be discharged and get outpatient treatment.
    I'm not looking down at floor nurses, nor am I calling them glorified waiters. I'm simply making a comparision that some days as a floor nurse, I felt like one ex. having a busy day r/t to the multitude of small and insignificant things that patients ask for. And I'm not saying its always like that. I do respect floor nurses, as they have to catch small details that hint at a patient about to go downhill, with less concrete numbers available compared to the ICU. Floor nursing is difficult, but in ways that differ than in the ICU.

    ICU nurses where I work are usually very aggressive in advocating for patients, are aggressive in getting things done in fast but in a safe and correct way. We do this to stay 2 steps ahead in case something unexpected happens. Sometimes this personality can come across when giving or getting report from floor nurses, hence the idea that ICU nurses look down on floor nurses. Some strongly opinionated ICU nurses that I know don't care what other nurses think of them, so this can come off as standoffish. I personally do not look down on floor nurses, nor do I think I am better than floor nurses. I'm just offerring some perspective as to the reasons why some of us are the way we are.

    Since I do have floor nursing exp, I try to apply that to my practice i.e. changing dsg in the am so they don't have to do them, getting an extra walk in with my pt so it's one less they have to do on the floor, etc. I am more patient when giving or receiving report, because I do remember how it was on the floor. And I try to help other nurses on my unit, specifically the newer orientees, in understanding floor nursing, and in trying to dispel this attitude that ICU nurses are superior to floor nurses. So I hope this clarifies my previous post, in that I do not support the idea of ICU v. Floor nurse, I'm merely stating the reasons why it exists.

    ICU & floor nursing...It's all apples to oranges, and unless you've done both, it is difficult to understand.
    Last edit by EtherFever on Nov 28, '12
    nurseguyjosh, Stalirris, Heather33, and 2 others like this.
  5. Visit  Stormy8 profile page
    1
    Woww....we all have right to speak our opinion so here goes mine in response to yours...I feel sorry that there are people like you in this profession that feel it's okay to speak down about others..."many of you are not proficient in basic nursing procedures..." Really?!?!

    You obviously need some growth or can I say maturity. I wish you well.
    tonightwedance likes this.
  6. Visit  Stormy8 profile page
    0
    My comment was for SICU Murse
  7. Visit  Dodongo profile page
    1
    Settle down everyone! Haha. Cray cray.

    I think med-surg nurses have a roooouuuugh job. They have 6-10 patients at a time. And even if they are the healthiest patients that's still a lot to keep track of during a shift with regular patient care and meds. They don't have the time or luxury to know every single thing about their patients like us ICU nurses do. It's apples and oranges. My time is filled with charting q1 and q2, drawing serial labs and abgs, replacing electrolytes and blood products, managing their vent, titrating their pressors and sedatives, dealing with rotoprone beds, CRRT, ECMO, IABPs, swans, hypothermia, etc. So there's a reason I have 2 patients at time. But it's not like med-surg nurses are just sitting around either.

    Although, I do have one story about a med surg nurse that just irritated me so much for some reason. I was transferring a patient out of the ICU to a monitored bed and the zoll started ringing out v-tach, but it was obviously not v-tach. Obviously. And the nurse started panicking and asking if we should start cpr. I said no, it's just artifact and it's nothing to worry about. But she would not believe me and just let it alone. It was aggravating. Even more-so because she works with monitored patients fairly often so she should know how to interperet an ekg.
    Stalirris likes this.
  8. Visit  loftay13 profile page
    0
    I work on a medical respiratory ward and care for 9 patients on a good day. If we are short staffed however (which is the majority of the time) I look after 12 patients. Its hard work, you are constantly run off your feet and unfortunately you cannot possibly be able to recall every detail about a patient who you are transferring. I can understand why critical care nurses need to have all the information so I do try to have it to hand in advance, but CC nurses do sometimes need to be a little more understanding of the fact that us floor nurses are extremely busy, often caring for several complex care patients aswell as the critical patient whom we are transferring to your care, we can only be in one place at a time and have lots of patients who need us. I'm not trying to criticize anyone, we should all have more respect and understanding for one anothers roles, after all we are a team and there is no 'I' in team.
  9. Visit  loftay13 profile page
    0
    Craymond18, you list all of the jobs you have to do with your 2 patients in a day. I will say two things.
    1. I have to do many of the same jobs for my 9-12 patients every day.
    2. ICU nurses are very good at delegating the non nursing tasks to healthcare assistants.
    That is all.
  10. Visit  Dodongo profile page
    3
    Quote from loftay13
    Craymond18, you list all of the jobs you have to do with your 2 patients in a day. I will say two things. 1. I have to do many of the same jobs for my 9-12 patients every day. 2. ICU nurses are very good at delegating the non nursing tasks to healthcare assistants.That is all.
    For your second point, I find the opposite to be true. The floors at my hospital have PCTs that do the majority of basic pt care, while the ICUs don't have PCTs. Or they do but they stock supplies and maybe do blood sugars. If my ICU has a PCT on a shift they do blood sugars and restock basic things like gloves. And maybe help boost a pt in bed. I give all my baths, wipe crap, etc. At any rate, when I get a transfer up I ask about why they're coming and the physical assessment. I can look up labs and everything else in the computer. I work with a few high strung CC nurses and they grind my gears sometimes too. Do I know what a pt's abg looked like a week ago? No. Not generally.
    YanMinor, Stalirris, and Janey496 like this.
  11. Visit  festanie1 profile page
    1
    Wow. There is such animosity on here. We are all nurses and all have our own specialties. but yes. Icu nurses ask a lot of questions when the patient is brought. I am such a nurse. Here's why I ask what I ask. Generally from the floor the patient is rushed down in a hurry. More times than not the patient is circling the drain during that time all hands are on deck so to speak. The reason questions are asked is because THE DOCTOR asks us those questions!!! We have become accustomed to answering the doctors questions on the fly while providing care (starting second and third iv's setting up for Intubation and ect..) The reason why we ask what happened and why was this not done is again because the doctor asks. But also some times this is a vital piece of the puzzle that might have been over looked. Like a med was not given because a patient was nauseated or having swallowing difficulties ect.... another thing as far as lab values go you should know your lab values on a medsurg floor. There are so many medications that are given that u need to know. You ESP need to know potassium!
    I am afraid to admit that sometime I get short with a nurse bringing a patient. But That's when every question I ask is followed with a response of "I don't know."
    Please tell us what happened. Why do u think it happened. What is their history. Could it have contributed? What are any pertinent labs. Have u noticed anything changing. Like wbc from 5 to 35. Ect.... U know what needs to be shared. Info u would need yourself. Don't make this about messing vs icu. This is about the PATIENT. And that info the icu nurse quizzes u about.... U might have that one piece of info that you might not perceive as being important but it sends a red flag to the icu nurse that ultimately saves their life. All because you the medsurg nurse had the answer. alot of time I know we come off as being hateful and short but too that's because our brains r going 100000 miles an hour of what's going on. What will the doctor want to know. What do I need to next. And so on and so on. As well as I have a sick pt next door and I have all this other stuff to do as well....
    Again you a medsurg nurse are asked a medly of questions because we value what u know and what u tell us is passed on.
    Janey496 likes this.
  12. Visit  nursetvs profile page
    2
    Shame on anyone of you who are talking down to Med/Surg and ICU nurses alike. We all went to nursing school, we all passed the NCLEX examination and at the end of the day, we are there for our patients! I am a RN who is trained in both critical care and medical/surgical specialties. I have my CMSRN credential, can take care of 6+ patients and have excellent assessment and management skills. I chose to specialize in medical/surgical nursing because I like the fast paced environment and patient interaction. I also enjoyed my time in MICU taking care of very high acuity patients and their families. The focus on each unit is different, the pace is different, the patient load is different, the acuity is different....but we are all nurses. ICU nurses are not smarter, they don't understand pathophysiology better....they have a specific interest and talent for working with very high acuity patients. Med/Surg nurses aren't always better at handling more patients and don't always work harder than ICU nurses on a given day.......they have an interest in working with many clients who have many unique medical conditions. These are two separate specialties within the same profession. We must stand our ground as professional nurses together. If you feel superior because you work in ICU or ED or OR, than I feel bad for you. Please do yourself a favor and leave the nursing profession. I became a nurse because I didn't feel like having ******* contests with my colleagues all day. I want my patients to go home to their families and get better. Remember where you came from please. If you need to see credentials or hear from someone how well they did in school or how well they know disease process based on their chosen specialty of nursing practice- then check your facts, I'm sure you will be surprised at what you find.
    mumarada and IH8Poodlez like this.
  13. Visit  Stratiotes profile page
    3
    There is no excuse for any specialty to look down on another. We are all on the same team. That said, for anyone who hasn't worked in ICU, I want to highlight a few things I've noticed.

    When I worked med/surg, unless I had patients several nights in a row, I never felt like I really knew everything that was going on with them. I could grab my report sheet and tell you my current observations, admitting diagnosis, vitals, where their IV's are, lab values, etc--but I would never know all that off the top of my head or be able to tell you that their urine output had been falling over the past 3 hours, for example. When you're passing a million meds, restarting bad IVs, often covering for lack of PCA staffing, admitting, discharging, unless perhaps you're super nurse who's been doing it for 30 years, I don't think it is realistic to expect you to know your patients very well.

    From an ICU nurses perspective, it is really hard to treat a patient without knowing some things. When responding to rapid responses or codes, I don't know how often I hear "I don't know" to every question asked of the nurse caring for the patient. The patient is lethargic and diaphoretic... has anyone checked a blood sugar? "No, not yet." Blood pressure is dropping--how has the urine output been? "I don't know". They've had a heart rhythm change, what do their labs look like? "No idea." These are just examples I've come across again and again. Some nurses look at us like, "I don't know, just fix them or take them to ICU!" But we all know it isn't that simple most of the time. Do I look down on the nurse or think them less intelligent? Heck no. I remember feeling like a deer in the headlights whenever a patient went south. That isn't a fault of the nurse but a fault of the system for such a high patient to nurse ratio.

    On the flip side, I think med/surg nurses often think ICU nurses are just sitting around chilling with two patients. But those two patients truly do require almost constant attention. At my facility, we don't have PCA's in the ICU-and no secretary at night. So, we put orders in, clean the poop, get patients up, give the baths, draw labs, dress the wounds, and all this on top of managing drips, writing down vitals every 15 minutes, charting, etc.

    All this to say--I think we should all have respect for what we each do. We all do the jobs we're trained to do. If anyone could manage 6 patients and know and care for each of them as well as an ICU nurse with their 2 patients, there would be no need for ICUs in the first place.
    Yuppers21, Janey496, and nrsang97 like this.

Need Help Searching For Someone's Comment? Enter your keywords in the box below and we will display any comment that matches your keywords.



Nursing Jobs in every specialty and state. Visit today and find your dream job.

A Big Thank You To Our Sponsors
Top
close
close