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

Specialties Critical

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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 unit - it doesn't matter which one- MI, CTI CCI, Neuro, or Burn, the critical care nurse asks all sorts of irrelevant questions, such as what K+ was four shifts ago? Why is it so hard for critical care nurses to understand that floor nurses don't have the luxury of sitting in their little booths outside the patient's room and picking through the weeds in the chart? I understand that medical nursing and CC nursing are two different levels of care, so why ca't CC nurses understand that as well. Why do they think we are grunts and they are the fighter pilots of the hospital? Can anyone who works in CC give me some insight into the condescending attitude of CC nurses toward floor nurses? Oh well, for every time I encounter condescension from a CC receiving nurse, I have just as many opportunities to graciously throw them a life preserver when they are forced to float to the floor and can't handle the 5 easiest patients on the floor. Seriously, can anyone help me better understand where a CC nurse is coming from and what/why they expect so many details - details that they could just as easily find in the chart vs. expecting to be spoon feed from the sending nurse?

Well said Craymond!

Specializes in Critical care.

Huh, if I didn't know better, after reading this thread I'd conclude that nursing is a hard job on most fronts.

Silly, eh? It's best we just plug along with the idea that we all suffer alone.:sarcastic:

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.

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.

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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.

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.

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.

My comment was for SICU Murse

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.

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.

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.

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.
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