[pilateschick7]

I have followed this board since nursing school and would really appreciate any feedback.
I am pondering transitioning from neuro icu (18 bed) to surgical icu (8bed) in the same inner city level 2 hospital. I have worked evening shift for 3 years since graduation. I love the fast pace, great learning experience and sick patients (but rarely with a swan ganz). However, due to unit drama, lack of Neuro surgury MD's updating families and families' understandable stress and rudeness usually directed at nurses, I think I am begining to burn out and need a change. General Surgury MD's are generally more willing to speak with families in a timely fashion then Neuro surgury. On some levels this seems to be due to slow and uncertain recovery of brain injuries, SAH and glio's and the like. This has been the most difficult aspect to me. This general trend has worsened in the last year.
I am trying to consiter all apects of this decision.Taking my CCRN in January before my possible transfer as a refresher I already have my CNRN. I am applying for a weekend day shift position. The manager I spoke with mentioned that the weekend shift would often involve transfering surg. pts out and recieving some overflow from medical ICU and ER. (often happens in NICU, but our pts take longer to tx out- trach'd peg'd and to LTC.)
I am also applying to CRNA schools soon (Aug 08 or Jan 09). I plan on staying part-time in NICU-they are like family. I have good letters of recommendation. I would appreciate any feedback regarding any aspects I would not be aware of. I realize that surgical ICU will have a steep learning curve and I would love a new challenge.
Sorry this is such a long post, didn't want to leave anything out

Pilateschick7

[meandragonbrett]

I would definitely go to the SICU. Sounds like you've gotten good experience in your NeuroICU and that it's time to spread your wings a bit and learn some more. You'll get great experience with the other types of shock that you don't see as often in neuroICU. Go for it and good luck!

[RNperdiem]

I am biased. I work SICU, but have floated to neuro a lot.
There are also fewer road trips to MRI, to CT scan and angio.
The doctors are a little more acessable, but if this is a big issue, consider MICU where you can work with the medical docs; it is a different culture in medicine rather than surgery.
SICU patients generally have better outcomes. I find it less tragic a place than the neuro unit.