Shannon. . .I worked as an RN on an ICU Stepdown for over 5 years. We had patients coming and going to the ICU. We were like an intermediate unit between the medical floor and the ICU. We had patients who were on ventilators, had chest tubes, were just recovering from Code Blues, were about to go Code Blue, had had huge abdominal or thoracic surgery and needed attention to wounds and a lot of different kind of drainage tubes coming out of everywhere and usually had all kinds of IVs running including a lot of central IV lines. These patients are usually sick. We didn't have nursing assistants at the time only RN and LPNs. We were split into teams of an RN and LPN for 10 patients. So, basically, it was a ratio of 1:5. However, as a nurse tech you will most likely be assigned to do vital signs, basic patient care (baths, take people to the bathroom and answer call lights) and whatever duties they deem reasonable for you to do. You may have as many as 15 or more patients. I really couldn't know. This is something you would have to ask when you go for your job interview.
I have very strong feelings about new grads on stepdown units. I do not think that it is a place for new grads. The First Year in Nursing Forum is filled with posts by new grads who accepted positions on stepdown/telemetry units and regretted it. My head nurse hired one new grad who talked her into it and it didn't work out. Most new grads can just not keep up with the pace. The pace is too hectic and chaotic and they have not perfected the organizational skills to cope with it. New grads need a semblance of stability so they can develop under a regular routine which helps them learn to prioritize and organize. There is no time to learn that on a stepdown unit as a new grad. From the very beginning you are at a run and it is incredibly hard to learn to organize and prioritize while you are under constant chaos like that. I also feel that any manager who is eager and willing to hire new grads into stepdown positions is looking to fill holes in their schedules and not looking out for the welfare of the new grad. I'd much rather see new grads on a more stable unit such as a surgical, oncology or medical unit where they have a regular routine type of patient. You settle in better there and learn how to prioritize and organize your time better in that kind of environment. There is much to learn as a new grad in your first year or two on the job.
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