Attn Icu & Er Nurses:what's You Opinion Of Med-surg Nurses?

  1. I have been a med-surg nurse for fifteen years and have considered critical care for quite some time. What stops me from making the move is the general attitude I have recieved from ICU and ER nurses when I inquire about positions. Lets just say it's not positive. I would like to hear honest opinions from other critical care nurses out there on this topic and maybe, just maybe, change some misconceptions.
    Thanks, Cath
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  2. 26 Comments

  3. by   fedupnurse
    I give Med Surg nurses all the respect in the world. I just don't know how you guys do it day in and day out with the horrific patient loads they force you to carry. I have never worked med surg but have had a few people come to the unit because they thought it would be easy. When they came they found out why it was like comparing apples to oranges. It is just totally different. My unit is very accepting of new staff but the SICU in my facility has a real prima donna attitude. Have you considered making a fresh start at a new facility? Maybe a new place would be more supportive?
    Whatever you decide, I wish you the best of luck!
  4. by   -jt
    <I would like to hear honest opinions from other critical care nurses out there on this topic and maybe, just maybe, change some misconceptions.>

    I dont know exactly what youre referring to about the attitudes. Do you mean the nurses you have talked to are discouraging experienced med-surg RNs from transferring into the ICU?? I cant imagine why they would do that cause thats where most of us came from & those are the nurses we need. I may get flack for saying this but as an ICU RN, I would much prefer an experienced med surg RN working next to me as the orientee than a new grad. Nothing against new grads but there is alot to learn on the job about pt care & disease processes & putting theory into practicality that only hands on experience can give the RN & its alot harder for a new grad to specialize in critical care before they have had a chance to be an RN & do any of that. And in the ICU, we have to depend on each other in a split second. Its just easier all around for everyone when its an experienced med surg RN who is the orientee.

    Our hospital only accepts experienced RNs into the critical care areas. And whenever an RN with no critical care experience transfers to critical care in our hospital, they are expected to use one of their paid continuing education days to attend one of the many seminars for RNs new to critical care - such as Barbara Clark Mims seminar "Critical Care Essentials for Non-Critical Care Nurses". The union pays for the seminar & the hospital pays the RN a days salary for attending. Also, our hospital system has a critical care course that is available to an experienced RN in any of our hospitals who has applied to transfer to a critical care unit -its part of their classroom orientation before they come to the unit for clinical orientation.

    Most of the RNs in our critical care units are experienced RNs recruited from our med-surg units. Others are experienced RNs recruited from our PACU, hemodialysis, & step down units and a few were already experienced critical care RNs recruited from outside the hospital.
    Last edit by -jt on Aug 9, '02
  5. by   live4today
    I am a former med/surg nurse who went from med/surg to an ICU (SICU) unit, then to a pedi unit. I've done just about everything in nursing, and have never ran into any flack from the ICU nurses. The ones I've worked with before love to teach, and I loved learning from them. :kiss
  6. by   fab4fan
    Med-Surg nurses have my complete respect...I did M/S briefly and HATED it. You guys put up with some unbelievable stuff; M/S nurses are some of the most organized people you will ever see in the profession, and the most versatile.


    One thing that bothers me is that M/S will refuse to take report on one of my ED pts, or ED has to hold their pts. because "M/S is at their max." The ED never closes its doors, we rarely go on divert, so it can be frustrating to hold M/S pts when you have ED pts hanging from the ceiling. Our M/S nurses also expect us to start all the admission paperwork, assessments, care plans, fall assessments, etc. when we hold them. That bugs me...we're helping them out by holding their pt, but I don't think we should have to do all the paperwork, too.

    Other than that, I think you guys are great, and I don't subscribe to the attitude some have that M/S nurses are somehow "lesser" than ICU/ED nurses. We all have our gifts; thank God someone does want to do M/S!!
  7. by   -jt
    <<One thing that bothers me is that M/S will refuse to take report on one of my ED pts, or ED has to hold their pts. because "M/S is at their max." The ED never closes its doors, we rarely go on divert, so it can be frustrating to hold M/S pts when you have ED pts hanging from the ceiling. Our M/S nurses also expect us to start all the admission paperwork, assessments, care plans, fall assessments, etc. when we hold them. That bugs me...we're helping them out by holding their pt, but I don't think we should have to do all the paperwork, too.>>

    The thing that bothers me is that we turn on each other in things like this rather than realizing it is a systems failure & the fault of the facilitys administration - not the fault of the med-surg RN & also not within her control. Too often we lambast each other for things like this - the ER RN gets angry with the floor RN - the floor RN gets angry with the ER RN - when what we should be doing is getting together to make the administration deal with their problem instead of dumping it on us.

    It all stems from inadequate staffing & excessive pt loads. If the floor RN already has more than pts than she can handle safely, or all hell is breaking loose up there, she cant safely take another sick person into the fray until she can give him the attention he needs. She only has 2 hands & professional judgement.

    In Minnesota, nurses have the right to temporarily close their units until relief is brought in if they feel they dont have enough staff to safely care for any more pts. Yes that backs up the ER but it doesnt help to move people out of the ER to a place where there is no one to take care of them.

    Sometimes the ED doesnt realize that the RN is caring for upwards of 8 people at once. may have just gotten an admission & is tending to that pt, may be in the midst of a procedure, or emergency on the floor, has her hands full - and just cant come to the phone for report at that very second. We pressure each other rather than pressuring the hospital to make the improvements in staffing to alleviate this problem. Maybe because its just easier to fight with each other than to fight with the suits.

    I work in ICU & we recently couldnt take report on a new admission because we had 2 codes going on at once & everybody was at those. When we get an admission into ICU, it takes at least 2 RNs, sometimes 4 or more, to handle it initially - depending on the stability of that pt. Theres only 8 of us & we were already divided up between 15 pts - 2 of them crashing at the same time. We could not drop everything to admit another unstable pt right then. We explained to the ER that we'd call back when it settled down. They hung up & 2 seconds later called the supervisor. Funny thing, the supervisor was in our unit helping at one of the codes herself & answered her pager from our nurses station. It was the ER calling to complain about & report us - saying "the ICU RNs refused to take report on the admission".

    The supervisor told them "and rightly so".
    Last edit by -jt on Aug 9, '02
  8. by   -jt
    <Our M/S nurses also expect us to start all the admission paperwork, assessments, care plans, fall assessments, etc. when we hold them.>

    Sometimes a pt can be waiting in the ER for a bed for more than 24 hrs. Since its a required standard that admission histories & other paperwork be compiled in the first 24 hrs, it falls on the ER RN to do it if the pt is being held there that long. It is a burden on the ER RN but that rule wasnt made up by the med surg RN. Come to think of it, all this paperwork is a burden on any RN working anywhere but fighting over who has to do it isnt going to solve that problem. Bringing it right back to the administration & demanding solutions that dont dump the problem in any RNs lap might.

    We're all busy, we're all overwhelmed & overloaded on every unit & just about any hospital. We have to look beyond our own floor, see the whole picture, & have a little more understanding for what each other is going thru.

    Another reason why experienced med-surg RNs are an asset when transferring into the ED & other critical care areas - they can see all sides.
  9. by   RNinICU
    I would never go back to med-surg!!! I float out to the floors on occassion, but would not go back for good. At our hospital, a year of med surg is required before working in ICU. You gain so many skills, like assessment and prioritizing in med surg. Keeping track of 8-10 patients also helps you learn organization. Med surg nurse take a lot of crap from administration, families, and doctors. I think they get less respect from these people because they are seen as less skilled, even though they are well trained and experienced. I can tell you that at our facility, the docs see ICU nurses more as collegues than they do the med surg nurses. I am a designated preceptor for our unit. If you have any questions or need any morale support, pm me any time.
  10. by   Fgr8Out
    As a Med-Surg Nurse... may I offer my sincere thanks for all the supportive and positive statements I'm reading on this Post.

    Thank you, Jt, for your insightful comments... I won't reiterate what you've already stated so well, except to remind those of us who DON'T work ER to bear in mind the chaos they too are experiencing.

    Peace
  11. by   RN-PA
    Originally posted by RNinICU:
    Med surg nurse take a lot of crap from administration, families, and doctors. I think they get less respect from these people because they are seen as less skilled, even though they are well trained and experienced. I can tell you that at our facility, the docs see ICU nurses more as collegues than they do the med surg nurses.
    First, thanks to you all for the kind words about Med/Surg nurses, and I totally agree with what RNinICU posted above. I've heard that many doctors and nurses in our ICU are on a first-name basis and on our Med/Surg floor, you're lucky if certain docs even make eye contact. I also worked last night 3-11 and had 3 out of 3 phone calls with docs who were somewhat nasty and rude to deal with, and it gets really old. I always read the threads here to get ideas for dealing with rudeness, but I'm usually caught off guard and am so focused on getting orders needed that I never have a snappy come-back. I tend to then just carry around my anger and play conversations over in my head, "next time I'll say..." or "why didn't I say..."

    Back more on topic, I tend to feel respect from the other specialties in our hospital. Many hear horror stories about our floor and have worked Med/Surg in the past or been pulled to our floor to help out, so they have no illusions about our work. I look at ICU, CCU, ED, and Telemetry nurses with awe and respect-- I can't imagine doing all the titrating and monitors and IV meds and arterial lines and {{{shudder}}} I checked out the thread entitled "Torsedas?" thinking it must be a new Mexican dish! :imbar We all have our niche and specialty and I don't think I could do what you all do! (Also, after reading many of the L&D threads, I've learned so much and take my cap off to those special nurses, too!) :kiss
  12. by   aj1973
    Hey there, Personally I think that having a med/surg background is a brilliant foundation for working in an ICU. I've worked in adult ICU, then on the wards, mainly in orthopaedics, for a few years and have recently transferred to PICU. I think working in with wards gave me alot of skills that the ICU nurses don't have - time management, communication etc.
    I have noticed that there are SOME ICU nurses out there who are, unfortunately, reluctant to appreciate the years of med/surg experience, I'm facing that myself a bit at the moment, not quite being trusted by nurses who have done ICU for a long time, and it does infuriate me I just hope that one day, when I have lots of ICU experience that I'll remember to appreciate the talents and skills of ALL new staff.
    Haviing said all this though, i don't think I'll be able to go back to ward work, physically and mentally killing myself when ICU is SO much more interesting but less physically demanding
    Cath, all the best in your job hunt, I'm sure you'll find an ICU that will give you the chance you deserve!!!
  13. by   erezebet
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    Last edit by erezebet on Aug 11, '02
  14. by   erezebet
    I was a med-surg RN not long ago and I recently transferred hospitals to get into an ICU. The reason I did this was because the supervisor discouraged me from applying for an ICU job. Unfortunately, the ICU's at my hospital were taking new grads and passing up experienced nurses from my neuro-step down unit who were applying for the same position. I was outraged and some people told me that its harder to staff the more "difficult" floors because of high turnover and thats the real reason I was "discouraged" from ICU. Instead, the supervisor made me feel I wasn't good enough to work in an ICU and that is just not true. I strongly agree that ICU nurses do have a demeaning attitude toward floor nurses. I am not sure why that is. Personally, I think its because ICU nurses know more information and feel like they can do a medsurg nurse's job, but a medsurg nurse could not do an ICU nurse's job. Same senario as with nursing assistants.....we can do what they do, but they can not perform our job duties. Its petty and stupid but will always be there. Don't let anyone tell you you are not good enough to work in an ICU. I am glad I had med-surg experience and I am a better nurse for my past experience. I love the ICU and would not return to the floor for anything!

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