francoml 10,202 Views
Joined Nov 7, '12 - from 'Dirty South'.
francoml is a ICU Nurse.
Posts: 142 (40% Liked)
I am a rapid response nurse as well as an MICU nurse in a level one hospital I am CCRN certified and have my BSN. I run CRRT, and can place ultrasound guided PICC lines and PIVs. I can run codes and order diagnostics and interventions without consulting a doctor. I do not get any more pay. In fact medsurg nurses get a $2 differential. Financially fair? maybe not. Will I get into a top CRNA school because of these skills coupled with high grades? Absolutely. If you plan on being a bedside nurse long term than it is a big deal. If you are going into advanced practice then your ICU time is really just an extension of the class room and one long clinical rotation where you learn critical reasoning, advanced pathophysiology, and improve your dexterity with procedures. I look at it like I am getting paid to go to school everytime I go to work. Just my 2 cents
The reason, as you may know, why PICC's aren't emergent is that it is virtually impossible to place a PICC quickly without comprimising sterile technique. This is one reason why IV catheters which get placed in an emergent situation, should be changed out within 24 hours... The nurse who places the line has to worry more about the patient dying, rather than maintaining sterile technique. But, if you maintained it, you're amazing, and thank you.
You are a rock star! (seriously, they couldn't get a femoral line in?!)
Obviously you are more vaulable in an emergency than the gen surgery or internal med teams, lol... Good thing you came though, and helped the patient out.
We have a dedicated PICC team at my facility. They say we in CCU are the only ones who actually notice and come running when they tickle the ventricle on a deep insertion...
I respectfully disagree with the other comments left below. Certification is the designation given for those nurses that prove knowledge base in evidence based standards for a specific area. Many institutions view this as the very minimum, or "gate-keeper" to practicing as a nurse in the ICU setting. I believe a year is sufficient time, and I do believe in doing a review course and a review book. There are many reasons that hospitals demand their nurses be CCRN certified after a year of work, meaning they set the bar very high for nursing in those units. Now if you were looking to become a CC-NP, or an Acute Care NP, then I would recommend taking time to learn and enroll in fellowships, or internships. I say, go forth and become a CCRN nurse, don't waste time, continue to set the bar high for minimum standards in your institution!
Good job on this article my work friend, nicely written for great encouragement -Krisie
Sorry to bump an old thread, but I thought I'd throw my $0.02 in.
I've done both med-surg and ICU. Everywhere I've worked has a "Critical care" differential. In my opinion, this is absolutely fair. I never claim to work harder than a med-surg nurse, but critical care requires more education and skills. ICU nurses where I work have to maintain PALS and ACLS. We must train annually on balloon pumps, impellas, and other technologies. We must know several protocols like hypothermia, DKA, etc. I can't believe anyone wouldn't support at least a buck or two more an hour for specialized nursing roles.
I was helping a colleague reposition her recently extubated post op CABG x 3 patient when the woman began to complain and curse angrily at all her chest tubes. She was angry and did not want " all these (choice curse word) tubes" because they hurt and they got in her way. She had a history of smoking, obesity, HTN, DM....the usual cardiac arrest package. I don't know what came over me but I was in able to bite my tongue! I simple stated to her, "You are here because of you! You did this to yourself! You came to us to save your life and that's exactly what we did! So you remember that every time you get angry about having all these, in your words, (choice curse word) tubes!". Surprisingly I didn't get pulled into the managers office. In fact, after that, the patient was extremely appreciative. Do we really have to be that way for people to come outside do themselves and own up to what they do?
Agree with everything except the medications: If I am unfamiliar with a medication it is my responsibility to look it up and clarify with the provider/pharmacy if I am still unclear. I don't just give it because it's ordered. I thought this was basic.
Wow I didn't realize that this was not standard of care. I guess I have been sheltered working for my institution..... The things I have taken for granted O_o
I went in to a Trauma ICU as a new grad & loved it!!! Got my CCRN as soon as I was eligible - moved on to MSN (critical care CNS & nursing education) after 5 years of bedside/unit educator experience.... worked in all types of ICU settings &, with the exception of Neo, I have enjoyed them all.
Over these many years (decades?? LOL) I came to realize a few things. In order to be a 'happy' ICU nurse, you need to be a "control enthusiast". Managing titrations for hemodynamics & heart rate/rhythm, Maintaining ICP parameters, Keeping oxygenation just right with mechanical ventilation & other titrations?? Those are re-assuring to me. I get nervous if I don't have access to all the "stuff" going on with my patient. My nightmare? Pregnant trauma patient - a teensy little being that I can't even see, let alone monitor..... (shudder). I don't understand how nurses can cope with all those 'walkie talkie' patients that have no monitors at all - YIKES!!!
But I also realize that a lot of what goes on in ICU is not pure nursing at all... it's technology. We love the machines that go 'Bing' (Monty Python reference for you young ones) & hand to hand combat with the Grim Reaper. That's the easy stuff. Advocating for patients & families who are dealing with life-changing or terminal events.... that's the hard stuff. That's what nursing is all about.
I actually get paid more in the ICU than I did on Med/Surg in the form of a "specialty bonus."
I worked at a unionized hospital in Texas. It isn't everything its cracked up to be. I am pretty sure we were better off before they came around....Seriously. Before they came our raises were 3-5% yearly based on evaluations. Now they are <2% across the board no matter the performance. I paid one hour per pay period union dues...for what? A lower raise. I also found that the union often protected lazy nurses from disciplinary action. That plus the loss of raise incentive made for very poor work ethic among some of my colleagues.
Good luck with your issues. I am so glad to hear your passion. But, there has to be another way!!!
Thank u francomi for this piece of advice. I actually need help because i'm in a dilemma right now. I am starting the Rn - bsn program next week. I registered for the full time class because it is possible with the job i have right now. However, I have an interview for an internship with ICU department at one of the best hospitals in the metroplex. Being a new grad, I've always wanted this. But I don't know how tedious it is going to be combining an internship with a full time rn-bsn program at texas tech. Please is there someone out there who has done or is doing the rn - bsn program at texas tech health science center?
Is it going to be doable or do I just go for part time program? Pls I need all of your advices. Thanks
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