Any suggestions for a MedSurg nurse interested in ICU?

Specialties MICU

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Specializes in Oncology, Urology, Gyn.

I'm a nurse of 3 years, background in oncology/urology/gyn. I am strongly considering ICU nursing. Can't decide if I'd be just terrified and overwhelmed and hate it, or love having a much broader knowledge base.

I'm considering a change because I crave more complicated tasks/diagnoses...I like to interact with doctors and know the what's and why's of plan of care. I love to study, want to know more about medicine and I enjoy autonomy and more responsibility. Recently after code blue situations on my floor, I've been feeling energized and I've so respected (even envied :))the CCRNs who show up to help us run the code because they are so calm and knowledgeable. I find myself saying, 'I wanna know more!"

At the same time, I just don't know if it would be too stressful for me.

I think I could be good at it, but the thought of being a 'newbie' again sounds awful! Really just fearing failing.

Any suggestions/words of encouragement?

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Specializes in Telemetry, ICU.
...Can't decide if I'd be just terrified and overwhelmed and hate it, or love having a much broader knowledge base...

You won't know unless you try it. That's what orientation is for, to let you get a feel for it without completely throwing you to the wolves. It may feel strange to be a "newbie" again, but the transition will probably be easier now than if you wait another 3 years. By then, you'll have formed even more habits which may or may not be conducive to the ICU mentality...

Just out of curiosity, are you looking at any specialty, or just a general MICU? And if you have a specific hospital in mind, knowing the most common patient types (Sepsis vs. Resp Failure vs. Post-code, etc etc) can also help prepare you.

As far as advice, the thing that I find most important is understanding the concept of trending data. Labs (and even VS) don't mean nearly as much when standing alone. A systolic in the high 80s doesn't bother me one bit (assuming a decent MAP of course) if the patient has been running around there all shift, whereas a BP of 110/70 [normally great by itself, right!?!?] would be extremely alarming if the patient had been severely hypertensive recently and had not received any medications...

Also, know your heart rhythms. Being able to recognize the pre-code rhythms before the montior alarms is a good way to save a patient's life ;)

And finally, get to know you RTs. They are certainly lifesavers when it comes to respiratory issues. Especially when dealing with vented/tubed patients.

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You won't until you try it! I say take the jump and get out of your comfort zone. It's time to learn something new!

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I think I am in the same boat as you! I have been a nurse now for 3 years on a med surg/neuroscience floor. I just recently accepted a offer in the MICU afer trying for 2 months. I feel like I am ready to take on a challenge and actually take care of people that really do need to be in the hospital! I've always been good at noticing a change in a pts condition and have been willing and ready to help out in codes. From how you described yourself I think that you will have a good transition from med surg to ICU. You already have a great foundation and you can go anywhere from the ICU. I should be starting sometimes in late September. I am scared, excited, and worried about doing "swing shifts" but Im not gonna let that stop me:)

Just Do It

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Specializes in Oncology, Urology, Gyn.

THANK YOU ALL! for all the 'go get em' attitudes.

I am ready to try it!

As for my hospital, its Trauma1, Im looking for a job in the SCC and as for pt types, I'm not sure. We frequently deal with MVAs, a lot of motorcycle wrecks. But I'm ready for a challenge and I appreciate the comments.

Bound&DeterminedRN, let me know how your orientation goes!

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Specializes in NICU.

Hey y'all.... I was recently in your shoes. I worked on a medsurg floor for 3 years and then transferred to ICU. I've now been in ICU for 1.5 years. I love it. You won't really be considered a newbie. Now that I've been in ICU I know it is a relief when new hires have experience. For one, you can already multitask. That is one of the hardest things to grasp. And you've already got it!

You are just going to be building onto your knowledge base. I love it because I love to learn. And I love to focus on my 2 patients. Really get to know them. Front to back, side to side, inside and out. I love being able to answer any question about my patient that someone throws at me. Unlike the floor where I would ask... Is that the old man with glasses your asking me about?

I agree with assidere about following trends... Very important!!! Also attention to detail. You want to notice a drop in urine output before is shows on labs. You want to catch things before damage is done!! You are like a detective... Oh so fun!

Doesn't mean it isn't tough. Doesn't mean your won't have bad days. Doesn't mean you won't go home and feel the need to drink a beer or take a hot bath or whatever you do to destress. ICU is tough. ICU isn't for the faint of heart.

If you are gonna do it... Do it! Give it all you got!

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Specializes in Medical/Telemetry. Now ICU.
I'm a nurse of 3 years, background in oncology/urology/gyn. I am strongly considering ICU nursing. Can't decide if I'd be just terrified and overwhelmed and hate it, or love having a much broader knowledge base.

I'm considering a change because I crave more complicated tasks/diagnoses...I like to interact with doctors and know the what's and why's of plan of care. I love to study, want to know more about medicine and I enjoy autonomy and more responsibility. Recently after code blue situations on my floor, I've been feeling energized and I've so respected (even envied :))the CCRNs who show up to help us run the code because they are so calm and knowledgeable. I find myself saying, 'I wanna know more!"

At the same time, I just don't know if it would be too stressful for me.

I think I could be good at it, but the thought of being a 'newbie' again sounds awful! Really just fearing failing.

Any suggestions/words of encouragement?

Hey . I think it's awesome you want to step it up. I think you should take a critical care course before applying to ICUs. I did that, and got a bunch of calls for interviews after. Plus, it helps give you basic knowledge on critical care. I was a medical/tele (soft) for almost 3 years...now in a MICU/SICU.

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Specializes in Medical/Telemetry. Now ICU.

Oh and you will feel like a new grad again. Haha. It's very tough to juggle 2 sick pts, vented, on multiple pressors and gtts, titrating up and down, on top of everything else and all the documentation ( I feel like there is 20x the documentation that I did on the medical floor). But i hear it gets better. I have only been in the ICU for 2 months....prob 1.5 months taking care of pts.

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Oh and you will feel like a new grad again. Haha. It's very tough to juggle 2 sick pts, vented, on multiple pressors and gtts, titrating up and down, on top of everything else and all the documentation ( I feel like there is 20x the documentation that I did on the medical floor). But i hear it gets better. I have only been in the ICU for 2 months....prob 1.5 months taking care of pts.

Hello! I was just wondering how did you make your move into the ICU and where??? Im considering relocating OUT OF FLA, and my ultimate goal is CRNA....but I LOVE ICU as I did it in my preceptorship in school.

Any info you can give would be great! Im ok with moving accross the states if I have to for a good opportunity! :D

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Oh and you will feel like a new grad again. Haha. It's very tough to juggle 2 sick pts, vented, on multiple pressors and gtts, titrating up and down, on top of everything else and all the documentation ( I feel like there is 20x the documentation that I did on the medical floor). But i hear it gets better. I have only been in the ICU for 2 months....prob 1.5 months taking care of pts.

Oh by the way...I am one year Med Surg/Tele nurse...6:1 ratio.

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