Floor nursing vs ICU nursing

betmic2002 · Jul 24, 2006

I get so tired of ccu/icu/imc/tele nurses that think a medsurg nurse is second best. I work very hard for my patients. I started nursing when i was 18. I worked LTC for 6 years and then medsurg for currently 8 years as an RN. I float on all units when needed and I believe have a good reputation, but when I am on other units, I get the same question " How could you stay on medsurg?" This is usually followed by a look of disgust. I respect all nurses and love teamwork. But this subject is very touchy for me and makes me disappointed in my colleagues. Or, is this just an happening in the community hospital I work in? Thanks for all who shares their opinion!

Nieuport · Jul 24, 2006

Med/Surg floor nurses have ALL of my respect and envy!!! I just can't seem to figure out how they do it! They're great at it. They give all the care (OK, MOST of them) that I seem to feel I need to give to my pts, PLUS they get all their charting in, extra little double entry stuff included, all their chart checks, plus help me and other new nurses.......on and on and on!! Med/Surg nurses should by NO means be looked at as anything other that Wonder Women....and I honestly mean that! They DON'T get the respect from the MDs that the "unit" nurses get, in fact I'm told that in some places "unit" nurses are actually paid more. That's just wrong! I think the floor nurses just have a gene that I lack. Maybe it's my time mgmnt or my anal-control-freak thing, but I just seem to be much more content on a 1 on 1 - 1 on 3 basis max, even though I don't have the advantage of an assistant. Does that clarify things a little?

I really do know what you mean, though. And to repeat something said earlier....even our own "unit" nurses say they don't know how the "floor" nurses do it. They'd rather have a bad unit night anytime vs. a good floor night cuz they just can't do it and maintain any sort of sanity.

I think Med/Surg ought to be a specialty and get paid for it!!

dfk, RN, CRNA · Jul 26, 2006

I graduated from my school on Saturday. I take my boards June 9th, and already have a job on a very busy med/surg floor. My passion is ER nursing and that is what I want to do. The hospital I am going to work at doesnt take grad nurses in the ER, so I need to have experience. Does any one have any advice?
Thanks

advice? sure... muddle through and just do it.. i needed med/surg before i could get to my ER.. i did the bare minimum of 8 months and took off to the ER as soon as i got the chance..

it's tough work, but well worth the experience.. you definitely learn time management and priority..

you'll get there..

dfk, RN, CRNA · Jul 26, 2006

Med/Surg nurses should by NO means be looked at as anything other that Wonder Women....and I honestly mean that!

former med/surg here - obviously you haven't worked with men in the field.. this statement is a blanket one that gets old really fast

I think Med/Surg ought to be a specialty and get paid for it!!

med/surg is a specialty, as just about any hospital-based nursing area is.. take a look at allnurse's nursing specialty area.. it's there.. google nursing specialties and med/surg.. it's there.. even if pay is not as up to par, it's near.. i feel, as an ICU nurse, OR gets paid higher, and being a circulating nurse is basically a gopher for a case.. is that justified? i don't know, and i am by no means bashing OR..

gradcare, LPN · Jul 30, 2006

I find that the workload for ICU (I work neuro/general/burns combined unit) is pretty much the same as for most surgical units most of thes time except all the work is just in one place. In both areas however there are rises and falls in how unwell the patient is, their pre-existing illnessess and of course the experience level of everyone else in the unit. Any change in these can dramatically alter you workload. Mind you I think that with the way the acuity on ward units is increasing med/surg units are going to have a greater workload in the not too distant future. Currently though I personally think that for workload nothing compares to ED on a full moon in summer working acute and sub acute (triage cat 3-4 and 5:crying2:) or am shift in the burn unit ( 8 hrs doing burn dressings and burn baths is hot, heavy and hellish):cheers:

LadyT618, MSN, APRN, NP · Jul 30, 2006

I graduated from my school on Saturday. I take my boards June 9th, and already have a job on a very busy med/surg floor. My passion is ER nursing and that is what I want to do. The hospital I am going to work at doesnt take grad nurses in the ER, so I need to have experience. Does any one have any advice?
Thanks

Kristy, if you're really interested in the ER, but not really feeling med-surg, look for a hospital who hires new grads in their critical care areas, such as ICU, CCU and the like (also gives required and proper training of course). I think since ER is considered a critical care area, it would be best to get started in a critical care area to get prepared. Just my opinion. Good Luck.

Brad_RN_Student_PA · Aug 3, 2006

med/surg floor nurses have all of my respect and envy!!! i just can't seem to figure out how they do it! they're great at it. they give all the care (ok, most of them) that i seem to feel i need to give to my pts, plus they get all their charting in, extra little double entry stuff included, all their chart checks, plus help me and other new nurses.......on and on and on!! med/surg nurses should by no means be looked at as anything other that [color=yellow]wonder women....and i honestly mean that! they don't get the respect from the mds that the "unit" nurses get, in fact i'm told that in some places "unit" nurses are actually paid more. that's just wrong! i think the floor nurses just have a gene that i lack. maybe it's my time mgmnt or my anal-control-freak thing, but i just seem to be much more content on a 1 on 1 - 1 on 3 basis max, even though i don't have the advantage of an assistant. does that clarify things a little?
i really do know what you mean, though. and to repeat something said earlier....even our own "unit" nurses say they don't know how the "floor" nurses do it. they'd rather have a bad unit night anytime vs. a good floor night cuz they just can't do it and maintain any sort of sanity.
i think med/surg ought to be a specialty and get paid for it!!

"wonder women?"!!! what about men?! haha jk...well, not really! :)

dfk, RN, CRNA · Aug 3, 2006

"Wonder Women?"!!! WHAT ABOUT MEN?! haha jk...well, not really! :)

not kidding brad.. but still, we are still all a team here.. the 6-8% of men who are nurses (and NOT male nurses) should be just as comfortable and heard as the rest of the "population".

no disrespect given...

working4aBSN · Aug 8, 2006

I agree floor nursing is a special nack that some nurses possess. I rather have two patients and one crashing and bout to code with fifteen drips going then deal with the assignment on a med-surg floor.

I agree with everyone else..ICU nursing and med-surg nursing are two different types of busy. I know the ICU that I work in the acuity is usually pretty high and those patients are really sick and anything could change at any moment and you could be in a life or death situation. I understand that could happen anywhere...

I do not think that an ICU nurse is any better than a med-surg nurse. I think we are all there for the common wealth of the patient and we are there to help the patient progress through their illness and hopefully, eventually return home to their loved ones.

Every nurse has their love and to each nurse their own whether it be ER, ICU, Med-Surg or OB...there is a reason we went into nursing and if you have found your nitch then congrats and pursue your nitch and perfect it with pride.

JazzyRN · Aug 8, 2006

Yes I definitly think ICU nursing can be as stressful if not more as floor nursing. But what I feel it depends on is, the staffing of a unit, the acuity of pts and ancillary staff. Ive done both ICU and floor nursing. Some places I found it easier to work the ICU, some I preferred the floor. They are different kinds of busy. In a poorly staffed floor, yes you will run around like crazy with your 8 pts and be pulled in different directions all over the unit. But the plus is that the pts arent as sick. They can hold their own somewhat,when things get hectic. There arent (or shouldnt be), codes every day on the floor. In the ICU setting, the pts cant get any closer to death. If you are understaffed and havev 3 very sick ICU pts, pts can get into trouble really fast. If you dont have RTs, CNAs, enought nurses and other support there to help, there are so many things that you need to do that cant possibly get done. There is so much responsibility lying on the nurse's shoulders for the well-being of her pt. ICU pts are typically total care, and one nurse cant do it all. If you get busy and caught up with one of your pts(maybe he is crashing or even coding) another pts dopa/epi/norepi drip may run dry and crash also. Or you havent checked on your intubated pt in a while, they may have selfextubated and be in some life or death trouble. Maybe your A-line connection is loose, you dont notice until an hour later, when your pt has exsanguinated all over the bed. If you are working in a well run, well staffed ICU you probably dont realize how stressful it could possibly be. If you just float there occasionally and dont get the sick sick pts, you wouldnt understand the amt of stress one can be put under. Its amazing to me that so many people on this thread can say how the ICU is less stressful. I think its very individual to the ICU you are in. So my opinion is that in a good nursing environment, where all is well(or most things are ok), I would prefer to be in the ICU. But if working conditions are not ideal, I will take the floor anyday of the week. Because typically on the floors, if you have more pts than you can handle or get caught up with another pt or dont get things done you need to do or dont have a chance to check on certain things,etc. It typically wont lead to a possible code, death or very bad situation for your pt.

dfk, RN, CRNA · Aug 8, 2006

one thing i have noticed, on both sides, is that floor nurses are always happy to see critical care nurses respond to a code.. i've come across some codes where no one is doing anything, just waiting.. for that, i enjoy and prefer the icu.

geekgolightly, BSN, RN · Aug 8, 2006

one thing i have noticed, on both sides, is that floor nurses are always happy to see critical care nurses respond to a code.. i've come across some codes where no one is doing anything, just waiting.. for that, i enjoy and prefer the icu.

could you elaborate?

i have decided that i hate floor nursing. despise it. im caught and frustrated and am just gonna go off on a tangent and vent. i want out of floor nursing badly. im weekend work (two days work for three days pay) and any time worked outside of weekend, is time and a half, so its excellent money, and hard to walk away from especially since i have a toddler and a husband who is studying MCAT right now and plans on becoming an AA (lord willing), so im stuck in the job that will pay me the most money. i want out! i want to be able to focus deeply on two patients and really sort things rather than be pulled ten million different ways for all of the various people that want to see all the various patients i have under my care as well as pleasing very demanding-feeling-better-so-back-to-normal-and-BORED patients.

i can go through seven patients in a day, and with discharges and admits and quite frankly on days like that the patients all blur together. after three years ive decided that i know that concentrated care would be best for my personality, at least for now. im not giving the best care i can give. im in the wrong place.

but i need weekend work. here's hoping that something opens up. at this point i would take anything that is weekend work in ICU.