Micu Vs. Sicu

[IDoNotGiveOut]

I am a new RN (have some years of health care experience though), and got offered positions in both the SICU and the MICU at my dream-hospital. I just received the two most exciting job offers of my life, and I have no idea what to do.

I apologize if this has been asked a million times (it's not exactly easy to search for since every topic contains those words), but what is the vital information I need to know about the two different areas and how they compare? I spent a day job-shadowing in the MICU and got a short tour of the SICU, and basically all I gathered was that the MICU nurses were welcoming, calm, seemed content. Tons of groups of doctors came and went, patients were very sick and there were lots of interesting things, but it still seemed somehow calm and quiet. My five minute tour of the SICU made me feel like I was on the trading floor on Wall Street or something. In other words seemed like total chaos. But the manager was awesome and all the nurses seemed enthusiastic.

I just don't know which to pick. Those of you who have worked these kind of units, what do you think are the most important differences? Which would you rather work in? Where can I learn more as a new grad?

Any input would be greatly appreciated, the sooner the better!

[IDoNotGiveOut]

Here is something I found interesting that an experienced nurse told me today. She said that in MICU you greatly improve your critical thinking, but in SICU you gain significantly more skills.

Does anyone agree with this? And, again, which area would a new grad want to learn the most in first?

Thanks again for any replies.

[Guest193822]

I would have to disagree on the MICU /SICU critical thinking & skills portion they told you about.

It’s the ICU, you will learn & master both in any of these sections, Period. It’s critical care that’s what so different than regular ward nursing. You can’t do the job with out both critical thinking & critical skills together. They both go hand in hand - 1 to1

For me I find that MICU & CCU the patients are more chronic b/c of the long standing illness. The population is much older. They have multiple medical health issues (Diabetics, CHF, MI’s, and Hypertensive Crisis). So you’re managing more then just complications of a surgery or injury. Not to say that we don’t see them in the SICU, TICUor Neuro. It’s just less liking we have those issues.

I can tell you my crashes on the SICU/TICU/Neuro are no joke we don’t like losing them b/c the population is much younger & healthier & the fact that the complication is due to a voluntary/involuntary surgery that needed to be done to sustain the life. (Car Accidents, Gunshots, TBI’s, Open Hearts)

I do think that MICU is a slower ward & SICU/TICU is a “chaos” ward. We have to be honest that in the SICU the goal is for the pt to stat for 2 days & you’re being transferred to the ward. On MICU I could have a pt’s for months & transfer them to a rehab long term facility. I’ve had the “slow codes” on MICU & I’ve had the “rapid codes” on SICU/TICU.

The decision is yours but you will learn all you need in any ICU it all depends on how you like the pace of the ICU & how well you’re able to pick up & learn with of course competency & safety for the pt.

GOOD LUCK!

[IDoNotGiveOut]

Thanks for your reply! I took the job offer in SICU. I don't know exactly why but I just felt more drawn to that unit. I'm a little worried about the intensity and stress level but also really excited about everything I'm going to learn. We'll see how it goes, I'll post again once I have gotten a taste.

[tutored]

Congratulations on your new job! I guess I posted a response a little late. Here's my take: I, too, am a fairly new RN, and I've been working a few months in a unit that is combined SICU and MICU. So there are days I'm in SICU, and days I'm in another. I love this format! There are different doctors in charge of patients in the SICU (surgeons, not to state the obvious), than in the MICU. Plusses for the SICU: cool dressing changes, unbelieveable states of injury and trauma (including lots of neuro stuff) that are a steep but exciting learning curve. Minuses for the SICU: arrogant surgeons that act like butt-munches at times, and tend to forget the humanity of their patients, along with their surgical PAs who are sometimes younger than you, yet you have to go to them "cap-in-hand" to beg for an altered PRN pain med protocol. Plusses for the MICU: multiple organ breakdowns and co-morbidities (lots of renal if you like that think - I do), and more different types of consulting MDs adding their orders to the attending's; I agree with the previous poster's opinion that there's more critical thinking here, because often so many systems are breaking down at the same time. Minuses to MICU: more stool, urine, blood, and generally-messy nursing duties. These are all sweeping generalities, but I thought I'd throw them out. Good luck to you!