Should ICU get more pay than floor nursing?!? - page 11

Okay so I don't want to come off as rude or biased but I am pretty confused as to how my facility can pay medsurg nurses an extra $3/hr over what they pay me! I know they work very hard but I... Read More

  1. by   LL2788
    I was a MS RN for 3 years prior to transferring to ICU. I took a 9$/HR pay increase. They are both stressful in their own way. But I did a 3 month training program before ICU, it was like a short nursing school all over again. The ICU has the sickest patients in the hospital and your decisions are immediate life and death. In MS the mental stimulation and decisions are not as critical, the level of acuity is not nearly the same and it's mostly discharges and admissions. HOWEVER you can get a patient who needs to be Intermediate care as a MS nurse and you need to be able to pick up early signs of deterioration before they become ICU status. When they begin to detoriate you play detective and care for them the best you can and get the patient to the proper unit and this can take up your time and be a challenging day on a MS floor. MS is about time management, basic nursing skills, prioritization, and customer service skills. ICU is all of those, plus taking the 3 month training, more autonomy, immediate life/death decisions, care of the patient and family after death, drips, vents, more lines, more complex illnesses, etc. the point is icu requires more skills and more liability. I never had a patient code in MS, it's called critical care for a reason. I think all critical care floors should be paid more ( and most hospitals and agencies usually do pay more ) not saying MS is easy but it's not as critical as icu. This includes cath lab, picu, nicu, and ER. Think about this: An ICU nurse can float to MS with no additional training but a MS nurse couldn't float to ICU without months of training.
  2. by   William2
    "An ICU nurse can float to MS with no additional training but a MS nurse couldn't float to ICU without months of training."

    ^This
  3. by   Julius Seizure
    Quote from Harveyslake
    If you want nursing to be treated well,...you need to accept that better training should result in better pay. As it stands now,...a nurse is a nurse is a nurse. Just quit that thinking!
    Quote from Here.I.Stand

    I am not arguing that a nurse is a nurse is a nurse. To the contrary I am arguing that each specialty has different areas of expertise and training
    To add to this, there are absolutely reasons that some nurses expertise and training in their field of specialty should warrant higher compensation. Certifications and degrees. Show that you are a leader in your field. Get your CCRN certification. For other specialties, get the certification that pertains to that specialty.

    If you want to be worth more to your company, you have to go above and beyond.
  4. by   Julius Seizure
    Quote from Harveyslake
    Well,...sorry to say,....despite your inferiority complex,....ICU nurses are better. More skills, more experience, more ability. Please let the whining stop and give me evidence to the contrary......
    What about new grads (like me) who started out in the ICU? They didn't have 'more experience'. Should they be paid more?
  5. by   purplegal
    Quote from Julius Seizure
    What about new grads (like me) who started out in the ICU? They didn't have 'more experience'. Should they be paid more?
    Maybe you don't have more experience, but your job requires a greater deal of knowledge and skills than most other areas of nursing. Critical care nursing is more stressful in that you must be able to apply all those knowledge and skills within extremely short amounts of time, whereas other nurses generally have more time when their patients start deteriorating. Expansive knowledge, complex nursing skills and the ability to act quickly in stressful situations...if that doesn't warrant more compensation, I don't know what does.
  6. by   TicTok411
    Critical care does not require way more knowledge or skill. Heck, there are associate degree nurses working in these units. The nerve of these task master nurses thinking they have actual skill is beyond funny. Hospitals can plug in any med-surg nurse and in 12 weeks she will be an "expert". Plus nurses do not make decisions - they follow orders, check boxes and call a provider when told to. Wait is cleaning poo a specialized skill? Get real! If you gain a real degree or attain a certification then sure maybe a dollar more an hour otherwise get over yourself....
  7. by   Cowboyardee
    Here's something of a philosophical answer. Hope you'll forgive my meanderings.

    Right off the bat, I don't really have an opinion as to whether ICU nurses should make more than med-surg nurses. That's for the market to figure out. If there aren't enough ICU nurses, or if hospitals want to make that particular specialty more competitive among applicants, then rates need to go up. If not, I guess not. ICU RNs are already a bit more marketable when applying for jobs or advanced schooling, and perhaps that's compensation enough. In my case, I like ICU work just because I think it is more interesting than med surg, having worked both.

    To me, it's the underlying question that is more interesting: should ICU nurses be considered more valuable and more prestigious than med-surg nurses. I'm of two minds on the matter.

    I'll admit I take a certain pride in working in intensive care, and even more in being good at it. And for the most part, I think that's a good thing. It serves a real purpose. There are often times where I'm assigning a patient to a nurse who has already had a busy day and isn't much in the mood for a heavier workload, and the nurse wants to know why the med-surg floor or the ED can't just solve some of their own problems and hold the patient a little longer rather than dumping on us. And often the best answer I can come up with at the time is this: we are the hospital's last line of defense, the unit that is expected to solve whatever problems come our way whatever they are. The nurse SHOULD take some pride in that. Taking some pride in what you do is often one of the best motivators there is to do good work, to keep working in less than ideal conditions, and to keep coming back and actually even enjoying your career. Taking pride in the nature of your work is a good thing.

    Then of course there's the other side: looking down on others for the nature of their work is not a good thing. Taking pride in working intensive care doesn't have to mean that med-surg RNs are to be scorned or derided, even if you feel as though you have a stronger skill set. One of my biggest problems with American culture in general is that we attach way too much value to what you do and not anywhere near enough value to how you do it. A doctor or a lawyer or a politician or an engineer are impressive and valuable by default, no matter whether they do a half decent job of their work; meanwhile, a teacher, a nurse, a waiter, a CNA - all less valuable by default, regardless of the quality of their work.

    The fact of the matter is that a great nurse is hugely valuable to all who come into contact with her, while a terrible doctor is a drain on and danger to most of the people he comes across. So it goes with just about any other distinctions between classes and skillsets you want to investigate. Are ICU nurses better than med-surg nurses? Who cares. A good ICU nurse is a great thing, and so is a good med-surg nurse. If you think the prestige of some job and ability to look down on others for holding 'lesser' jobs is what's important, you are living a hollow life, in my not so humble opinion. You are a fool, educated or not.

    Take some pride in what you do, do it well, and give respect to others who are good at what they do, regardless of its prestige or lack thereof.

    Quote from TicTok411
    Critical care does not require way more knowledge or skill. Heck, there are associate degree nurses working in these units. The nerve of these task master nurses thinking they have actual skill is beyond funny. Hospitals can plug in any med-surg nurse and in 12 weeks she will be an "expert". Plus nurses do not make decisions - they follow orders, check boxes and call a provider when told to. Wait is cleaning poo a specialized skill? Get real! If you gain a real degree or attain a certification then sure maybe a dollar more an hour otherwise get over yourself....
    Exhibit A
  8. by   William2
    Quote from TicTok411
    Critical care does not require way more knowledge or skill. Heck, there are associate degree nurses working in these units. The nerve of these task master nurses thinking they have actual skill is beyond funny. Hospitals can plug in any med-surg nurse and in 12 weeks she will be an "expert". Plus nurses do not make decisions - they follow orders, check boxes and call a provider when told to. Wait is cleaning poo a specialized skill? Get real! If you gain a real degree or attain a certification then sure maybe a dollar more an hour otherwise get over yourself....
    ADN and BSN has nothing to do with skill or knowledge and ICU. You learn from the same material. What you retain is your own. BSN may spend more time on it than ADN school, but the end result is both are nurses capable of working ICU if they so choose. The secondary learning starts day one of that job and continues and accumulates through experience. The nurses with 35 years experience of critical care are experts in their field more so than a doc that has been there 5. This is evident in my place of work. How ignorant. Any nurse follows orders and checks boxes its part of the job done anywhere. Until you work ICU will you EVER understand.

    Now you are just being a troll. Why are you even here?
  9. by   francoml
    holy crap I started this thread years ago and people are still debating it... Kinda proud lol.

    After years of experience I now believe that all acute care nurses (MS, ICU, ER, ect.) should start off getting paid the same. The caveat to that is we should be substantially compensated for the training and certifications we get. If I pass my CCRN that should be a few dollars extra, if I completed hours upon hours of specialty training in critical care competency I should be paid more. Learn to place PICC lines more pay, CRRT, therapeutic hypothermia, LVADS, ECMO more pay. ACLS, PALS, NRP, TNCC more pay.

    Currently I have all of these certifications/training and with exception of my CCRN (+$1/hr) I am not compensated for any of these skills. Funny thing is the MS nurse with the same years at the hospital still gets +$3/hr more than me in differential pay for simply being a MS nurse.

    I am all about MS being a difficult area, I have picked up there multiple times. They should be compensated if they get their specialty certs as well. THE THING IS... in no way should a MS nurse (or any nurse for that matter) get paid more than me with the same years at the facility with FAR LESS training, certifications, and liability.

    Although its kinda of a moot point now because I am in ACNP school and will get a substantial pay raise when I finish
  10. by   MunoRN
    It's supply and demand, night shift nurses don't get paid more because they are superior nurses, it's because extra pay is required to offset the fact that nurses don't generally like to work nights. The same is true for ICU vs floor nursing. I wouldn't willingly work on the floor for the same pay as I get as an ICU nurse, in fact I wouldn't switch to the floor for more money, at least not until you got into the range of $5 or more an hour increase.

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