Should ICU get more pay than floor nursing?!?

Specialties MICU

Published

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 work in a large level one ICU and I make critical life altering decisions on a daily bases. I have far more autonomy and with that comes more risk to my license. Don't get me wrong I LOVE my job and LOVE my facility but how can a nurse get paid more to pass meds on the floor than I do in the ICU. And before anyone makes any comments about the "just passing meds" remark, I have worked a few shifts on the floor and that is just about all I did was pass meds!

Is it like this on y'all's unit or is this specific to my facility?

You opened a can of worms with this one buddy! Lol

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Specializes in Acute Care - Adult, Med Surg, Neuro.
I'm guessing the ones you discussed wages w/ have worked there longer, and are paid more for seniority, not for being med-surg nurses.

I'll also say as one who has worked more than "a few shifts" on the floor, if all you did was pass meds on your few shifts you had it easy.

The hardest place I've ever worked was the floor of an LTACH. A typical day could include 4-5 pts, all w/ complex wounds. M/W/F were vac change days, but Mondays was when the wound dr. rounded and thus when the WOCN did their changes. Soooo...that meant on Wed. and Fri, the floor RN had several vac changes. One could take 2 hours, if the pt had 4 stage IV pressure ulcers. Among other lengthy dressing changes I had personally were circumfrential burns to bilat LEs...big open belly w/ a Wound Manager covering all the packing...Fournier's gangrene of bilat groin...freak dental lab accident resulting in burns from the waist to the top of the head... Many of these pts were on ventilators. Many needed their meds crushed and had those teeeeeny little bore feeding tubes that are VERY easy to plug, so even the "med pass" could get complicated. TPN, enteral feeds, IV fluids. Admissions. Pts and families who had already been through the ringer, and the behaviors that accompany chronic critical illness. (This cannot be underestimated!! Think helicopter families and people acting out of frustration that you see in the ICU, and take that to the nth degree.) Multisystem physical effects of chronic critical illness. Pain. Lots and lots of pain. Routine and critical labs...no phlebotomists. Paper MD order entry and paper charting.

Now I work in the SICU of a busy urban Level 1 trauma center. I took a $4/hr pay cut to come here. It was well deserved. ;)

Quoted for truth.

Not to sound bitter, but you guys already get all the glory. As a med-surg nurse, I'll be bending over backwards for my patient, and the family will say "Those ICU nurses were fabulous!"

Caring for six + patients with frequent admissions and discharges, better give me a pay raise too.

For fairness, both our jobs are hard, but in different ways.

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Op, I am guessing that the same reasons that keep you from transferring to the floor are the same reasons those floor nurses are being offered the incentives you spoke of.

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Specializes in ICU Surgical Trauma.

Yes to answer your question.

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Also notice that those diffs are not built into the base pay. If at any time the supply/demand changes those "incentives" will be lost and the MS nurses will again be at the same base pay as yourself. If you don't like it, feel free to request a dept change to MS so you can get the same pay. If you desire to be an ICU nurse and not a MS nurse, well...then I guess you will make $3/hr less (until your experience, education, etc. changes and you qualify for more incentive pay).

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In Alberta, you make the same regardless of what department you work in. I would make the same in a public nursing home as I would in an OR or ICU :( I agree that in ICU you should definitely make more. I have to pay more to have extra certification and to renew them annually!

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

I've worked Med/Surg, I've worked ICU. It's a different skill set, but each job requires it's own skill set. I'm guessing that the laws of supply and demand are at work. If every new grad wants to get into ICU so they can get into CRNA school as soon as possible, perhaps Med/Surg pays more so they can staff it. Med/Surg nurses work hard for their pay.

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Specializes in ICU.

I actually get paid more in the ICU than I did on Med/Surg in the form of a "specialty bonus."

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Specializes in Critical Care.

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.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
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.

You are lucky you wrl at a place that does this....most places do not.
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Specializes in Emergency and Critical Care.

When I worked ED, and ICU most of my patients never remembered me, they would always talk about the floor nurses. Most places I have ever worked gave a stipend for critical care nurses. The point made about requiring the additional certifications is a good point. But I got to tell you that M/S certification exam I thought was harder than my CCRN, CEN, and OCN, chemo. The overall toughest is the Heart Rhythm societies electrophysiology. That was a booger, I did not pass it, I did pass all the others. I think it all comes down to supply and demand. Others have noted that it is not part of the base pay which makes it easier to cut it. I have seen them come and go often over my past 30+ years.

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Well, this argument is as old as time. The correct answer is yes, critical care nurses should be paid more than med/surg nurses. The only nurses that disagree have never worked critical care. If a code is called, who shows up, a floor nurse? If a patient is crashing do they get transfered to a med/surg floor? ICU nurses have a skill set far beyond anything a med/surg nurse possesses. Part of the problem in nursing is that nurses often accept the a nurse is a nurse banter from administration. The fact is, in just about every human endeavor, except nursing, the better your skills and training, the better your earning potential. When I get floated to the floor, the patients are well cared for. If a floor nurse gets floated to an ICU and has to take care of a real ICU patient, well,...the outcome would be less than desirable. Not knocking floor nurses in the least. They work hard too, however, let's be realistic. A neuro surgeon makes a lot more than a family practice physician because he has a different, more advanced skill set. The family practice Doc probably sees many more patients in a day and does a lot more paperwork than the neuro surgeon but the one with more advanced skills and training takes home the bigger pay check. Why should nursing be different??? Let the flaming begin! 😀

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