ICU nurses attitude toward med-surg nurses - page 4

1. 
   Aug 28, '09

   Quote from meandragonbrett

   I REFUSE to float to any other unit outside of an ICU and accept a patient assignment. I will float around, do accu checks, give meds, help with vitals, etc. but I am NOT taking a patient assignment. If they are demanding that I take an assignment I'll delcare it unsafe and go home.
   
   I don't know why administratio and other non-critical care nurses think that because we can manage 2-3 critically ill patients that we can manage 7-8 medsurg patients. It doesn't work that way. I cannot turn the critical care nurse off and the medsurg nurse on. I am certified as a critical care nurse and am trained in that fashion. I have *no* training how to function on a medsurg/stepdown/tele floor and I shouldn't be expected to carry a patient assignment when I've not received a proper orientation to that unit.

   I agree with this. If I was floated anywhere else I'd refuse a full patient load as well because right now I am no longer competent to do anything other than OR. I haven't given meds in about 4 years. I can give bed baths, take vitals and help with feeding and make beds but that's probably about the most I could manage. It's not because I feel that other areas are beneath me it's because I simply would not know what to do.
2. 
   Aug 28, '09

   In a cost saving measure, my hospital recently told ICU nurses they would be floated to general units if the ICU was not full.
   
   The PRN nurses are sent home first, before anyone else. They get paid the most, so it is cheaper to have an ICU nurse go to the general floor than to keep giving casual status workers hours. At first some refused, got upset, but I haven't heard much about it since.
   
   The one time I was working and there was a Critical Care nurse floated to our unit, I thought it was a positive experience. This nurse was given a full pt. load on the part of the unit that sits alone, detached from the rest of the unit. She complained about being left there on an island and changes were made. Other nurses who called the unit home had made the same complaints before but nothing was done.
3. 
   Aug 28, '09

   I float all over the hospital--med/surg, intermediate and the ICUs. I have yet to float to an "easy" area. Every area has its stressers for different reasons. As others have said, it's best to play nice and be kind to all our co-workers because you never know when you're going to need them.
   
   Unstable patients are stressful for obvious reasons but a handful of medically stable patients can have LOTS of needs--particulary in this customer service environment. We all need to walk in each other's shoes from time to time.
4. 
   Aug 28, '09

   I have worked the majority of my years in the ED (level one trauma center with 400 patient visits per day). I currently work med surg. I have also worked in the ICU, psychiatry and in day surgery so I know about each area and the kind of work they have to do there. So I think my perspective is a bit different. I know what sick looks like and even though I am now a "floor nurse" I do know what I am doing.
   
   On my floor, when I am getting a patient from anywhere I need to know some specific information in order to place the patient in the correct location because of the way our floor is set up. It is like pulling teeth to find out if a patient is on isolation or is climbing out of bed. I very often cannot get a correct report from the other units sending me patients. I give a bed assignment into a semi private room and then they show up with everyone in an isolation gown, needing an isolation room that I don't have. Also, I cannot take every transfer at the same time. I am getting patients from multiple locations: outpatients, direct admits, ED, ICU, PCU, OR, day surgery. No one seems to understand this.
   
   I need to make sure the patient is stable. About two weeks ago I received a patient from surgery who had a respiratory rate of 4-6. I cannot monitor that patient properly on a 34 bed floor when each nurse has 5 patients. We do not have the proper monitoring equipment. We take care of near critical care patients on our floor every day. We had a lady the other day who's blood sugar would not stay above 40 no matter what we did. It took me 24 hours to convince the doctor to transfer here. I just cannot do Q30 min glucose checks on my floor when the nurse has 5 other pts. It is very frustrating.
   
   I think it would be nice if all of us could rotate one day in each others areas to see what is going on there. Then perhaps people would have a better understanding and less friction would go on between units.
   
   The bottom line is that I need accurate information so I can assign the patient to the proper room with the proper nurse. That's what I need. I need to have the patient come up with a working IV (not an infiltrated IV) and can the ED PLEASE learn to start an IV somewhere other than the AC. I have to pull that line as soon as they come to me and restart that IV somewhere else or the pump alarms all night and the line clots off because the pt bends their arm.
5. 
   Aug 30, '09

   at the end of the day, it all comes down to RESPECT! one may have all the credentials the world has to offer, but if he/she does not know how to show respect for others, this culture of "I am smarter than you" will always be present in the workplace.
   
   thank you to those who left messages. i like what meandragonbrett wrote, "Just let it roll off your shoulder and know that some nurses will always be jerks."
6. 
   Aug 30, '09

   I disagree with meandragonbrett, one of the reasons for the shortage is Nurses are treating each other disrespectfully on a regular basis so 'just letting it roll off your shoulder' technique is never going to improve the current work environment. Nurses tolerate behaviors that go against basic polite rules of engagment. There is a underlying bigger problem but that is for another blog.
7. 
   Aug 30, '09

   I am a new grad who got hired for the ICU. I am currently in a new grad residency program and I am finishing up my Med-Surg rotation. While I was at work the other night, someone asked me what department did I get hired for. When I said MICU, I got the teeth sucking sound and the person looked at me crazy. When I asked what's that all about, she told me that the ICU nurses in the hospital got a horrible rep of being "stuck up and snotty" and they always transfer patients to the med-surg floor in a "mess", with blown IV's, dirty gowns, etc.
   
   I just smiled and said "well I'm glad I had this experience in Med-Surg to understand what's it like when I do get to the MICU". I've also heard this "ICU nurse generalization" at other hospitals.
   
   I also hear bad things about ER nurses, which is my next rotation. And that night we also got a new admit from the ER and the patient didnt have any IV access and the Med-Surg nurses spent atleast 10 minutes complaining about the ER nurses and how they always "dump" patients on them and they know good and well they should have started an IV on the patient, etc.
   
   All I will say is that I'm glad for this experience in my new grad residency program so I can see the entire picture. I don't think one department is better than the other, and after handling 4 patients on my own who all have meds due at the same time and who are all on their call lights at the same time, I will say I have a great respect for Med-Surg nurses. I think respect need to be given both ways, and if you have never walked in another shoes, you have no idea.
8. 
   Aug 30, '09

   I'm in Med-Surg and haven't seen any of this "ego stuff" amongst departments. Actually, of all the reports I've given/have gotten, the other nurse has been nice and not condescending at all! Maybe I'm just lucky??
9. 
   Aug 30, '09

   I dislike this thread, but I have an idea. Let's all just get along. We all have difficult jobs, for various reasons. We all have strengths and weaknesses. We are all nurses and the most important thing is patient care. Assume positive intent. The end.
10. 
    Aug 31, '09

    Quote from JomoNurse

    I'm in Med-Surg and haven't seen any of this "ego stuff" amongst departments. Actually, of all the reports I've given/have gotten, the other nurse has been nice and not condescending at all! Maybe I'm just lucky??

    You are lucky.
    
    After 19 years of doing this, I have learned that every job in the hospital has its place and every job is difficult. I work in PACU. I get a lot of eye-rolling when I bring my patients upstairs, but I just smile. I explain everything I could've possibly done for the patient and speak with the nurse in a collegiate, respectful, and mostly humorous way. We connect as nurses, we connect as people. I do not feel I need to make another person feel bad to make myself feel good--and if they don't like what I've done, I just tell them the truth--and that is I've done all of I can and "thank you for the care you will be giving this patient."
    
    Know what? It works. I know a lot of nurses on MedSurg, Pedi, ICU, and they are always nice to me. Maybe it is because I have great respect for them and what they do, and I let them know it.
    
    How about ALL of us do that for each other????????
11. 
    Aug 31, '09

    Quote from Scrubby

    I've worked in ICU and med-surg and seen the good and bad of both worlds. I guess the problem is lack of understanding of what other nursing areas involve. Every speciality area has different set of priorities.

    That's exactly it. As a telemetry floor nurse, I used to wonder why I got such cruddy reports from the ED, or why they couldn't seem to place an IV anywhere other than the AC, or why my patients got sent up with wet undergarments or clothes still on. Now that I'm in the ED, I totally get it. Of course, knowing the kind of report the floor nurse wants will make me better at giving report, but I still cannot go into the depth that would normally happen during shift change report on the floor. If the patient has a nice vein somewhere other than the AC, I'll go for it. But if I don't have time to dink around, the AC it is. In fact, I started my first AC IV for the first time ever just the other night. I usually go for the cephalic in the forearm, but most of the time I need to get those labs drawn yesterday, and the AC is going to be the quickest and easiest. If they came in saturated with urine, I've changed them, but in the meantime, they may have wet again and I won't have necessarily had time to address it. It's not that I don't care or that I'm sloppy, it's just that my priorities are really the ABCs, and most everything else can wait.
    
    Having never worked in ICU nor Med/Surg, I can only say it must be a similar kind of dynamic. I remember getting report from ICU nurses, and getting the patient's entire life story, from whether they were breast or bottle fed and at what age they first ate solid food, to what kind of toilet paper they use...yes, I am exaggerating, but that is often how I felt. All I really needed to know, as a floor nurse, was much less detailed.

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