Changing to ICU

[Ckh003]

Hello! I have been a nurse for a little over 3 years now and my whole career I have been working at an acute care rehab. We are mostly neuro but sometimes have an ortho, cardiac, or respiratory patient here or there. We take very sick patients often right from the ICU and they stay until they can be sent to a subacute rehab or even home.

Anyway, I started there because I worked there through school and ended up staying because I had a baby early this year and they worked with my schedule. But now I would really like to expand my career. I have been thinking about trying to get into ICU nursing. I have my BSN and have my ACLS already. I like a challenge. And I like the idea of having 2 patients that I can take thorough care of. Right now when I am on the floor I usually have 6-9 patients depending on staffing. I never can dedicate the time I would like to each individual patient and their family.

I also have leadership experience as charge nurse and fill in supervisor on weekends/holidays as needed.

I would love love to hear from some ICU nurses. Hear some pros and cons of the position and some ways I could prepare myself if I chose to take this route. Tips and tricks all welcome!

[RNNPICU, BSN, RN]

The ICU is a very fast paced environment. You will see a lot of patients that you are seeing in the the rehab facilities. Although you have 1-2 patients, you still won't have a lot of time to dedicate to patient family as your day is many times consumed by tasks, roadtrips, total care, labs, calling pharmacy, calling MDs with critical values, etc. For the sick patients, you will be calculating medications, on a half hour/hourly basis, sometimes even more frequently. You will start to learn the subtle changes, how to respond to ABGs/VBGs that are abnormal, or finally WNL, learning to titrate drips, advocating for appropriate sedation, or specific consults. You will be educating about meeication, treatments, there will be days when you wished you could have spent more time with your patients.

It sounds like you have a great background, that rehab has made you familiar with trachs and vents and neuro assessments which are so important. Multitasking will be very important as well as setting priorities. Some days, just be thankful all the meds got in on time and your patient is still alive.

On the positive side, it is great when the patient you have had the past several shifts, is finally starting to respond to therapy. There is a lot of team work because you will need 3-4 people to help turn/bathe/change your patient, someone always knows something more than you or has read something new, or attended a conference with interesting information.