Critical Care Eliticism?

Sour Lemon · Feb 21, 2020

1 hour ago, LibraNurse27 said:
Hi all, wondering if anyone has come across an attitude from some critical care doctors and nurses that suggests critical care providers are more elite than other specialties like med/surg, postpartum, etc. I currently work in critical care but due to my mental health issue I want to transfer to a different department. I have an interview for postpartum that but when I talk to my coworkers they say I will lose all my skills, be bored, etc. one doctor said I’m “too smart” to go there, another said I will “just hold babies and pass out colace”.
these are all nice people so I was surprised at the comments. I get the feeling they think critical care is the most important and challenging department where the smartest people work. I respect all specialties and they all have their challenges. The ratios, time management and assessment skills in med/surg are the most difficult things I’ve dealt with as a nurse. Is going to postpartum really that big of a “step back”? I’m excited about it and think I will learn new things. Postpartum hemorrhage and eclampsia are no joke! Any opinions? Thanks!

I wouldn't get wound up about it. It makes sense that they'd think their area is the best area. That's why they chose to work there, right? ?

**LibraSunCNM, BSN, MSN, CNM** · Feb 21, 2020

As a former med/surg and postpartum nurse who is now a CNM, I can tell you that postpartum is often scoffed at as being a cake job (just as med/surg often is by critical care folks). And in some facilities, it is true that nurses don't do much there, TBH. But if you work in a good unit that prioritizes education for patients and breastfeeding assistance, you will be very busy! I was just as busy on postpartum as I was on med/surg, I was just less worried that my patients would drop dead at any moment ?

brownbook · Feb 21, 2020

Say something like, "I believe giving mothers and newborns a healthy, educated, start in life should be prioritized in health care". Smile and walk away....think to yourself "you can't fix stupid".

Closed Account 12345 · Feb 21, 2020

Critical care and postpartum are extremely different, but different doesn't always have to mean better/worse! A typical postpartum day for me looked like quick assessments, pain management, occasional PRN medications, breastfeeding assistance, patient education, sometimes glucose management, occasional caths, rare blood transfusions, 3-4 discharges, and 3-4 admissions (pretty straightforward so never took very long). It was definitely a lower acuity, lower stress environment. Your friends aren't wrong that you will use fewer nursing skills. At least in the regions where I've worked, most hospitals manage Pre-E/mag patients in L&D for first 24 hours. Thankfully, PP hemorrhaging is pretty rare. I only started one IV while working in postpartum. But here's the awesome thing about nursing skills... They're like riding a bike, if you've done them enough times for them to become part of your muscle memory. Your ability to start IVs won't just disappear, if your skills are strong to begin with! You'd also be a great resource for unexpected medical complications that arise in PP. Let yourself take a break from critical care. If you completely regret it, you can always go back. If you find that you love OB but want higher acuity patients and more skills, you can crosstrain for L&D or NICU down the road. If any of your peers think that your worth as a person or nurse is defined by which unit you work in a few days a week... that's on them. They're wrong, and that's a sad way to think. Good luck!

SteelGrey · Feb 21, 2020

Go for it! There is nothing wrong with liking something new or dare I say being comfortable, happy and enjoying your job.

As previous poster recommended, you could always cross train in the future into L&D if you want more excitement in the future- I call it ER for pregnant peoples ?

Also NICU, but that would be closer to the 12 hours of ICU your used to and trying to get away from depending on the acuity of NICU’s around you.

HandsOffMySteth · Feb 21, 2020

All fields are important. Do what makes you happy. No one is better than anyone else.?

Horseshoe, BSN, RN · Feb 21, 2020

18 hours ago, LibraNurse27 said:
these are all nice people so I was surprised at the comments. I get the feeling they think critical care is the most important and challenging department where the smartest people work.

Yes, that's what they think. Meh.

But they're still "nice people."

K+MgSO4, BSN · Feb 22, 2020

I had a senior ED nurse clash with a number of my nurses over a few weeks. Ego galore, why were we taking so long for beds, why couldn't we organise things when the pt arrived.

Spoke with her NM and invited her up for a shift on the ward. By 11.30 she was freaking out. By 2pm she was contrite. And it wasn't even a busy day! Only 1 theatre case, one active GI bleeder, and 2 other patients. But lack of constant access to medical staff, less ancillary staff, more allied health staff with requests and a ward that actually followed P&P opened her eyes.

I always say each area is special or busy in their own way. Also there is only 1 ED and 1 ICU but 20 multi day wards in our hospital, which suggests that most people need more that critical care...

juviasama · Feb 22, 2020

Well, some people just have a God complex..

GrumpyRN, NP · Feb 22, 2020

9 hours ago, K+MgSO4 said:
I had a senior ED nurse clash with a number of my nurses over a few weeks. Ego galore, why were we taking so long for beds, why couldn't we organise things when the pt arrived.

Sounds like you work in my hospital.???

Some of my colleagues can be a bit abrasive. Not me though, I was always wonderful and helpful and understanding.???

RNFANP, BSN, MSN, RN, NP · Feb 22, 2020

I've seen this from a couple of different sides. I worked ED and was constantly harassed by the ICU nurses - "I don't think this patient needs to be in ICU" or "why didn't you clean the patient up before transfer?!" (I did but I can't help it if they have a bowel movement or pee everywhere during transfer - can't stop in the hallway to do that!) or my personal favorite: taking care of a SVT patient "why didn't you empty the foley and count it?!" Um sorry I was making sure her heart rate was in an acceptable range? These nurses were also the ones who would somehow be magically gone when I arrived on the unit, leaving me to transfer the patient over myself, get them changed into the ICU gown (heaven forbid they be in the ER gowns which were different from all the rest of the floors - why I don't know) and get them hooked up to a monitor. Only then would they appear and ask if I needed help. Nope. I'm good.

Moving to the OR, I saw at lot of hate from the OR towards the ER. "Why wasn't this patient completely undressed? Why isn't their consent signed? Why this, why that." I actually had to sit and explain to some of these people that sometimes the going to surgery patient may not be priority (if they're stable and just waiting to go) and that I may have a crashing patient next door that requires all my attention. I never complained when I went to pick a surgery patient up if they weren't completely ready. Instead, I -gasp- helped get them ready - grabbed fluids, got admission paperwork, signed consents, etc.

It's all about people's attitudes. I think it's a grand idea to have people who complain the most about other departments go to those departments and see what it's really like. Many of the OR nurses who complained about the ER nurses would never survive an 8 hour shift in the ER.

Moral of the story - haters gonna hate and you just gotta block that negativity from your life. You do you.