Floor to ICU

Specialties Critical

Published

Good morning AllNurses!

Almost 1 year as a floor nurse has gone by (it's my first job after school). I have a chance to go to an ICU at a smaller hospital. I'm thinking it through, and just wondering how others have felt going from the floor to the ICU.

There will be a pay cut of $4/hr since it's a smaller health system, but that doesn't bother me so far. I would be going from Level 1 to Level 2 trauma, but as a floor nurse I don't ever see Level 1 stuff anyway. I do look forward to the 1 on 1 or 1 on 2 ratio, since I typically have 5 busy floor patients.

Any words of wisdom in the transition from floor to ICU? I'm welcoming all advice...

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Specializes in tele, ICU, CVICU.

I also went from a med-surg RN to ICU and LOVED it. Yes, it was also a smaller hospital, but learned a LOT that was missing in tying together lose ends (pathophysiologically, etc) on the floor. Eventually, we even started doing open hearts & lots of very ill patients, so I couldn't have been happier, until i left to travel for ICU & trauma.

As far as any tips: ask away. Don't be afraid (as long as you trust your fellow nurses, of course) to ask how & why things work, etc. I know I had to take a critical care course for a few weeks & really enjoyed that as well. I can't really think of anything specifically that aided me on the floor, other than making sure you ensure good understanding of clinical practices & application of theory into practice. Congratulations & best of luck on your transition!

There are different specialties listed if you go to the top of page. You might try there, to get more feedback. :-)

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Moved to the Critical Care/ICU forum for more responses.

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I am making this transition too, from step-down to ICU, but at a smaller hospital! Very excited/nervous to be working in ICU! It was my favorite rotation in school.

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One thing that I noticed while transitioning from a step down unit to the ICU was prioritization. Frequencies (at least where I work) were different for example on the step down unit we did intake/output totals Q6H and in the ICU we do them Q2H. I find that I am sometimes busier with 2 actual ICU patients (unstable vent, TBI, triple pressors ect.) as opposed to 5 telemetry/step down ICU patients. I love the ICU and never regret transitioning to a higher level of care. The amount of knowledge you gain is invaluable and the team aspect of the ICU is something very unique and special. My biggest piece of advice is to enjoy it and make the most out of it.

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Specializes in CCU, med/surg (cardiac/tel).

So I started off as a Surg/Telmetry RN spent 2.5yrs and then switched to ICU nursing. I loved the switch. I have attempted to go back to med/surg but my heart is in the ICU. I now am a Agency RN and am willing to do what ever where ever. I do not think that going to a smaller hospital would be a huge change from the larger level 1 trauma hospital. Maybe you won't get the big GSW's or the MVA's, but you will still get the sicker than a dog/hovering on deaths door patient's. I am excited for you. I love ICU nursing. Yes you can run harder, critically think more, and get your behind handed to you on ICU as much as you do in med/surg, but you can see your efforts more. I have run my butt off on med/surg and look back at my shift and go "what in the world have I been doing all night that I am so tired" but did not feel like I got anything done, but in the ICU you can actually see what "YOUR" actions have done. You get to be more involved with family and patient. You can bring some one back from death. It can be a high stress, high emotion, high intensity, high reward job. If you are an adrenaline junky ICU can be for you. You have the responsibility of taking care of a patient that you can heal or break.

I would not change my med/surg experience for anything. When I went to the ICU I could out assess (because in med/surg you can see everything, cardiac, ortho, pneumonia, renal, neuro and so I had experience with so that I could pull from past experience. Never had to stop and ask myself is this a normal lung sound), out chart (cause you know you have had the 5 patient's you started with sent 3 home and got 3 more)and out organize other nurse walking in from nursing school. You have a lot more tools in you basket of goodies to pull from.

I am excited for you. You will have fun.

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Specializes in MedSurg, OR, Cardiac step down.
I also went from a med-surg RN to ICU and LOVED it. Yes, it was also a smaller hospital, but learned a LOT that was missing in tying together lose ends (pathophysiologically, etc) on the floor. Eventually, we even started doing open hearts & lots of very ill patients, so I couldn't have been happier, until i left to travel for ICU & trauma.

As far as any tips: ask away. Don't be afraid (as long as you trust your fellow nurses, of course) to ask how & why things work, etc. I know I had to take a critical care course for a few weeks & really enjoyed that as well. I can't really think of anything specifically that aided me on the floor, other than making sure you ensure good understanding of clinical practices & application of theory into practice. Congratulations & best of luck on your transition!

There are different specialties listed if you go to the top of page. You might try there, to get more feedback. :-)

Why do you say until you left to travel for ICU and trauma?

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