Which unit is more manageable for a newbie: MICU or SICU?

[Workinghard123]

Hello. I've been an IMC RN for almost two years and ready to make a move to ICU. Does anyone know which unit would be less stressful between MICU and SICU? Thanks for your help. I want to make sure I'm making the right move

[Cvepo]

I have worked both. They are both stressful. If you are trying to avoid stress, the ICU is not the place to go. Personally I enjoy SICU more than MICU though.

[Julius Seizure]

I would pick the one where you have the most interest in the patient population. Are you interested in patients who have had surgery, or patients with infections, etc?

[gigi_rn]

MICU often has longer stay, great learning opportunities for intricate pathophysiology. SICU has higher pt turnover, unless trauma included.

[ClauICURN]

"Less stressful" This part made me laugh, haha

MICU patients tend to be older with multiple comorbidities, while SICU varies but can have more of a mix or even a higher number of comparatively younger patients. In MICU you will see very sick patients, mostly infections, multiple organ failure, and pulmonary issues. As others have mentioned MICU patients tend to stay longer, some might be comatose so get ready for issues of futility and end of life. Not to say it is not an issue in the SICU, so be warned if you think it can be a problem for you. SICU patients that are younger tend to have a good chance to make it out of the unit, which can be emotionally rewarding. However, these are only generalizations and both are demanding and high stress. ICUs tend to attract interesting personalities, so the most important thing is to be proactive and enthusiastic about learning, as well as willing to become competent in your role. I won't lie the environment can be cut-throat so if you would like to work in a more relaxed environment, critical care might not be the right fit for you.

[TicTok411]

MICU has all the chronic patients that make you dread going into to work, it feels like they never leave and even worse they always come back. SICU I always thought was way more fun. You see them get better and leave and you do not always see them again. Yes, those patients turn over quicker but I always enjoy a fresh patient right out of OR/Recovery. I never thought the ICUs were stressful. You usually need to know a handful of medicines fairly well, understand normal hemodynamics (and when someone is trending) and what labs you should look out for. People get scared and make it into way more than it is...

[NewHam CRNA]

I've worked both MICU and SICU at a few different hospitals. I think MICU is a better ICU to start in. No doubt it's challenging, and there's no reliable way to know which patients will be sicker in which unit - all depends on the hospital. That said, SICU patients have a ton of drains, wound vacs, traction etc which is a bit of a pain when you're trying to adjust to ICU. Also, I think MICU exposes you to a wider array of pathophysiologies. Good place to get the critical care basics down. The downside, as TicTok said, is that there can be a lot of chronic patients which can be challenging.

[outriton]

I've worked in both and prefer the SICU. I also found it to be more personally rewarding as the above commenters mentioned. Not only do the people tend to be able to leave, it's generally a more positive experience their families as well. For example, I worked in a SICU that had a lot of thoracic surgeries, especially lobectomies, so patients knew this surgery was coming up, families could plan to be with the patient, and, when things went to plan, everybody was happy that grandpa was recovering from cutting the cancer out. It can really feel like you're connecting with a patient and their family during a joyful, momentous occasion in their lives, and the surgery often a big enough wake up call to get them to take your education seriously and make life changes.

In the MICU, on the other hand, you do get a lot of "frequent fliers" for asthma/COPD exacerbation, CHF exacerbation, drug ODs, etc. It can definitely feel demoralizing that you keep seeing the same people every few months, like all the education and care was for nothing. Plus the family dynamics can be very challenging, like helping a patient call a family member to let them know they're in the ICU again after *another* OD.

For "less stressful" in terms of learning your way in critical care, I would just say that, in some ways, you can plan your day in the SICU better. Sometimes you know Bed 3 is slotted for that ENT surgery patient when they get out of the OR in approximately 3-4 hours, so you also know when you need to get everything done with Bed 4 by.

[MurseJJ]

I've worked in both and prefer the SICU. I also found it to be more personally rewarding as the above commenters mentioned. Not only do the people tend to be able to leave, it's generally a more positive experience their families as well. For example, I worked in a SICU that had a lot of thoracic surgeries, especially lobectomies, so patients knew this surgery was coming up, families could plan to be with the patient, and, when things went to plan, everybody was happy that grandpa was recovering from cutting the cancer out. It can really feel like you're connecting with a patient and their family during a joyful, momentous occasion in their lives, and the surgery often a big enough wake up call to get them to take your education seriously and make life changes.

In the MICU, on the other hand, you do get a lot of "frequent fliers" for asthma/COPD exacerbation, CHF exacerbation, drug ODs, etc. It can definitely feel demoralizing that you keep seeing the same people every few months, like all the education and care was for nothing. Plus the family dynamics can be very challenging, like helping a patient call a family member to let them know they're in the ICU again after *another* OD.

For "less stressful" in terms of learning your way in critical care, I would just say that, in some ways, you can plan your day in the SICU better. Sometimes you know Bed 3 is slotted for that ENT surgery patient when they get out of the OR in approximately 3-4 hours, so you also know when you need to get everything done with Bed 4 by.

This is why i'm leaning towards CTICU...I think it would be pretty awesome to care for patients after long-awaited heart/lung transplants.