critical care vs floor

ParrotHeadRN · Apr 6, 2004

In my experience in ICU, there were no aides of any kind. The primary nurse was responsible for all care, including bathing and changing, etc. The ICU in the hospital where I work now also has no aides. Both hospitals are smaller community hospitals, so I suppose it could be different if you are in a larger facility.

ParrotHeadRN · Apr 6, 2004

There were many many squabbles in ICU as well. People are people wherever you go.

preCRNA · Apr 6, 2004

I have been in the critical care arena for a little over a year now. I currently am working in the MICU/CCU at my hospital.

I think that it totally depends on where you work. The CNA's were I work are really helpful. It also helps that you are (most of the time) only responsible for 2 patients in the critical care setting. (Less Butts, Less wiping) Just Kidding. I look at working on the Unit, even though it may not be the most pleasant, will only last a little while and will be well worth it once I become a CRNA.

Trauma Tom · Apr 6, 2004

My best advise is go spend time in an ICU and shadow an ICU nurse for a day. This will give you more insight into the difference between the two. Although, I think you will find that medical/surgical nursing, whether on the floor, or in the unit is basically the same. The difference involves the acuity of the patients and the patient to nurse ratios. I work in a Trauma/Surgical ICU. We do have aids and clerks. Granted, we do work with invasive monitors, ventilators, and vasoactive drips, which in my mind is more interesting than floor work, but we still have our fair share of dealing with "butt wiping, bathing, and linen changing. In addition, ICU nurses do deal with "other people's bodily functions and secretions." We are all in fact nurses, whether on the floor, in the ICU, or sitting on the stool as a CRNA.

jbro · Apr 6, 2004

i spent 2 years in trauma/cvicu, and have been up to my elbows in other people body fluids, but now i'm in crna school, i think the benifits out way the costs, you have to take the good with the bad

i know a year or more of CC is required for CRNA school, which is a very good idea, but..............
i have worked in a hospital and have a lot of contact with med surg nurses and not so much with critical care........i like everything about the role and education of the CRNA but im not sure i could last a year or two + if CC is anything like regular floor nursing.
this is a serious question...... what are the day to day hour by hour duties of a CCU nurse, other than the meds and monitoring and skilled work........... is there a lot of butt wiping and linen changing involved...ive heard there is less CNA and LPN support in CC and the RN takes on everything......i have no problem with stress of life and death, no problem and lots of experience dealing with docs, and families, ability to stay out of floor/unit squabbles(seems to be prevalent in floor nursing) but i do try to avoid as much as possible other peoples bodily functions and excretions.....
any comments welcome..................thanks

Roland · Apr 7, 2004

If you were to develop a "butt wipe/bodily fluid exposure" index that ranged from one to a hundred how would ICU nurse work compare to other areas? As a CNA/ and BSN student nurse who works in a poor LTC facility (which is constantly being inspected by the state for complaints) I have anywhere from 14 to 20 patients on a given shift. Thus, I face a veritable assembly line of bowel movements (ten to twenty percent of which occur in the shower while I am bathing the resident). Furthermore, we are not given or allowed bags to take in the rooms, and thus must "hand carry" the dirty Depends/rags to the bins. In addition, I get stuck with changing/cleaning an average of three to five colostomy bags (this technically should be done by LPN's, but they pawn it off to the CNA's/QMA's who have been checked off). Thus, I would give my current position a BWBFE index rating of maybe 65 to 70. A trauma surgeon would probably score much higher maybe in the 90's even without the BM's due to all the blood ect. My guess is that the average Med/Surg RN at a typical, understaffed facility might score around 50 (in fact this would be a good way to define a 50th percentile score). Given these assumptions (which you may feel free to correct, and or adjust) how would the typical MICU, SICU, and CRNA position rank on the "BWBFE" index?

suzanne4, RN · Apr 7, 2004

Working as a CRNA, you are going to have to deal with body functions:

a lot of suctioning, vomiting, etc. And patients do "poop" on the OR table and have to be cleaned before taking them to the PACU.....at least they should be clean before you transfer them.......there will be many body odors also.................so please take this in to account............

Roland · Apr 7, 2004

So how would you rate the relative, aspects of what you describe for the different "jobs" in question? Are my average, relative exposure levels reasonable or are they way out of line (keeping in mind we are speaking of averages here). As for smells, it's not an issue for me, but my wife does have a nasty, gag, reflex when it comes to smells. Personally, I have always wondered what would happen if someone had their olfactory nerves, surgically severed. It could be a solution both to aversion to smells AND weight control since without smell there is little or no taste (and it would be no more invasive than having half your stomach resected).

sway · Apr 7, 2004

In my experience, working in an MICU for a year and floating several times to our floors, I'd say that ICU nurses deal with significantly MORE poop and other bodily fluids than do floor nurses. I'm sure many floor nurses will disagree with this. People on the floors can often get to the bathroom, or at least to a commode before things get nasty. Someone who is really sick and obtunded just shits the bed. Usually, you are hoping that they will do this, and giving them things like senna and ducolax to encourage bowel movements. People who are really sick puke, and cough up all kinds of nasty stuff (hopefully not in your face). The other day I took care of an old lady with a vaginorectal fistula and c-diff!!! Talk about nasty...

Cleaning up poop isn't my favorite part of the job, but you just suck it up and deal. I like to think that someone would do it for me, if I needed it. If you're thinking cleaning butts is a reason not to become a CRNA, then I'd say you were probably interested in it for the wrong reasons anyway. You either step up and be a professional or not...

MICU RN · Apr 7, 2004

Hard to get away from body fluids while in the ICU, most I have worked in did not have aids. However, I would use it as a motivator to keep me pushing towards my goal of becoming a crna. And once you are a srna and then a crna you are not responsible for cleaning crap. If you want to help that is fine , but not required. Especially if the pt. is still tubed when they have a BM. YOU stay at the head of the bed and protect the airway. The OR nurse may cop an attitude for not wanting to clean the poop, but that is his/her problem. And as for dealing with secretions, well that is what the suction device is for and believe me I would much rather deal with secretions than poop. BUt as others said you basically have to suck it up in the ICU and deal with the crap if you want to get your critical care experience. IF not go be a NP or something else. GOOD LUCK!

BikeGurl · Apr 7, 2004

Out of my experiences in CCU, MICU, and CTSU, I would have to say I prefer CCU (if you're in a big hospital- where you get really sick pt--balloon pumps, swans, etc). The poop is definately there, but I would have to say there is nothing worse than a MICU GI bleed admit...upper or lower GI. As for working in ICU vs. floor I think you will really enjoy the challenge of learning advanced hemodynamic monitoring, drips, vents, and more 1:1 pt. care. You seem to have more of a say about a pt's care and a closer relationship with doctors, so you don't mind the poop so much. Plus, ICU nurses do lots of team work during code browns. Be strong, you can do it for one year! You can do anything for one year! Or you can always put a face mask on to block the scent.