Critical care vs Med-Surg

[curetheworld]

I have heard many comparisons b/w critical care nursing and Med-Surg nursing. Here's my preceptor's POV.

I started on a Med-Surg floor to get some experience before transferring to cardiac ICU. During weekly evaluation, my Med-Surg preceptor said...." this (med-surg) is a acute care floor, things change fast and people come in & out all the time. You need fast-pace and high-level of expertise to work at such a place. You have FIVE patients, not like ICU where you have only 1 or 2. ICU is much easier !!!"

while I do agree with her partially

-yes, you do need to be organized and have excellent time management skills in Med-surg

-yes, you have 5 patients and people come in and out.

BUT

-ICU is not exactly "EASY"

The ratios were made after much consideration. In ICUs your 1 or 2 patients are much sicker and need constant care/monitoring. Tell me she was wrong in making that statement.

I was irked even more because she is one of those people who're not only stubborn but refuse to even listen to another person's argument.

How do I deal with her?

BTW, this is not the 1st time she has made such a statement. She says things like... "ICU nurses could NEVER work on this floor."

"I'm the best on this floor, even better than nurses working longer than me."

I really dislike her.

[RNperdiem, RN]

There is a status system in nursing. It is unstated and unfair but real. At the top are the specialty units- ICU, ER, L&D, flight nurses, OR. Closer to the bottom are Med-surg, long term care, geriatrics and long term care.

I think your preceptor sounds defensive. Med-surg does not get the respect it deserves, and the she seems stung by it.

Ok, so you do not like her. Beware of touchy egos. Listen politely, give no opinions and try to get through orientation without rocking the boat.

I think ICU is easier once you have mastered ICU skills.

[nursemike, ASN, RN]

One does, occassionally, encounter an attitude that, "My patients are sicker, so I'm more important/a better nurse/whatever than you." It can tend to rankle, a bit, and it's no less stupid than the attitude your preceptor displayed.

At our facility, ICU nurses are sometimes floated, but only to stepdown assignments, where the ratios are 3:1. That happened on my unit awhile back, and one of our nurses had to give up her stepdown assignment and move to a regular, acute care (floor) assignment. So it was kinda refreshing when the ICU nurse remarked that it had been a long time since she had to manage 3 patients, and she didn't know how we did it night after night. There wasn't even a hint of pretense that she would have just breezed through with a floor assignment of 5 or 6.

Likewise, a lot of us have heard of a Swan-Ganz, but aren't entirely sure how to spell it, much less what to do with it. And while a lot of us can manage comfortably with five, get along okay with six, and could probably cope with 7 or 8 if we had to, it's hard to conceive of doing a med pass for 30.

It seems pretty clear that every acuity level has its skill set, and anyone with any sense should realize that the only easy jobs in nursing are sitting in the ER, waiting for the ambulance to roll up with another stoved toe.

(Uh, you do realize I was being ironic, there, right?)