CSICU vs Onc

Ruby Vee, BSN · Sep 21, 2017

Hi Everyone,
I can't tell you how many times I have looked through topics and comments for insight and information. Well now I need a little help. I have been a nurse for 5 years. I currently work on a heme/onc floor with heavy emphasis on acute leukemia/lymphoma in an academic medical center. I am between two jobs right now, one is a leadership position on an onc floor in a community hospital and the other is a staff nurse position on a CSICU at a teaching hospital.
I love my onc patients and I also like charging/being in a leadership role. I also have been eyeing a possible transition to an icu for some time. I know it is going to be a big learning curve for the icu position. I was just wondering if anyone else on here has made a similar transition. If so here are my questions: What was it like? Did you ever regret changing specialties? What was the most rewarding or exciting experience on the new unit? What was the hardest part about changing specialties? If you have any other info for me please pass it along!
Thanks!!

I transferred from Heme/BMT to MICU/CCU at a midwest teaching hospital years ago. There were many reasons for my transfer -- the culture of the particular Heme/BMT floor was not a good fit for me, the new nurse manager was getting rid of every nurse who had more experience than she did, and all of my primary patients had died within a month or two of each other. I had never considered ICU, but the manager signed me up on the transfer list and before I knew it, I was interviewing and transferring. It turned out to have been a really good move.

In Heme, most of my patients came back over and over again. It was great when they went into remission; not so great when they relapsed. In the ICU, a large percentage of the patients got better, went home and didn't come back. I found that aspect of the change to be very refreshing. In the ICU, the emphasis was on the physical needs of the patients, and all of the psychosocial needs were addressed only after the patient was stable. In Heme, the psychosocial needs were waited equally or above the physical needs. I had a very difficult time fetching orange juice, fresh blankets and kleenex for the able-bodied spouses of my Heme patients while other patients were in need of meds, transfusions, toileting, etc. In the ICU that just didn't happen. Once everyone was stable, yes. But not before.

I found the ICU classes to be interesting and challenging and I welcomed the opportunity to learn new things. It turns out that ICU was my niche and I've been happily employed as an ICU nurse since 1982.

23AtTheTeeth · Sep 21, 2017

I started in a Level I Trauma Center CVICU at the end of last year, and it has proven to be the most challenging/rewarding thing I have ever done. I, too, transferred from a leadership, Charge Nurse role at a smaller hospital to a staff nurse at this teaching hospital. I was astounded at the level of expertise, skill, and knowledge every single nurse on the unit had, many of whom were younger than me. Not only that, but I felt from day one that I was a brand new nurse all over again, because Cardiac ICU is like nothing you have ever seen or done before. It is the exact opposite of everything you are taught in school. We even have our own ACLS (CALS), we do CPR and resuscitation different. CVICU is the top of the totem pole. I don't mean that other nurses are not as smart, or as skilled... I just mean that CVICU patients, open hearts, experience all co-morbidities under the sun while under your care. Strokes, GI bleeds, sepsis, shock, aneurysms, respiratory failure, kidney failure, shock liver... you see and treat it all. You fix it all. I do my own dialysis, neuro checks on a Neuro ICU nurse level, CRRT, we administer chemo to our patients who have cardiomyopathy secondary to their cancer, we do lumbar drains and bolts and pins, we do full C Spine precautions for the patients who have blunt force trauma from car wrecks, we do postpartum care for the mothers who have postpartum cardiomyopathy. Literally every kind of nursing you can think of will come into play in CVICU. Just be prepared to be challenged, to fail, to get back up and be better the next day. Your comfort zone no longer exists.