CVICU vs SICU. Help!?!

Specialties Critical


Specializes in Critical Care.

I've been working in an SICU in a county hospital 50 miles from my house for the last 15 months. I was practically a new grad when I started (I had only worked in Home health and outpatient dialysis). I completed an intense critical care training which was a total emotional rollercoaster.

I worked nights for a year. Super brutal. I knew it would be tough for me (I'm definitely not a night person). Sometimes it would take me 90+ minutes to get home in the morning because of traffic. Finally, in April I got a position on the PM shift - 3-11. Way way better. I feel human again. Sleeping at night. No traffic (though still about an hour each way)....

about a month ago I had an interview at a local private HMO hospital for a CVICU position. I dragged my feet since I had just started the PM shift and was getting my bearings and didn't really have such a drive anymore to look for another job like I had when I was miserable working nights. But I went to the interview anyway. And it was pretty cool. Less than a mile from home. Same shift. Same amount of hours. Way better pay.

So when they offered, knowing I didn't really have heart experience (I told them I had heart exposure - I had just begun orienting to the open hearts on my SI unit) they still wanted to hire me. Of course they expect me to do a lot of studying on my own.

So I accepted. Duh!?! Right!?!


I went to give notice to my current manager. She told me I'd likelg hate the new place, they're very strict, they'll float me, it's all seniority based, my personality is more of a county type than private fancy hospital (I kinda agree), I'll get bored doing just hearts, they don't have the same possibilities of learning new disciplines since they're not a teaching hospital...... she actually worked for the same institution for a number of years before her current position.

And it gave me pause.

so here I am....2 more days at county. Already doing all my paperwork to start the new job a week from today and totally worried.

My current manager expressed how disappointed she is in my decision to leave, how she raised me, how ill never have as supportive of a manager as her..... and it's not super hard to make me feel guilty. Because she gave me a chance. Trained me in the icu. Stuck up for me when my unit didn't believe I could make it. She fought for me.

And im having serious doubts.

People have told me that the new place is very strict. Very organized. (Not a bad thing. ). Not a teaching hospital. They fire people more easily. You can't get away with the stuff we get away with at county (not necessarily a bad thing).

I mean the money and commute make so much sense. But I am sad to leave the trauma I had at county. The variety of patients. Working with residents from all disciplines. Getting so much training and education.

Having worked so hard to get some semblance of respect on my unit.

I feel like I'm more county... I'm gritty, got a potty mouth, not super great with authority .... love the teaching and demographic of a county hospital.

This is new job will make me super efficient in hearts. But will it translate? What if I want to go back to a trauma icu? Will they take me?


Specializes in SICU,CTICU,PACU.

I don't think its professional for your current manager to say those things to guilt you into staying. If you are interested in CVICU then you should try it out because you will never know what you like if you don't try things out. Is it possible to stay per diem in SICU so you can still get experience in both departments? Try to be excited for your new job and focus on learning because there is a lot to learn in open heart. Good luck!

Specializes in Critical Care.

Your current manager is psycho. Run!

Specializes in Critical care.

For all you know some of the things your manager has told you might no longer be true.

It's hard when you are leaving a manager you like. It was so hard for me to give notice to my last manager (she was awesome and a refreshing change after the unit had been floundering with a not so nice or receptive manager), but I had to do what was best for me. Changing units and organizations meant more room to grow, better pay, and a location that was more favorable to my social life.

Best of luck!

Specializes in SICU.

I say go for the CVICU position. It sounds amazing. Your manager has no business saying all of those things to you, and they probably are incredibly exaggerated to begin with. You will learn so much there, and 1 year from now you will be looking back on how far you've come, and thinking about that time when you almost let somebody hold you back.

If you are that unsure about the new position, stay PRN at your current facility until you see how you like the new one. If you find it is not your "cup of tea," you haven't completely closed the door on a position that you know you like.

While I believe your managers response was unprofessional to say the least, a bit exaggerated and maybe stems from disappointment more than anything else, I've been in a similar situation. I've gotten to the "other side" (new job) and realized everything that was being said was true, understood the differences and appreciated the perspective then realized it was just way - to - much.

But that's my story.

You have to write yours.

I think CVICU has a lot to offer to someone who hasn't been. Of course it does! You're learning a different area of critical care. You're expanding your knowledge & portfolio! I'm all for a nicer commute too. This decision is a tough one but unless you plan on moving closer to county and switching/cross-training & floating to cvicu at County, then private local has to be something to consider.

This is tough but on the bright side, sounds like you're a stellar nurse in high demand! ������������ :)

If possible per diem at county while learning cvicu might be the most balanced decision. Do something nice for your manager to show her your appreciation. Make it as sincere as all the effort she put into you. If not today, at some point she will understand.

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