Published Jun 16, 2003
Do you think ICU nursing is as STRESSFUL (crazy, hectic, etc) as med/surg floor nursing? I realize ICU nursing takes a great deal of knowledge and the patients are more critical, . . . .I need an opinion on med/surg patient ratio of 8 patient to 1 nurse as opposed to 2 or 3 patients to a nurse.
What does it really take to be an ICU (MICU, SICU) nurse?
I find floor nursing much more frustrating than ICU nursing. In ICU, yes you have to know EVERYTHING that's going on with your patient. You have to know a lot about a lot of things. You have to be able to confer with the MD on a knowlegeble level. But I find it easier than floor nursing because I want to do too much for patients on the floor and I make myself crazy! You can't possible properly look after 8 patients every day and know everything you're supposed to know, and follow up on everything you're supposed to follow up on, teach, listen and pee when you need to. Argghhhhhhhhhhhhhhhhhhhhhhhhhhhhh! Give me a good old ICU anytime!
Floor nursing is definitely more frustrating. Usually tere is a high patient to nurse ration where the patient to nurse ratio in ICU is much lower. And you never have the time to do everything you want to do for the patient. Yes, it happens in ICU too but not quite as often.
In ICU, you must possess excellent assessment and organizational skills in ICU because you muct be on top of every little thing with your patient and be able to report the slightest change in trends for the worse or better to the doc. You must be able to confer and speak in a professional knowledgeable fashion with the doc......it is just easier all the way around to remember everything that you need to k now on 2-4 patients as opposed to 8-12 (depending on the facility you work at)....intense at times yes....but so very rewarding.....more so than floor nursing.
I was floated to CICU a few weeks ago, and found it to be very relaxing compared to the telemetry unit I'm assigned to where each dayshift nurse gets up to five or six patients each.
I miss those nursing days when nurses got to know much more about their patients than the nurse to patient ratio today allots us. I feel out of the loop about my patients because I feel like I'm working against the clock most days and never getting caught up. By the time I leave work, I'm exhausted mentally, emotionally, and have even cried before falling asleep.
WHAT has happened to nursing today, ya'll?
ICU nursing CAN be as hectic as floor nursing, but in a different way. One critically ill patient can keep you running nonstop for hours.
I much prefer the ICU craziness over a floor. Every now and then I have a shift where my patients are stable and relatively easy, but those are few and far between in my unit.
Every now and then, when I get pulled to Telemetry, I have to make myself change how I nurse, in that I cannot spend as much time at the bedside, nor will I have the opportunity to sit down and read the charts. It's frustrating.
I worked a Med-Surg floor a while back and it was hard for me because a lot of my patients slept all night and I was terrified that I was going to round and find one of them dead (no monitor, no NOTHING...)
I think Med-Surg nurses deserve a HUGE medal of honor for the hard work they do. It's challenging, to say the least...
In days of old, the stress of med/surg was a lot less. Not that it was zero by any means. Nowdays, if you ask me, many patients on med/surg should be in ICU or on telemetry. Usually there is no room for them in those high acuity units. If a med/surg nurse had 4/5 patients like a med/surg nurse should it would all be much more managable. Did anyone ever notice that the patient and family goes through a period of shock when their family member first comes out of ICU? Suddenly after having a nurse at their beck and call for so long it is hard getting used to the sudden decrease in attention. Sometimes you have to sit them down and explain that their is one RN for 8,10 or even 12 patients and that the sickest get the most attention.
Thank you for everyone that posted to my question. . . .the info really helps. . . .probably have more ques later. . . . .
I float from ICU to med/surg...depending on need...have been in ICU mostly as of late..but was med/surg last night..and it KICKED MY BUTT...was utterly exhausted when I got home this am...I had 5 pts....as opposed to the usual 2 in ICU...these 5 folks kept my big bootie hopping ALL night longggg...no cna..no ward clerk..we do total care...and my back sure the heck feels it ...hope like the devil I'm in ICU tonight...lmao....don't get me wrong, we've had nights from hellll in icu also..but seems like an above poster mentioned..the acuity of med/surg is getting higher and higher..making everyone's job harder/more stressful.
thanks for the post
chuckc, BSN, RN
I am graduating this year and expected to do the med-surg path for starters. I think I would like ICU better than med-surg. I know the intensity is high, but I feel I would handle higher intensity/less pts better than dealing with 5 different patients. We are just beginning to take on multiple patients, it can get so crazy back and forth, keeping track of them. Have many of you started as a new grad in ICU? I have heard pros and cons about this. Your insight?
I started out in ICU as a new grad and had a great experience. The hospital must offer critical care classes and preceptorship in order for you to learn most of the things you need to learn by the time you get set free as a countable staff member.
I currently work as a travel nurse in a small hospital ICU. They hired a recent grad and are having her hang around for observational OJT, and it's really not working out. She is afraid to get in the way, especially when someone goes south, but the 'old' nurses think she just lacks enthusiasm and is not willing to get involved. As an outsider I've seen this happen before. Not everyone is cut out for ICU. Not every ICU nurse can prosper in every ICU.
I think it's great to get new grads into ICU, before they are so burnt out from med-surg that they are just looking for a place to hide. Even the largest hospitals with higher acuity are usually willing to train a new grad or two every year for critical care areas. It's very important that you get you organizational skills down now, while you have the chance and your nursing school instructors available to you. The more you do it, the easier it will get. Who knows, you might end up liking med-surg. Hang in there!
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