Floor nursing vs ICU nursing

123456yy · Apr 3, 2006

For the most part, I do think that the tele and med surg nurses have it a little rougher than we do in the ICU. That is not to say I'm not busy, I'm always busy. But it's a different kind of busy. Floating to the tele or medsurg floor is a nightmare for me. In the ICU you are required to know very detailed information on your patients. Not knowing can be very dangerous. So i'm a detail and a control freak by habit and necessity. Trying to find out that much info on 5-6 pts is impossible, and frustruating. But it's a very well ingrained habit and I can't just stop doing it. So I spend the entire shift micromanaging. NIGHTMARE. So, yes, I think in general, floor nurses have it harder. Having said that, spend one shift in the shoes of an ICU nurse whose patient is crashing for the entire shift, and you'll understand why we're so anal! That's the kind of stress there's barely a name for. Give me good ol' ICU any day!!

gassrn · Apr 3, 2006

My perspective is a tad different, in that before I was a practing RN, I was a registered Respiratory Thearpist for aprox.6 yrs. I floated all over the hospital and saw the RN's in all area's. In my opinion, nurses who are working in direct patient care areas all have days that are bad, frustrating, and exhausting. It seems that the more patients you are responsible for the greater the potietial of those senerios. Currently I work in Large level one hospital in the Trauma/Surgical/ Neuro ICU and most of my days are pedal to the metal with multiple mini crisis's within taking care of 2 critical Ill patients. However I worked in a pulmonary stepdown unit before ICU and there we took vents with trachs plus had some medical and surgical pt mixed in. 4-6 pt per RN was a typical assignment I have to say stress and frustration ran rampent thru out that unit because the acuity of the patients. Overall I personally deal better with chaos of 2-3 CRITICAL pts, than the constant frustration of being pulled in 20million different directions that a floor nurse (med/surg, tele) usually experiences. I give a hats off to them for their dedication.

traumaprincess · Apr 9, 2006

I really think that EVERY nursing job is hard. There is no easy nursing job. There are so many different areas in nursing. Each person needs to find where they are happy and go there. I have trained several floor nurses coming into ICU. Sometimes these nurses start out thinking it is going to be easier because they are responsible for less patients. Sometimes they have liked the reality of how busy just two patients can be. Other times they have found that they hate the environment and even with all of their experience they become overwhelmed and they have left to go back to what they were doing before. It is good sometimes for us to see how other areas function. It seems sometimes that nurses, and just people in general, think they are the busiest or working the hardest when in reality others are in the same boat. Recently a nurse with 15 years ER experience came to work in our unit. She has said so many times how hard it is to work in our unit. She never sits, runs all night long, she has been very overwhelmed (her words). I had to laugh with her one night when she said this, I told her that I was quite sure I would have to run out of the ER crying after half a shift, with how overwhelming that would be for me. It is funny how many house sups then think a nurse is a nurse and can work in any area. Yes, maybe we can but it does make most of us very uncomfortable.

As far as med surg patients being sicker, yes they are, they are because icu patients are also sicker, so the patients who use to stay in icu a little longer get pushed out to make room for only the sickest. Therefore the acuity in the icu is also higher lately.

Anyway..... I guess my whole point is, if you think you will like the type of busy one area has to offer, and you are feeling froggy, JUMP. But I really do not think there is an easier nurse job to be found. I could be wrong though, maybe I just have been working in all the wrong places;)

JMHO

s1716698 · Apr 16, 2006

hi. I am from australia, I am in my 3rd year and have mainly worked in medical wards , BUT SOON i AM GOING TO HAVE STINT IN ICU, DOES ANYONE HAVE ANY TIPS OR ADVICE FOR ME

:nurse:

REGARDS s1716698

geekgolightly, BSN, RN · Apr 17, 2006

I was pulled from telemetry to go to the "CCU" (we dont do interventional caths anymore so the CCU is now a mix of touch-and-go tele patients and ICU patients) and it was a wonderfully refreshing experience.

On the tele floor, Saturday, I was belittled by residents, had two bedridden confused and agitated hepatic failures who were full codes and lactulose do NOT titrate for stools as well as a total AMS with possible SIADH and one stable SCC with mets to brain. And no CNA. The entire day was spent running around trying to save macerated bottoms while making sure that all labs were acocunted for and trying to stave off any disasters, all the while, each time I called a resident, I was chewed out and snorted at. Not fun.

Sunday I was pulled to CCU and was frightened as I have put off critical care until I have more experience, but the entire day was controlled chaos, instead of explosive insane make-you-want-to-cry chaos. I was constantly on the move, but felt like I gave excellent care and to boot, the same doctors who were snorting at me yesterday, were joking and laughing today as well as asking my opinion when I explained situations to them. (!!!!!)

IMHO, it seems ICU can be the best type of experience, if only because you can really use the skills earned by experience and education. With floor (and tele!) nursing, most of the time it's a war zone and you're the grunt that everybody takes a shot at.

BTW, I applied for the open CCU position last night. I hope I get it!

Artemis2 · May 8, 2006

24 years ago when I was finishing up nursing school I looked at what was happening on the floors and RAN to the nearest ICU. Fortunately I found one that was willing to take me as a new grad. In those days the ratio on the floor was more like 15:1! The last time I was pulled to the floor (it has only happened a few times and I go unwillingly) I nearly broke down in tears and I was only passing meds! I don't see how med surg nurses do it!

I have had many nights in the ICU when I haven't stopped to even pee much less eat but on those nights I often feel the most satisfied...like I've given good patient care and had a challenge that was acutally fun. I will take the 2 sickest patients in any ICU with multiple drips and lines over any med surg assignment any day! I liked the comment another poster made about the ICU being "controlled chaos". Well, some days it is not so controlled but no matter how hard it gets I (usually ) only have 2 patients. I get to provide a deep and through level of patient care (usually ). I am also someone that likes puzzles and gadgets so the ICU suits me. When they want to float me to the floor I tell them that it is a big mistake... that I am incompent on the floor and it is true!

My hat is off to floor nurses! They are my heros! :yeah:

kenesha212002 · May 20, 2006

I am a new grad and I am currently doing a 24 week critical care internship. We went through a med-surg floor, a telemetry unit, and now currently the ICU. I can say that they are all stressful. Going from 5 patients to just 2 patients I thought would be a breeze but the acuity of these patients in the ICU can be equivalent to 10 patients. You run around all day. New lab orders, new radiology studies, vent settings, IV antibiotics, ABGs, and when an ICU patient leaves the floor for a test the nurse from the ICU must accompany them. Which means you leave one patient behind. On med-surg and tele you have more patients but they all might not require as much 1 on 1 care. As a new grad they both the floor and ICU have mean leaving exhausted after 12 hours shifts. But I enjoy the challenge of both and I hope i feel like this 20 years from now!

dorimar, BSN, RN · May 20, 2006

you explained that very well kenesha

lvs2nrs3535 · May 23, 2006

I graduated from my school on Saturday. I take my boards June 9th, and already have a job on a very busy med/surg floor. My passion is ER nursing and that is what I want to do. The hospital I am going to work at doesnt take grad nurses in the ER, so I need to have experience. Does any one have any advice?

Thanks

s1716698 · Jul 19, 2006

yea sure is different in icu to the floor, I am a nurse in australia and have just started un icu, and finding it a little daunting but very interesting, when i was in the ward, you could clown around, sing interact with your patients in various ways, but its all so serious in icu, I realise that people are really sick, and its a different environment there, but i dont know whether its really me:uhoh3: :balloons:

regards s1716698

Nieuport · Jul 20, 2006

I really appreciate reading everyone's opinions here. I'm a new nurse (pinned May '05). I've worked med/surg now for just over a year and will transfer to ICU in 4 weeks. I'm by nature a vampire (lol) and the 6 or so weeks of day orientation is gonna be a bear, but I'm really excited to get the chance to work with some nurses I've REALLY come to respect. I'll attend a 5 day Critical Care Nursing Course at a regional educational hospital. Even THAT I'm actually looking forward to. My experience on the floor, too, has been very frustrating regarding available time to actually spend with pts. My peers keep telling me that I'm always running like crazy because I spend to much time with the pts and doing too many "little" things for them. I've found that the assistant assigned to my pts directly coorelates to experiencing a "good" night vs. a night from h..l. Confident that I have a second set of eyes and hands makes the shift SO much easier. That said, I think I'll feel better knowing that EVERYTHING that pt does or experiences will be observed or performed by me and I can SEE my pt the whole time. Is that stupid?

geekgolightly, BSN, RN · Jul 21, 2006

That said, I think I'll feel better knowing that EVERYTHING that pt does or experiences will be observed or performed by me and I can SEE my pt the whole time. Is that stupid?

I know I'm gonna love that, too. Like you, I appreciate assistants, but I am too much of a control freak to ever really be happy with someone else doing cares for me. I like to know e v e r y t h i n g. I think the assistants love me, too, bc I do so much of "their" job for my patients.