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Future ICU RN-better on day shift or night shift med/surg

gear585 gear585 (New) New

Hi. I'm a new grad. I am hired for ICU night shift but they are cross training me in med-surg/stepdown unit for 6 mos before I get transferred to ICU. I've heard that ICU nights and day shift are equally busy. Does anyone have suggestions on whether I should do med surg day or night shift to prepare for ICU? Does one shift offer more teaching or experience? Does working either shift matter or make a difference in preparing me? I'm torn right now. I've heard that working day shift teaches you more and keeps you busy so you're ready for ICU no matter what shift, but i really wouldnt know. I'm so torn right now. Please help? Thanks!

Both the day and night shift on ICU are challanging. On the day shift you learn how to care for pts. after procedures and learn who the DRs. are and what they like .TheDRs. also get to know you which is just as important. You also have the help of other departments if needed. You also have to deal more with the families. On night shift you are expected to know what to do without much supervision and without much backup. You also need to know what truely is a emergancy at 4 in the morning before you call the Dr. There is less staff and the notion that pts. sleep at night is a figment of peoples imagination.Both are busy .Both are challanging. I can't think of a more wonderful, stressful or fulfilling unit to work. One work of advice. REAL NURSES DO CRY.

You will have to base your decision of several factors. Some of those include:

Is your facility a teaching hospital? If so, patient rounds could start as early as 5am, or go on all day on the day shift, and I have always learned a ton of new material by listening to and participating in morning rounds.

Will there be an experience preceptor available to you, no matter what shift? It won't be helpful if you are thrown on nights with only other new nurses to guide you.

Are you a night person? Can you sleep well during the day? If you know you will be on nights in the ICU, would your body benefit by adjusting to a night schedule now?

Will there be opportunity to learn/study on nights? Are educational programs offered then? Will you have to cut into your sleep time to accommodate the educator and come in on a day shift for classes? Will a quieter time (no families, less travel, fewer procedures) give you more time for independant study and review?

Finally, although it is true that nights in the ICU are busy, they are truly not as busy as days in some respects. (Please don't slam me....I work perm nights in the ICU and have for years) In most hospitals, most of the post ops come out on days or evenings. The emergent cases happen at night. More travel happens during the day. Interventional radiology, CT guided drainage, Cath lab, are usually day based departments with call in availability at night. More rounding and therefore bedside teaching happens on days. You have the opportunity to see a lot on the day shift. But if your unit is chaotic or understaffed at baseline, you could be left hanging in the breeze on days whereas you might have more 1:1 time for learning and growth on nights, with the right preceptor.

See what I mean? There are advantages to both, and disadvantages too. This will be your career and you must advocate for yourself and your needs. Maybe you could shadow someone on both shifts before you decide, see what both shift are really like. You may find a connection with someone that would be worth investing in.

Good luck. I started in the ICUs decades age after only a few months on the floor. It has been a great experience. I wish you well.


thank you guys. one more question. im doing med/surg and step down unit right now. im focusing on mastering ekgs but when im done with that i wanna move onto getting a good critical care book. hopefully it will prep me. any recommendations on good books?

Most likely your facility uses the Core Curriculum for ICU training. That's pretty standard. Don't go crazy when you see it since it is a giant textbook. Concentrate on learning one system at a time. Right now, get a grasp on cardiovascular (EKGs, pulses, measuring edema, checking JVP, meds, MIs). Then move on to respiratory, neuro, GI, GU, endocrine.....slowly! It can be overwhelming otherwise.

If you really want a review book, look for one of the pocket guides (Critical Care Checkmate is very popular, or Porter's Pocket Guide to Emergency and Critical Care). Small enough to keep in your bag for quick reference. Google them for where to order.

In regard to medications, learn categories (beta blockers, ACE inhibitors, calcium channel blockers, vasopressors, vasodilators, diuetics, narcotics). For the most part, the info in each category is the applicable to all the drugs of that category. It will make your life easier overall.

Relax. Enjoy the transition. Check in and let us know how it is going.


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