Gaining skills. What is important?

AnonRNC · Dec 7, 2012

I don't think so. ICU is soooo different.

That said, I appreciate your humility, and I do think that most people would benefit from putting in more time in their first job. At six months, you're just barely starting to understand what the job is about. I would wait to switch until you are feeling competent at the first job. You'll still benefit from learning time management and especially prioritization. You'll be exposed to patients coming from or going to the ICU and in doing so you'll get a taste of higher acuity patients. More experience overall will benefit you.

Bec7074 · Dec 7, 2012

I did med surg to PCU to ICU in 3 years. I love ICU and will never go back. I admire the med surg nurses who juggle all those patients. I did it, but not very gracefully.

You need confidence and experience. You'll know when you've gained both of those. For me it happened around 1.5 years of nursing...I swear I just woke up one day and realized I hadn't had a need to look up something in a while and even knew what to do in certain situations. For the purpose of your job record, I'd say don't leave before a year.

Finally, to be a good APN, you're going to need experience. Just remember that there's no rush, and the more experience you have as an RN is going to make you a better NP.

classicdame, MSN, EdD · Dec 7, 2012

you are already in a good place to learn. You would be starting over in ICU. That said, I firmly believe people should try to work in an area that suits them. Solidify your goal. Why do you want to be an APN? What type nursing will you practice? I think you will feel more comfortable with a little more experience and then be able to chart your path. Good luck!

turnforthenurse, MSN, NP · Dec 7, 2012

At six months, a new nurse may be just starting to get comfortable in their role. On average it takes anywhere from six months to a year until a new nurse becomes comfortable. I'm not trying to discourage you from that career path but going to ICU at six months will be like starting over. I think you should become more comfortable in your setting before applying to an ICU position.

Typically ICU nurses have two patients per nurse, sometimes the patients are 1:1 or even 2:1 (two nurses for one patient) if they are THAT sick. Sometimes those two patients can be the equivalent to six patients on a med-surg floor.

Do you have CNAs on your floor? Delegate to them to keep track of the percentage of meals eaten as well as I&O. I&O can be very important, especially if patient is in renal failure or CHF. Typically in ICU I&O's are done Q1H but it depends on the hospital policy, too.

If you really have your heart set on ICU, what about applying to a step-down floor or progressive care unit? Typically those units have less patients per nurse because they require more frequently monitoring. I work on a progressive care unit and our ratio is 1:4-5, depending on staffing. Our med-surg unit ratio is 1:6-7. We see a large variety of patients but everyone is monitored on telemetry. We give medications that cannot be given on a med-surg floor (basically any med that requires a cardiac monitor) such as hydralazine, labetalol, Lopressor, Vasotec...and we may have patients on drips such as Cardizem, Lasix, dopamine, dobutamine (when the patient is being weaned), nitroglycerin, etc. We do not get mechanically ventilated patients but we do get a lot of patients on BiPAP. Some PCU's have mechanically ventilated patients on their units but for the most part it is uncommon. PCU would be a good step if you're trying to bridge from med-surg to ICU.