Any Step Down Nurses?

  1. I have an opportunity to grad-trek to get in the ER after I graduate. There is only one hospital that I am interested in, so finding another hospital that doesnt require this is not an option. So, here is how it works...

    For the First 6 months, I work either the Med-Surg floor or PCU (progressive Care Unit or Step Down ICU).

    The second 6 months, I work 1/2 time in Med Surg, and 1/2 time in ER.

    On year two, I go to the ER full time.

    No matter how much I hate the idea of being required to do Med-Surg for 6 months, I can choose to do the time in PCU instead of Med-Surg.

    Can anyone tell me what PCU is like? I have not working on a step down unit, just ICU.

    Has anyone been through a training program like this in your hospitals?

    Thanks in advance!
  2. Visit BrandyBSN profile page

    About BrandyBSN

    Joined: Jun '01; Posts: 973; Likes: 38
    Community Health Nurse


  3. by   CC NRSE
    Hi Brandy,

    We have a PCU at our hospital. Given the choice, I would work that ANYDAY before working the floor. I work ACCU (adult critical care) an we frequently get floated to PCU. Their nurse to patient ratio is 3-4/1. Much better than our floors where their ration is sometimes 10/1. They(PCU) take our chornic vent patient and anyone who might require a little more work and to be watched a little closer. Problem is,..sometimes you might have two really sick patient who actually need to be in the unit. But,..on the other hand,...we send our 1st day post-op CAB's to the cardiac floor!!!! I think it is a personal choice. Both would be an advantage in some ways. The floor will help with orgainizational skills where as PCU will help develop your more critical skills. But,..if you have already spent time in ICU, would probable feel more at home in PCU. Good Luck!!!!

  4. by   BrandyBSN
    Thanks a lot! I really didnt know what types of patients I would have in the Step Down unit (PCU). I worked as a Nurse Assistant in Med-Surg for 2 years, and also had a full semester of clinicals there, so I KNOW that I really do not enjoy it at all. I like ICU better (more personal time with patients, and more critical thinking). I am not completely thrilled with ICU, its a better fit for me than med surg, but not perfect. But, it seems that if I want to work for this hospital in the Emergency Department, there is not a way that I can get around this. Basically, I just need to get through 6 full months in a "not-so-perfect-fit" area to get where I really want to be. But, I do not want to be miserable during those 6 months either And I am pretty sure I would enjoy the more critical patients more than the general M-S patients.

    This MIGHT actually be a good thing. I'll be more sure of my skills before I have to use them to emergency situations full time. Just because I really dont like working somewhere I dont want to, It can still be a terrific learning experience as long as I keep my mind as open as possible. Atleast I will be working, finally earning a paycheck, and learning hospital policies as I go.

    I graduate in May, and post-grad life is finally starting to become more of a reality. I think culture shock is starting to set in. Bills, student loan repayments, lots of new things, this grad-track program was not something I was planning on dealing with.

    I would be extremely interested in talking to anyone who has worked PCU and Med-Surg, just to hear the differences. If anyone has AOL Instant Messenger, that would be even better. Im BrandyBSN on AOL too, so PLEASE CONTACT ME! You can think of it is you "good dead" for the YEAR for helping out a confused senior nursing student

    Thanks a lot!
  5. by   codebluechic

    You need to find out more about the different floors.I started on a PCU as a new grad. The pt's were VERY sick and on multiple drips but the ratio was 8:1 or sometimes 10:1! We had codes all the time (wonder why?). I found when I floated to m/s the pts weren't as "acute" and it was a lot easier to have 8 of them. Anyway, it WAS good experience and I'm glad I did it before going to the ICU.
  6. by   BrandyBSN
    Im a little confused CodeBlueChic?

    were you saying that you were in favor of doing PCU instead of Med-Surg for my "pre-Emergency section"? I got kinda mixed signals there.

  7. by   codebluechic
    My point was you need to research the unit. Is the ratio 10:1 or 4:1?What is the acuity level? Although I gained great experience it really was an awful place to work!!
  8. by   BrandyBSN
    yes. Good point.

    I am hoping to take a complete tour of all units soon, so that I can make the most informed decision that I can.