ICU nursing vs Floor nursing

  1. This will probably start a big cat fight, however that is not my intention. I am honestly curious.

    ICU nurses feel they have the toughest job, because the patient acuity is higher. Floor nurses feel they have the toughest because they have more patients, less monitors, more visitors, etc.

    I'd love to hear from some of the nurses that have done both. As a floor nurse, I honestly can not see how three patients on vents and monitors can be any harder than 8-12 patients on the floor, BUT I've not done ICU, so I can't say. Someone please enlighten me. thanks
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    About nurs4kids, ADN, BSN, RN

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    Nurse Clinician/Case Manager; from US
    Specialty: 20 year(s) of experience in Pediatric Rehabilitation


  3. by   breanna
    Did floor for a year, then years of ICU and other areas. By far, floor nursing the most difficult. Wouldn't, couldn't ever do that (floor nursing) again! Vents, swans, balloons, multiple lines & drips are easier.
  4. by   Zee_RN
    Been a floor nurse; been an ICU nurse--about equal times each (3 yrs floor; 2.5 yrs ICU). You're comparing apples and oranges. They are BOTH different ways. A floor nurse's hell day is pure HELL. An ICU nurse's hell day is pure HELL. They are different hells.

    I prefer an ICU hell have more autonmy and more control. But there have been days when both your patients DIE after you've spent HOURS and HOURS of very intensive care on them and very intensive family care...Is that worse than caring for 12 very ill patients with a lot of crazed nursing home patients in the mix too? Probably not. It's just different.
  5. by   askater
    Hi!! I've only done floor/step down units.

    But I wanted to say, I asked this question under MICU. I got a few good responses....and thought you might like to check out the thread. It's under Was anyone a floor nurse??
  6. by   PhantomRN
    I have done floor nursing and ICU nursing. I would have to say they both can be trying but in different ways. In the unit you will have one or two intense patients. On the floor you can have 8 patinets-- 5 walkie talkies, a real sickie that will zap your time and then add in two crazies and your are set up for one nutty day.

    The stress level is incredibly different. In the unit yes they are supposed to be sicker, but I have found that is not always the case. Because remember floor nurse when the beds were all full well guess what they still admitted more patients they just got a unit bed. And if I do have some sickies I have more support. There are more nurses available and usually one is free to lend a hand to a busy one, because hell they love to get their hand into something exciting.

    The down side of the unit is the patients can be very sick and the families can be very traumatized. Out on the floors I seen alot of older people in the unit the age of the real sickies are a lot younger. It is a little harder to justify a 35 yr old who has 3 small children at home dying, than it is a 75 yr old who has lived a full, rich life.
  7. by   fergus51
    I think floor nursing is scarier because in our facility ICU is guaranteed no more than 2 pts. per nurse and who is in ICU and who is on the floor is completely arbitrary. I had a patient as a student who was bumped down to the floor early because someone else was sicker and needed the bed in ICU. I was looking after him and 4 other patients. The next day he was bumped back up to ICU where a nurse looked after him and 1 other patient.
  8. by   Teshiee
    i dont think one is harder than the other. it depends on the individual. some nurses can't handle acutely ill patients or a major patient load. in either case they are both challenging. i have worked med/surg and icu. for me i hate lots of patient load. i prefer to focus on my acutely ill patients and rely on my critical thinking. not saying that floor nurses dont use critical thinking, with icu you are on a constant alert with the highest risk of your patient coding.

    it is no accident why we choose to do different areas. i can't do l&d but i know nurses who love it. what ever floats your boat i say :d :d
  9. by   Joshua21
    Apples and oranges. Two different types of nursing with their own stresses. Proof? Put an ICU nurse on the floor, put a ward nurse in ICU. Both will likely be fish out of water. I wouldn't try comparing the two as different organisational skills are required. Different kinds of people fill these jobs for that matter. They really can't be compared. Both are equally difficult.
  10. by   kewlnurse
    I've only been in the CMICU for a few weeks but here is the difference:

    Unit:2-3 patients, very ill, vent's, drips and moniters, MD's on the unit, or (at night) sleeping n a little room right down the hallway.

    Floor10-12 very ill patients, no vents, no drips, no moiters, MD or other HO a pager and 20-90 minutes wait for a return phone call.

    I must that that i canot ever forsee myslf going back to floor nursing.
  11. by   Zee_RN
    Our ICU does not have an MD sleeping down the hallway. Have a resident from 7-3 about 3-4 days week; 7-12noon the other 2-3 days; Sundays off. And the opposite occurs of the patient who was bumped to the floor--we ALWAYS take more patients...our nurses in ICU have been known to take up to 4 patients; they never bump down to med-surg or telemetry.

    But as I said in my previous post, it's apples and oranges. Not one is harder than the other; they are DIFFERENT.
    Last edit by Zee_RN on Dec 7, '01
  12. by   PhantomRN
    yes, they are different as stated above each has its own challenges.

    joshua21 stated that if you put an icu nurse on the floor they would be like a duck out of water and vice versa. well at my hospital that is exactly what we do. the unit nurses float to all of the floors of the hospital and we are expected to take a fair share of our load. we also have 2 sister floors who float to us, they are expected to take their share as well.
  13. by   LilgirlRN
    I don't even want to know, so I will stay my butt in the ER!!
  14. by   ryaninmtv
    I found the ICU far more enjoyable than the floor. I really enjoy the technical aspects of nursing (vents, swans, IVs, etc.) so ICU plays well to that. The floor was pure insanity. Too many patients, no doc support... just really wasn't my cup of tea. As such, I thought the floor was harder (or maybe I just enjoyed it less )