How to know when you should move from floor to ICU?

[ricki76, BSN, MSN, RN]

I have been an RN for 5 years, the last four years working Oncology/Med-Surg. I've been going back and forth about making the move to ICU, and just applied for an ICU training program yesterday.

I love Oncology, and in a lot of ways feel like that is my calling. However, working at a mid-sized hospital means that our Oncology floor gets a lot of Med-Surg overflow. So while I am an oncology nurse, when it comes down to it I'm really working med-surg. I've thought about applying to the local cancer clinic however I don't want to lose my hospital nursing skills, and frankly can't afford the pay cut until my student loans are paid off in a couple of years. But I love my oncology patients.

I have my MSN but don't want to go into administration or quality (too many bad politics where I am). But I want to live up to my potential and learn all that I can to be the most clinically sound, well rounded nurse I can be. While I love my cancer patients and the role I can play in their lives, I am feeling the urge to push myself and be surrounded by others who feel the same - people who actually care or need to know the intricacies of what's going on with their patient. I feel in some ways, working on my current floor is dumbing me down because when it comes down to it, nurses don't have to know the details of people's illnesses in order to do an "adequate" job. Without turning this into a floor vs unit debate, the manager on my floor does not exactly encourage excellence so people get away with a lot of crap that I know simply would not fly in an ICU. Basically I feel like I've reached the limit of my growth where I am currently and I'm getting bored, burned out, and frustrated with those around me who aren't as driven or seem to care as much about knowing the details of their patients.

Also, when I asked my manager to help me apply for the ONC exam she had a less than lackluster response (I think she's burned out too) and so I have not applied for my ONC certification. Shouldn't a manager be excited about their staff choosing to get certified? (We have grant money that pays for our testing). Then all of a sudden this ICU job posted and I applied. Obviously I may not get the job, but I guess what I'm asking is, how do you know if/when moving from the floor to ICU is the right thing to do?

[Trauma_drama14, BSN, MSN, RN, APRN, NP]

Honestly, you'll just know when you're ready to move to ICU. I was on a surgical care unit for a year prior to switching to SICU and I know it was the best decision I made! I understand completely, even though it was a good floor to start on as a new nurse, I felt like I was just skating across as a nurse and didn't feel like I knew anything. I'm not going to lie, switching from a regular floor to ICU was a little rough but definitely well worth it. I've been on my floor for a little over 8 months and even though I still feel pretty dumb (there is soooo much to learn) I am learning alot and it is challenging.

[Here.I.Stand, BSN, RN]

You sound ready to me! Good providence with your application!

[Pheebz777, BSN, RN]

I moved to the ICU after 3 years of Tele/Med-surg because I felt so "plateaued", stagnant, same routine over and over, nothing new to learn,

and felt like a plain 'ol pill pusher. What really pushed me to go ICU was when I noticed during Code Blues, I was oblivious to what to do and what to anticipate. It was a horrible feeling standing back and watching the ER and ICU nurses handle the codes. Of course we knew the basics, CPR, attaching the defib pads, and ambubagging, suction standby but that was it!

I didn't have a solid foundation regarding the ACLS algorithms.

[ricki76, BSN, MSN, RN]

Thank you for the feedback! I have an interview next week so fingers crossed!!!

[Maevish, ASN, RN]

It sounds like you're describing the floor I worked on right out of school!

I think it's different for everybody, though, because I moved to ICU just because I wanted to try something new and I'd been told I should stay on the floor for a year beforehand. After about 8 months they started making me charge nurse and I went to ICU about 5 months after that. I still don't think it's my "thang" (I do not wake up thinking "I love my job so much!" haha), but it will always keep you thinking and learning on a different level.

Actually, you'll learn no matter where you work, so never mind what I just said

You'll never feel like you know everything (hopefully) so if you wait "until then" you may never move. If you want to try it, do it and stick it out for a couple years since they're going to be training you, and if you don't like it, you'll know why.

good luck!

xo

[ricki76, BSN, MSN, RN]

Thank you to all who posted, I really appreciate the advice!

I ended up getting the job and throughout the interview process felt more and more like this is a good decision for me. I absolutely can't wait to get started and am so excited for this!!!

[montov]

How do you like the change? I have same experience med/oncology and very burned out. I'm about to start my ICU position in a week. I'm excited and nervous.

[ricki76, BSN, MSN, RN]

How do you like the change? I have same experience med/oncology and very burned out. I'm about to start my ICU position in a week. I'm excited and nervous.

Honestly, I can't imagine not making this change and going to ICU. It was a steep learning curve, but my onc/med-surg experience prepared me well. The burnout is a different kind in ICU than the floor, I can say for me personally it has been much better not having to care for 5-6 people anymore. Now whenever I have a patient ready to transfer to the floor, I think to myself "I cant imagine how I ever took care of 5 of these!" So whiny and demanding, lol. It is a nice adjustment to care for people who are too sick to complain. Like, don't even have a call light because they can't use it. But there are other things that can potentially burn you out, the morally distressing situations (never fully realized how miserable "life support" can actually be) and the fact that even when people are on the vent, they are often not fully sedated so you have to deal with the stress of that. However, not to put down med-surg, but I've learned more in my 1.5 yrs as an ICU nurse than I ever learned on the floor. Also getting to focus on only 1-2 patients at a time is awesome, getting to know literally everything about them and "dialing them in" So to speak is something I really love. Even though some shifts are more routine than others, I could never see myself getting bored with ICU and that's what keeps me there. You will do great! Remember that when it comes down to it, nursing is nursing and since you already have experience, even though this is a challenge you will do just fine. You already know how to be a nurse, now you're just learning how to be a nurse in a totally different environment. Best of luck to you!