How to Prepare to Transfer to Step Down

Dear Nurse Beth Advice Column - The following letter submitted anonymously in search for answers. Join the conversation! Nurses Nurse Beth Nursing Q/A


How to Prepare to Transfer to Step Down

I have around 1.5 years of med-surg experience and am looking to transfer to a step down unit. I want to know how I can prepare myself clinically for a step down floor while I am still on the floor. Can you describe the learning curve from med surg to step down?

Share this post

Specializes in Tele, ICU, Staff Development.

Dear Looking to Transfer,

Good for you!

Transferring to Step Down at this point is great timing with your 1.5 yrs of MedSurg experience. You know how to manage your time and you're familiar with many different kind of patients and conditions. You will have fewer patients, and the length of stay in StepDown is typically longer than the length of stay in MedSurg, so some aspects of this will be easy for you.

It's advisable to bone up on ABG interpretation. A lot of nurses don't really grasp the nuances of ABG interpretation until they take it upon themselves to self-study. A good understanding of ABGs will help you a great deal with more acute patients, and give you essential information about their respiratory and metabolic status.

You should also hone your arrhythmia skills as your patients will be monitored on a bedside monitor. Review the basics, and take a class if you have never had one. With arrhythmia interpretation, it's important to have a solid understanding from the ground up. If you miss understanding any of the basics such as the rules for each rhythm, you will not be able to master this very important skill.

Get your ACLS if you don't already have it. If you do have it, get your book out and review the algorithms.

Once you get to StepDown, befriend the Respiratory Therapist. He or she can teach you so much about managing airway delivery devices and ventilators.

Good luck, and I hope you love it!

Specializes in Critical Care; Cardiac; Professional Development.

I suggest also getting very good at the ins and outs of renal care, diabetes as a comorbidity to other conditions, COPD and CHF as comorbidities as well as other acute cardiac conditions. A lot of stepdown revolves around watching how fixing one problem causes or exacerbates another.