ICU to Tele

I can't answer as to whether they'll let you change specialties as a traveler. I can, however, relay the jist of a conversation I had recently with one of our most experienced ICU nurses. When our ICU nurses get pulled out to the floors, they're not given more than 4 patients unless they've been a floor nurse before going to ICU. The reasoning is because floor nursing is overwhelming in different ways than ICU is.

I'm also in a small community hospital and our ICU is 1:1 or 2:1. ICU, in general, will get overwhelming when the 1 or 2 patients needs a lot of individualized care. Floor patients are the same way, of course, but usually when it's overwhelming it's because you have at least 4 patients, all with different agendas for the day, they're all awake, their family members are in and out with questions, you have potentially at least 4 MDs all putting in orders all day long, and then you are depending on CNAs, lab, PT, ST, and all the rest to do their jobs, meaning they'll potentially interrupt your day, or you'll have to interrupt their day. It's just a different kind of busy.

I will say that the advantage to a small community hospital is that you've been trained in ICU nursing in all specialties. You weren't limited to neuro, cardiac, GI, etc. You have more knowledge and experience than I think you are giving yourself credit for.

I personally think that would be a reasonable switch. You will have to quickly adapt to different organizational skills, planning and implementing care of 4-8 patients with some number of support staff (at least a monitor tech). It will be a huge challenge for several weeks.

The other thing you should consider if you like ICU is to travel ICU! Pick your first assignments carefully so your learning curve is not extreme and work your way up to more difficult assignments slowly.

Thanks for your advice!!

I'm on my first assignment,as an ICU traveler. I went from a small community hospital ICU 170 bed facility), to and 800+ bed facility in a big city. It was a rough transition at first, due to acuity. HOWEVER, I recommend branching out and learning. I chose a facility that was traveler friendly, I was honest with the interviewing manager about my concerns and the patient load... and honestly, it was the best decision I've made. I can always float down if needed, but I'm not losing my ICU skills, I'm gaining more.

Coming from a rural community hospital, I actually did more as an RN there than I do here. This city hospital has staff to transport ICU patients, 24/7 Intensivists, code teams,iv teams, etc. At my community hospital, we as ICU nurses were the code nurse, iv nurse, and cover all in emergencies... So, keep that in mind, and dont let your fear hold you back.