IMCU to ICU transition seeking advice

[emac877]

I am a third year nurse having spent the last two years in a step-down intermediate care unit (IMCU). I realize that term is facility dependent. Where I work IMCU is considered critical care and we do manage stable vents, art lines, BiPap and some titratable drips (heparin, insulin, cardizem, precidex etc.). We don't do vasopressors unless they are set rate. It's a very heavy unit physically and feels a lot like a LTAC or SNIFF some days.Our polysubstance abuse and ETOH withdrawal patient population is generally a high percentage of the unit on any given day. Our ratio is 3:1 and while we do have a CNA they are extremely busy and much of the time full patient care is given by the nurse. Thus we've developed a strong team-nursing mode of survival for our safety as well as our patients. I've learned a lot here and absolutely love my coworkers to death. I am considering a move to a combined MICU/SICU as I am beginning to feel really burned out where I'm at and I'm ready to learn more advanced skills. I guess what I'm looking for is two-fold. I am seeking advice from those who have made this transition and also wondering if ultimately having ICU experience is better for my career experience since an IMCU is so variable between facilities? Any constructive thoughts would be appreciated. Thanks.

[TheCommuter, BSN, RN]

Welcome! Your thread was moved to our Critical Care Nursing forum with the goal of amassing more responses. Good luck to you.

[Cowboyardee]

Generally, I think ICU experience on your resume at this point could only help, assuming your leave your IMCU on good terms.

As for the transition... tough to give much general advice. On one hand, people from your kind of unit often transition well to an ICU. It tends to give you a decent base to build upon. Your collaborative skills are an especially great asset.

On the other hand, there are still most likely some key differences, depending on your ICU. You'll likely find that you're responsible for understanding pathophysiology and interventions on a considerably deeper level than you already do. You may find yourself working more closely with physicians than you're used to. Depending on the ICU, you also might find that the burnout isn't much better, as 3 patient assignments are not uncommon in many ICUs, quite possibly without aides.

The best advice I can give you is to ask a lot of questions. When you find someone who seems knowledgeable and who doesn't mind giving you lecture after lecture, latch onto them and learn as much as you can. Also, help other people out in emergencies, even as a newbie. You'll learn a ton during these scenarios, and your coworkers will be more likely to help you out in return. Let other people help you - you'll learn more and build stronger connections with your new coworkers.

Best wishes.

[emac877]

Thank you. I appreciate the advice!