Med-surg nurse who would like to change to ICU. How difficult will that be?

Specialties MICU


Hi everyone,

I am a 25 year old nurse who has 2.5 years of med-surg experience. My floor does not have telemetry. I started med surg as a new grad. I discovered in my time an interest in going into critical care/ step down/ ? ER. What I like about med surg is the variety but what I am missing is having to "ship patients to another unit" when they go sour, or send them to telemetry for cardiac/ cardiac "concerns." I am also tired of going up to 6-7 patients (when I was on overnights) or going up to 5 patients with 2 discharges 2 admissions. I am not very interested in the constant discharging and admitting that comes with med surg. I have experience with IV's (including insertion) with abx, blood products, heparin drip, PCA/ continuous pain medication drips. Also have experience with Foley's, GTubes, NG tubes, wound vacs, wound care... [med surg in a nutshell!] I recently electively got my ACLS (not needed for my floor). My long story short is with my experience so far, how difficult would it be for me to get a position in step down/ critical care/ ER with my current experience? Thank you for your insight!

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

You should have no difficulty getting hired into an ICU. Your orientation will include classes on rhythms, hemodynamic monitoring and all of the other ICU skills that you don't already possess. You do know how to assess patients, how to talk to patients, families, physicians and ancillary services, how to manage your time and how to prioritize. Those skills will serve you well in the ICU.

Given your dislike of admissions and discharges, you might like MICU better than SICU. SICUs are constantly transferring patients to the floor and then admitting new ones from the OR.

Specializes in Critical care.

A benefit with SICU though is you tend to not have the "frequent fliers". I did tele before moving on to ICU and it's just as tiring in the MICU (maybe even more so since you spend soooo much time with your 1-2 patients vs 5) as the floor. I get to work in both the MICU and SICU.

Good luck!

Thank you! I have thought MICU might be a good match. And I don't mind admissions as much as I do discharges oddly. Transferring patients doesn't bother me as much. I just don't think I can handle 5-6 patients with the amount of admissions and discharges forever. I took a gamble and applied to my hospitals icu (it's a small community hospital) and am waiting on an interview. Fingers crossed and thanks for your insight!

Specializes in Trauma Surgery.

I worked on a gen surg unit (who am I kidding, it was pretty much med surg) and a year later I transferred to my hospital's SICU. Just like Ruby Vee said, you'll learn all your ICU basics in orientation including prioritizing and time management. My orientation was 6 weeks and I was scared sh*tless but I must be doing something right-- it's been almost three years later and I still work there (though we've had alot of changes including combining with MICU). We definitely had alot of transfers and new admits before we merged. Don't get me wrong, we still do (especially since its almost overdose season) but it's not as frequent as it used to be. We still get alot of frequent fliers though!

Specializes in ICU.

I think its totally doable! I had the same exactly career trajectory: started out in med/surg and moved over to ICU. It is very different... the experience from med/surg helped some but you will essentially still feel like a brand new nurse. But with determination, an open mind, and lots of learning, you can do it!!

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