Med-Surg vs. ICU for a Broad Knowledge Base

[Shookclays, ASN, BSN, CNA, RN]

Hello guys,

I am debating on whether I should take a Med-Surg job, in which I will have 6-7 patients (nightshift with a combination of adult and peds) or ICU (nightshift/adults-peds). Both of these positions are at a rural medium sized hospital.

My goal is to have a broad range of knowledge and experience when it comes to health and nursing in general, not necessarily a higher level of skill(ICU). So my question is, which specialty will help me reach my goal. Keep in mind that even though this ICU has 3 patients at night, it's not a really high level acuity ICU.

Edit: Most of the time, there's a 5:1 patient load on the med surg floor but can go up to 7 if staffing is low. This is happening due to many of the nurses retiring and other nurses not willing to drive 35-45 minutes to work here because of opportunities in the city. ICU patient load depends on the acuity of the patients. Most of time there it's 2:1 but a lot of suicidal patients are admitted to the ICU if there's no room on the psych floor and no beds in another hospital.

[amzyRN]

Take the ICU job. Having 6 to 7 patients is crazy and probably unsafe. You'll be running your orifice off all night, no time to think and learn. Med surg can be a dumping ground, which can be good to learn but if the load is too much it can be overwhelming and stressful. A 3:1 patient ratio is high in ICU, most ICU's have a 2:1 or 1:1 ratio. I'd pick the job where I thought I could provide the safest and most high-quality care.

[Shookclays, ASN, BSN, CNA, RN]

Take the ICU job. Having 6 to 7 patients is crazy and probably unsafe. You'll be running your orifice off all night, no time to think and learn. Med surg can be a dumping ground, which can be good to learn but if the load is too much it can be overwhelming and stressful. A 3:1 patient ratio is high in ICU, most ICU's have a 2:1 or 1:1 ratio. I'd pick the job where I thought I could provide the safest and most high-quality care.

Thank you for your input. I didn't explain clearly about the patient load, it's rarely even 6 patients, most of the time its 5 but if staffing is low it can go up to 7. Many of the nurses are retiring and nurses from the city isn't willing to drive 35-45 minutes to work here because of the opportunities in the city. I worked here as a tech and it's a really nice place with high pay because they're trying to keep their nurses.

[brownbook]

I can't imagine the hospital functioning without cross training all staff between ICU and med/surg.

The ICU is low level, staffing and patient census fluctuate.

But that doesn't answer your question. I just can't get over the idea that the hospital wouldn't cross train, sorry, I'm no help. Unless you want to start a float pool of one nurse.

I worked at a smallish hospital and almost all the med/surg nurses floated from time to time to our low acuity ICU.

[cleback]

6:1 on nights for med surg isn't too bad. I'd still go for icu. I learn more with a lot of interaction for fewer patients.

[Shookclays, ASN, BSN, CNA, RN]

I can't imagine the hospital functioning without cross training all staff between ICU and med/surg.

The ICU is low level, staffing and patient census fluctuate.

But that doesn't answer your question. I just can't get over the idea that the hospital wouldn't cross train, sorry, I'm no help. Unless you want to start a float pool of one nurse.

I worked at a smallish hospital and almost all the med/surg nurses floated from time to time to our low acuity ICU.

Thanks for answering. At this hospital there's zero cross training for ICU.

6:1 on nights for med surg isn't too bad. I'd still go for icu. I learn more with a lot of interaction for fewer patients.

I have ADHD and feel as though ICU is a place where I can't be due to the fact of not being able to focus on every little detail about one patient.

Plus I learn better, not by interacting with patients, but by having multiple care plans in my face. I will end up in psych but before I go there I want to have a really good knowledge base on physical illnesses and basic nursing skills. I don't plan on being bedside for more than 3 yrs so I think I'm going to go with the med surg position.

[ThePrincessBride, MSN, RN, NP]

Weren't you the one who refused to take ANY job unless it was NICU?

Glad to see you have come to your senses. Pick the one with the best orientation and support for new grads. Also, benefits should be kept in mind.

[ThePrincessBride, MSN, RN, NP]

Take the ICU job. Having 6 to 7 patients is crazy and probably unsafe. You'll be running your orifice off all night, no time to think and learn. Med surg can be a dumping ground, which can be good to learn but if the load is too much it can be overwhelming and stressful. A 3:1 patient ratio is high in ICU, most ICU's have a 2:1 or 1:1 ratio. I'd pick the job where I thought I could provide the safest and most high-quality care.

That's become the norm, unfortunately, at least in my facility. Tripling ICU patients and giving med/surg nurses 6 or more patients is becoming quite common.

[Shookclays, ASN, BSN, CNA, RN]

Weren't you the one who refused to take ANY job unless it was NICU?

Glad to see you have come to your senses. Pick the one with the best orientation and support for new grads. Also, benefits should be kept in mind.

Gooood memory! Yes I was, then I took OB and although my love for babies is tripling everyday lol, I could never work there. Too many ethical issues especially when half of my patients were being taken by the state. It takes a special person for the NICU. Nursing school will certainly show where your strengths and weaknesses are. I'm not ashamed to admit that.

[Shookclays, ASN, BSN, CNA, RN]

That's become the norm, unfortunately, at least in my facility. Tripling ICU patients and giving med/surg nurses 6 or more patients is becoming quite common.

Wow! Do you work ICU in a rural community?

[elkpark]

No question -- if your interest is building a broad knowledge and skill base, take the med-surg job. Best wishes!

[Shookclays, ASN, BSN, CNA, RN]

No question -- if your interest is building a broad knowledge and skill base, take the med-surg job. Best wishes!

I always enjoy your posts. Thank you! I have accepted it.