medical and surgical intermediate floors....more like ICU or Med/Surg?

msjack · Mar 17, 2009

I have a job interviews for medical and surgical intermediate floors...what should I expect?? Are these floors more similar to medical/surgical floors or are they intense such as the ICU? I have never worked in a step-down unit nor have I had a clinical there so I am clueless!

I'm still in nursing school, but I was a tech on a step down ICU unit. I think it's more on the line of an ICU, but not as intense as the ICU, but the patients are more critical than in med/surg. Our nurses had 3 patients each. A lot of our patients were vented, trached and bed bound. As soon as they were well enough to get up out of bed themselves or stable and didn't need continuous monitoring they were sent to a med/surg floor. Hopefully this helped some, but I'm sure some of the experienced nurses have more info.

vashtee, RN · Mar 17, 2009

It's called DOU (direct observation unit) at my hospital, and the patients are less stable than they would be on a med-surg floor, but more stable than ICU. The ratio is 3 patients to 1 nurse. We have patients that are on cardiac drips, but we don't do any titrating. Otherwise, we do pretty much everything else, so far as I know (but I am a brand new nurse, so I could be wrong about that)...

jla623 · Mar 18, 2009

I think it depends on the hospital. I work as a tech on an intermediate unit and it's more like med/surg with telemetery in my opninion. Not really any drips or anything. Plus the nurse to patient ratio is like 1:5.

nuwbee25 · Mar 18, 2009

wow thank you guys for all the info...I have heard that the patient ratio is 4 to 1 nurse....however the patients are critical not so much stable. I guess I will have to wait and see the unit myself. it seems as though it may be a way for the hospital to have leeway to give RNs more critical pt maybe when it's not so safe. I am probably wrong or at least I hope so!

Transplant-BSNTx · Mar 18, 2009

"Intermediate" or "Step-Down" Units vary from hospital to hospital. At some hospitals they take "stable" vented patients, and some they do not. Usually there will be telemetry monitoring and a higher acuity than on a regular med/surg unit.

smilelikeumeanit · Mar 19, 2009

It definitely depends on the hospital, I am going into some interviews myself for IMC/Stepdown. Usually the bigger the hospital the more critical the patients in the step down unit. I know shands in gainesville is 1:2/3 in the IMC almost like an ICU, but the VA step down is 1:5 and not so critical. Definitely talk to some staff on duty if you can! They will hopefully tell you a little of the real deal and if they can't you can tell from their body language if it's a good place to work...Also think about the benefits the hospital has to offer...Smile be fresh!

wanderlust99 · Mar 19, 2009

It really does depend on your hospital. The SICU I currently work at sometimes feels like a med surg floor! These pts don't belong in an ICU, but it's just the hospital I'm at right now.

Sometimes floors won't take drips, sometimes they do. Really varies with each hospital!

newyorkgrrrrrrrrrrrl · Mar 22, 2009

I am a tech at an intermediate unit...at my hospital it is inbetween ccu and pcu. Most of the patients are on vents and all are total care. The nurse ratio is 1 nurse for every three patients.

cardiacRN2006, ADN, RN · Mar 25, 2009

They are more critical than the floor but far less critical than an ICU patient. I know this vaires a lot from hospital to hospital, but when we are looking to turf a pt to step down for we pick the easiest, most stable pt.

So, I would say they are closer to tele pts than icu pts, in general...

bulldoggurlie · Apr 2, 2009

i'm a nursing student and I extern on a stepdown unit....love it lot by the way. Its at a level 1 trauma center main one for its location. Our nurses get 3 pts except for in one of our areas they get two and they are usually higher acuity. It seems more like icu than medsurg. We do assessments a minimum of 4 hrs...a lot of time we'll do it more per orders. A lot of our pts are on tele. We take stable vents. There are a lot of total care pts. We will also get a lot of pts that are going through withdrawls that don't belong in icu. In our hospital only icu and our floor can participate in our withdrawl protocol. There are more codes on our floor then medsurg. Lots of transfers....they are either going to the floor or the unit or coming from ed or the later two. We do cardiac drips and titrate to a certain level (don't remember the dose) before they need to go to the unit. We don't manage Art lines....and because we're not icu when we have to do cvp readings we do them manually...super fun when the are q1-2 hrs lol. I guess it does depend on the hospital. Its pretty challenging sometimes you will get medsurg alot of times you will get patients that really should have gone to icu. The fast turnover is fun. oh well got winded....if you have any more questions please ask......even though it probably largely depends on the hospital you are applying to.