Was anyone ever a floor nurse?

  1. Two weekends ago we had a code. There was two R.N.'s on the floor with 10 patients. 2 of the 10 patients were unstable. We had no secretary. (by the way it's a cardiac stepdown)

    One of the CCU nurses came for the code. She said, "You should join us in the unit. We are better staffed. And we work as a team, we have to"

    I've been considering working a Unit a long time. I work at a large hospital. We have CCU, NICU, MICU, CVICU and SICU. I won't know which unit to start at. I've worked step-down cardiac and med/surgical. I enjoyed both. I am getting burned out of cardiac. Where should I start out?

    What do you enjoy about ICU compared to Floor nursing? Thanks for sharing your knowledge.
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    Joined: May '01; Posts: 365; Likes: 1


  3. by   Janet Barclay
    Hi askater,
    I worked in surgical specialities for 3.5 yrs befor moving to ICU. In some ways, ICU's are easier, only one or two patients (in our institution) and all the information about the patients conditions at your fingertips. It's not for everyone, though.
    As for which area to move, to, that is very individual. I have worked in CV, CCU, and general systems/trauma. The General systems/trauma unit is my favorite, I've been there for 10 years, and it never gets old to me.
    good luck, janet
  4. by   PhantomRN
    You are on a step-down unit no doubt you have medical and surgical patients. So maybe a good starting place would be to decide which population you like better medical or surgical.
    There is no right answer, we all like different things. I personally found, after working step-down, that I liked surgical, so that is the direction I went.

    CCU, MICU are medical units.

    SICU, CVICU are surgical units.

    Or do you want to work with neonates...NICU.

    Now you need to think about the population of patients on each unit.

    CCU will be cardiac medicals....CHF, COPD, MI's etc.

    MICU will be just about everything else. Pancreatitis, renal failure, sepsis, MODS.

    CVICU would be cardiac surgeries.

    SICU would be all the other surgeries.

    I personally switched into the unit from a step down such as yours and I love it. It is a lot less stressful, even though the patients are sicker. We actually have time to give care to the patient, and figure out what is going on with them.

    I can get in there and give my own baths and see the skin rather than relying on the aid to tell me.

    The patient ratio is great. The floor I was on we had 6-8:1 now in the unit at most I have 2:1.

    As for support. It is tremendous. The unit nurses seem to always be there for you. A few weeks back I had one of my two patients go bad, so one of the other nurses picked up the care on my second patient until I could get back to him. THAT WOULD HAVE NEVER HAPPENED ON THE STEP DOWN, we were always so busy trying to put out fires.

    I say go for it....................GOOD LUCK
  5. by   justanurse
    I worked 4 years in orthopedics until I went to CCU on the "buddy-plan". I worked 10 years in CCU and then did CN over our CCU/PCU (tele). I loved it (most of the time). It took me 8 or so years to say my worst day in CCU was actually worse than my worst floor day.

    If your hospital is like my hospital, the telemetry nurses are some of the most over-worked nurses there. Way too many patients, not enough staff, and expected to care for patients that should be in the units. I know all areas are like that now, but I have worked with too many nurses that floated off tele to other floors and had a much better day with less ill patients.

    Can you float to some of the units to check them out? If you can, you will see which ones are receptive to new staff. I love critical care. I am now in our float pool and go to ICU, CCU, PCU, ER. I started that this summer as I burned out as CN and didn't want to step back into a single unit role yet. Don't get me wrong, I have much respect for nurses who work the floors, (been there, done that) it's just a whole different ball game.

    Whatever you decide: GOOD LUCK!!!!!!
  6. by   l-andre
    ICU (whatever the speciality) is a great place to work. Even when we are short-staff, there is always someone to help, partly because of the nurse-patient ratio. There's usually someone with less work who can help. And the technology is there, we are equipped and formed to respond to (almost) every situation. It makes it less scary when a patient is crashing, WE ALL know what to do, and crashing patient IS part of the ICU "routine". We also know our patients, not only their diagnosis or meds. It's also a great learning place.
    It's not for everyone but if your interested, you should at least try. Good luck!
  7. by   debbyed
    You couldn't pay me enough to go back to floor nursing (I give those nurses lots and lots of credit). I did it many, many moons ago and just could not do it again.

    If i ever get to the point that I can't do ER anymore I would choose to go back to CCU.
  8. by   RNforLongTime
    I have been debating on whether or not I want to transfer to our ICU. I work in a 226 bed small hospital so we have only one ICU--6 beds and 1 code bed(for a floor patient that codes)--it is equipped for up to 10 patients but with the staffing shortages thier beds have been cut.

    I attended the Ohio Nurses Association convention a few weeks back and roomed with one of the ICU nurses and the Head Nurse of our ICU was also in attnedance.

    See at my hospital, the ICU nurses "float" out to the med/surg units when census is low. And the newbie is the one who HAS to float out--if you are cross-trained to the floors and some ICU nurses aren't. I hate "floating". In fact a lot to the ICU nurses work the floors more than they work in ICU. But the ICu has had some staff leave and those staffers haven't been replaced yet.

    Anyhow, according to our new union contract, I would have to wait until January as I can only change jobs twice in a year. But my current boss is a wimp and all of the ICU nurses LOVE their head nurse.

    Any advice?


  9. by   austin heart
    i was a floor nurse for 4 years before i transfered to crit care. mainly medical, but did do float pool the last year to get a feel for other areas. i am glad i did that, because working in icu/ccu you get it all. i have the opinion, not shared by all, that a nurse needs a good floor background in med/surg to be a good crit care nurse. i know it has helped me greatly. you learn your good time management skills and basic nursing working the floor. but.... i would never, ever go back!!! i have great respect for floor nurses. the good ones work their butts off. not that we crit care nurses don't, i just feel that it it is a different type of nursing. good luck to you!
  10. by   Lacey
    Hey, I have lots of med-surg and telemetry experience and decided to into the ICU only because I needed it to apply to nurse anesthetist school. I am in my last week of orientation and it seems so much better. On the floors, we would just pray the patient wouldn't crash until after we were gone, God Forbid that you would have to call a doctor and get screamed at. In the ICU, we see it coming and try and prevent it. The doctors actually call the RNs to check on the patients and ask if they need anything!
  11. by   christianRN
    The thing I like so much better about ICU is, you actually have time to take quality care of your pt (usually. THere are always exceptions!) In my experience, the teamwork is awesome also. Good luck on whatever you decide!!!
  12. by   hoolahan
    I did general M/S ICU for 3 years after almost 2 of M/S floor, then after that ICU, which in those days included trauma, and we were the "burn hospital" for the area as well, Then I moved on to a CT ICU.

    I loved CT ICU, very challenging. I think, for me, the difference between the two is really the long-term-ness of many if the general ICU pt's. Some of those pt's, in those days anyway, lingered on and on, on vents for months in the unit, etc.. Not to say we didn't have some long-termers in the CT ICU, but we usually transferred them to the medical ICU after a few weeks. So, for me, I like dthe CT ICU better b/c we had quicker turn around of 90% of the pt's, and you saw more of them do well than not. It was my happy place. I do think a general ICU is a good way to get a solid ICU background, CT ICU will always be there later if you want to try it, the MICU will give you the variety you need exposure to first. With that experience, a CT ICU would scoop you right up!

    Good luck.
  13. by   Tenn_ICU_RN
    I worked on "cardiac stepdown" or telemetry units for almost 7 years prior to transferring to ICU. I feel that I gained much valuable experience in my years as a floor nurse and wish that ICU's wouldn't take new grads...but that is another discussion altogether (sorry).
    I truly love the type of work that I do now in ICU. It is much more fun (for me) because I like to be presented with problems that I have to solve; I get to use my brain. When working the floor, I had gotten to the point of running on autopilot most of the time & felt I was not learning anything new. I enjoy learning new things daily, and ICU is a good place for that. There is always a new problem cropping up or a new solution presented by someone else that you hed not previously thought of. Yes, there are the shifts of pure drudgery, just like on the floor, but the shifts of pure adrenelin usually make up for it.
    Where I work, we try to have just 2 pts apiece, but of course this is not a perfect world, and one is occasionally stuck with 3...but not too often. When I worked on the floor, 7-8 pts were the norm, and some shifts up to 12-13pts, so yes, I do like that better. One of my favorite things is LIMITED VISITATION!!!! No longer do I have to crawl over family sleeping on the floor or in the armchair...I get to RUN THEM OUT after 20 min. This is a very BIG bonus!! ;-)
  14. by   mattsmom81
    I have enjoyed set visiting hours too and it has been a big bonus for me in critical care. Now...we are seeing a move towards open visiting...which is not good news to me at all.

    I myself was a floor nurse for quite a few years before moving into critical care...it seemed a natural transition into ICU for me. this was before the days of internships....I learned by OJT.

    When I started medsurg nursing (in the 70's) it was a much more controlled setting...we had team nursing with good team members and even actually had enough help!! It is much different today unfortunately...and a very frustrating setting for those who are anal like me...LOL! I go nuts now if I can't keep track of all the details.....hehe.

    Although I have enjoyed the stimulation and challenge of ICU, it can be very very stressful on it's own when you are fighting to save a life...nonstop codes are not infrequent...and when open hearts go bad and the surgeon expects us to set up a mini OR on a patient who is alive only due to high tech machines and multiple drips ...it gets wild. When we need 3 nurses on one patient due to the complexity...and the rest of the unit suffers. The quality of the surgeon comes into play here too. These are usually the type who blame everything on the nurses although we know whose skill is in question....

    Got off on a little tangent there..sorry...but meant to say ICU is not for everyone. Some nurses don't like feeling they are 'the end of the line' for that crashing patient...there is nobody else to call...it's YOURS.