MICU vs CCU for novice nurse

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Specializes in Emergency Department.

Hi All,

I wrote a thread earlier under the First Year in Nursing Forum about how the ED where I have worked for four months has decided that I would be a better fit for the ICU where I can invest a lot more time in each of my patients. I love my job in the ED and per the thoughtful and encouraging feedback I got from my previous post, I am going to speak with the nurse educator about the situation. However, in terms of considering ICU positions....

As I had mentioned in the previous post, the ED nurse educator and nurse managers have spoken with the nurse managers in both the CCU, NSICU, and MICU about them taking me on. I arranged interviews with the MICU and CCU for this week. Both units are known to have good employee retention and good management. I am vacilitating between which unit I should be more interested in. I am leaning toward MICU simply b/c I question whether it might be a good place to start for the reason that it would have more variety than hearts (although the CCU does take MICU overflow). However, I like cardiac, and really like learning about the CV system. I would be very interested in becoming extremely comfortable with cardiac rhythms, drips, lines. I have also been told that more of my patients in CCU will be able to talk to me b/c fewer are on ventilators (although I'm not positive that this is true). However, I would also enjoy learning about various other disease states and treating the variety of pt's who come to the MICU. Is there any particular reason for me to start out in MICU? Do you think either unit has a higher learning curve than the other? I am confident that I can manage the learning curve in either unit, but realize that I don't necessarily need to chase the highest learning curve.

Thanks

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Specializes in ER, Rural Nursing, Public Health.

I was in a similar situation to you a little while back, but chose to leave the ER on my own accord. I felt that a background in ICU would give me a stronger foundation to be an ER nurse. Now I am convinced what I did was the right choice, no contest! I moved up to the CCU/CVICU, even though I had considered the MICU also.

I can GUARANTEE you will see variety in the CCU because of overflow and such. In addition, remember, many conditions affect the caridac system - so where do these pts end up? Sure, you get open hearts and other surgical procedures, but these pts also have the most potential to go unstable on you FAST. Thus, you can fine tune your intuition/ critical thinking skills (which will be great as future ER nurse). We get a lot sepsis, shock states, gastro, DICs, diabetic issues, renal (CVVH training), surgical complications and so on. You will NOT regret the CCU. MICU gets a lot of respiratory (which was never my thing). Many of our pts are vented. It has been an AMAZING experience in terms of how much you can learn. The variety of drips and EKG rhythms are never ending (this is what you were looking for?)... And do you know what? I hated cardiac! I am surprised how much I am enjoying myself in the CCU - it is always interesting! I will only be here for another couple of months and than am moving to a different area of nursing BUT I will always be glad a did CCU. I hope to return to ICU in a few years.

Go with your gut!

Good luck

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Specializes in Emergency Department.

CamelHappy1,

I just want to say that I really appreciated your letter a lot. During my interview with CCU at the major teaching hospital where I work, a lot of what you said panned out to be true. The CCU gets a lot of overflow pts from medicine and also sometimes from trauma. I got an offer in the both the CCU and the MICU. A friend of mine works in the CCU and said that she really enjoys the unit and has felt that they set up a good orientation for her. My orientation would be 4-6 weeks, wheras a brand spanking new grad would get 8 weeks (I've been in the ED for 4 months already). I see that the CCU will offer me more variety than the MICU. I also learned that the CCU at our hospital, along with the CTICU, runs the code team and that on the CCU I would become very comfortable with codes (I haven't been around for a single code my whole time in the ED). Another thing that sounded interesting was the nurse manager kept emphasizing that the CCU nurse is a very definitive part of the treatment team for that pt. She said that sometimes it is the CCU nurse who is the most knowledgeable person when you have interns and first year residents rounding. She said that the CCU nurse is expected to participate in morning rounds and needs to be ready to intervene or correct someone if information is miscommunicated. In the ED, there is not too much time for listening to the doctors talk about the pts in very much detail. Our CCU does not take post open heart pts. They go to CTICU. I'm leaning toward CCU and wanted to thank you again for your letter.

OutdoorLovinRN

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Specializes in SICU-MICU,Radiology,ER.
We get a lot sepsis, shock states, gastro, DICs, diabetic issues, renal (CVVH training), surgical complications...

On the other hand, an MICU I worked in got exactly all of this, and more.

I got to help on codes almost everyday (it can get old at times).

I like the idea of an MICU early in ones career and am glad I worked in one before moving on to SICU/CCU.

Another thing to think about, being on house code team can get in the way of your charting and organization especially when you are new.

Sometimes choosing is a matter of staff and leadership.

You must be pretty good that they want to keep you on board!

Take care

11

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Specializes in Emergency Department.

Hi 11,

Thanks for your response. The whole house code thing wouldn't be for a while. They don't start new grads on that....so they say. In our hospital, the way it is is that the CCU gets so many overflow pts that there's a mix of medical and cardiac and even trauma occasionally. The MICU is all medical/respiratory. And our heart surgery pts go to CTICU. I wasn't sure if CCU was supposed to be "harder" than MICU, but that's not my understanding, just different. Another thing that I learned is that there are more pts you can talk to in CCU and more opportunity for pt education. (Fewer are on ventilators). Also...the staff leadership is playing a role in my decision...it's so important.

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Specializes in SICU-MICU,Radiology,ER.

It seems to me that you are really attracted to CCU and there is absolutely nothing wrong with that!

Both will be good areas to work in and neither will be a means to and end, but most likely a chapter in your career.

Could be that CCU might be were your heart always is.

I got into nursing to be in the ER. Somebody suggested I work in ICU for a year or two first. As it turns out thats kinda where my heart is even when I am so sick of it I dont want to go to work.

Now, I do work some ER and even prehospital for variety...but Ill always be an ICU nurse I suppose.

I guess, make your choice, and leave it with the powers that be. Then go with what they decide.

Either way you it sounds like you are going to get some great experience-

Best of luck

11

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Hi I am responding to your question about going to the MICU vs. CCU. I think it really depends on what you are looking for in reference to experience. I think that both areas are good to start in prior to going to the ED but I feel that the MICU will give you the most experience. In the MICU that I work in at a teaching hospital we end up getting all service patients. You see all types of different illnesses. This will help you to be more broad with your nursing career. I don't know alot about the CCU but they do get some overflow but at our hospital it is not many medicine patients. We send our overflow medicine patients to another ICU such as SICU,Trauma. The MICU is very busy though and they generally get some of the more sick patients that they don't know what is wrong with them. The majority of our patients are intubated but you do have times when there are people in there that are able to talk with you but sometimes that is really good because you can get to know that patient a little better.

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Specializes in Emergency Department.

Hi,

Just wanted to let everyone reading this thread know that I accepted a position in CCU. I start work next Thursday. Tonight will be my last night as a nurse in the ED...for a while. Who knows...maybe I'll fall in love with ICU and never look back.

The nurse manager in CCU asked if I would mind precepting on weekends. I was just wondering...how different are ICUs on weekends than on weekdays? I mean, would I be at a disadvantage to precept on weekends and then work weekdays? Or is it about the same?

Thanks

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