Published Apr 21, 2008
hoopette34
10 Posts
I am currently working on a med/surg Oncology unit (1 yr). I have been thinking about working in critical care.
Could someone please explain to me the differences between MICU and SICU? I know that one is medical and the other is surgical. In the SICU, are you taking care of more post-operative patients that require critical cares?
Also could you briefly tell me how best to prepare for either MICU or SICU? I recenlty purchased an ACLS book, and am looking to become telemetry certified (as it is not required on my current unit). Thanks.
Reno1978, BSN, RN
1,133 Posts
I work in a mixed MICU/SICU. My facility also has a CICU and Neuro/TraumaICU, so we don't see a lot of hearts, heads or trauma.
SICU patients are post-op patients that require critical care. Here's the scenario that brought in one of my recent patients. He presented at another small facility with chest pain and had elevated trops. They xfered him to our facility to go for a heart cath. However he was complaining of abdominal pain instead of chest pain when he arrived and had stated his abdomen had been distended and painful for 2 weeks. CT showed ischemic bowel, he went to surgery and they did an appendectomy, released a midgut volvulus. He came to the ICU with his midline incision remaining open with vacuum closure, pressors to maintain BP, ventillator, PCA for continuous morphine, multiple drains. When he returned to the OR for closure of the midline incision, he also had a cholecystectomy for gangrenous gallbladder and a gastrojejunostomy tube placed. On his date of admission, he looked like he had one foot in the grave. He was extubated yesterday, slightly confused, but improving tremendously.
MICU patients are medically unstable. Lately, I've been seeing a lot of respiratory failure, pneumonia, kidney failure, sepsis, and overdoses stand out as well as a variety of other chronic conditions.
I think to best prepare...hrm...I'd brush up on your cardiac rhythms, mechanical ventilation, hemodynamics. The resources listed at https://allnurses.com/forums/f30/sticky-threads-interest-please-read-272449.html are quite helpful.
Good luck in what you decide to do!
ukstudent
805 Posts
MICU has more chronic pts, such as COPD, renal failure, CHF with some acute such as DKA, overdoses.
SICU are mostly acute conditions, gun shot wounds, stabbings, transplants, open hearts, head bleeds etc. In the SICU all of your patients should be post op. In most SICU's you will also be recovering your pt directly from the OR.
In either place learn your ASL drugs, pressors, inotrops, and EKG strips.
Thank you for your replies.