MICU VS SICU

[froggy8]

Hello! I am deciding between going to a MICU or SICU (if I even have the choice in this economy but was curious anyway) What the difference was, and which one you preferred and why...

Thanks in advance!! for your support and advice!

[ProgressiveThinking, MSN, CRNA]

I know this is an old thread, but I just wanted to add my 2 cents for future readers with the same question:

I work in a MICU at a 500+ bed hospital with an MICU and SICU. Where I am, an ICU bed is an ICU bed. Medical patients go to the SICU, and Surgical patients go to the MICU. It's all based on bed availability, and we never seem to have any available beds. Our MICU sees everything from GSWs/TBIs to ARDS/DKA/Stroke. I think I like surgical/trauma patients a little better, since they generally tend to be a little healthier at baseline, but I would rather work with a pulmonologist/intensivist over a trauma surgeon any day of the week.

I can definitely see how working in a closed MICU with nothing but medical patients would get depressing after awhile. However, sometimes you just wanna go to work and not have to deal with the fast-paced trauma, and just do your job, and go home. This is why I like working with a mixed patient population. On a side note, the other day I had a surgical patient who has been in the unit since last September, so it's not always the medical patients who stay in the unit forever. Either way, you can't go wrong.

If you start off in a general SICU/MICU that isn't too specialized, switching back and forth won't be all the difficult as long as you have the basics of critical care down!

[RNDude2012]

I work in a mixed ICU at an academic trauma center that has one of the busiest ERs in our state. It's in a less than desirable area that serves and extremely underserved and indigent population. We get a lot of traumas (GSW, MVA, stabbings, etc.) I think as far as learning goes, medical patients are where it's at. Surgical, including trauma patients can be very "cookbook," and are extubated fairly quickly. Although they are seemingly daunting at first, trauma patients are exciting, but it gets old and routine after awhile. A lot of trauma patients that we get are young and healthy and recover very quickly. Very seldomly do they require pressors, and when they do, it's usually only temporarily. Most of the time in the ICU we receive trauma patients from the OR who are stabilized for the most part. They do however frequently require a lot of blood products and fluid resuscitation. I think that to get an elite trauma experience one would have to work in an emergency department trauma bay. Sure, we occasionally do get the very sick trauma patient who is literally teetering on the brink of death. This is the exception, not the rule. Most of the trauma patients who die either die at the scene or in the trauma bay.

Medical patients are where you learn your bread and butter pathophys. A lot are very sick and require multiple vasopressors and gtts including sedation. This is all managed while taking multiple comorbidities into consideration. I look at this from a potential SRNA perspective since I'm applying to anesthesia school soon. Aside from open heart patients, medical patients require me to take care of intubated patients w/ a-lines, central lines, and pressors far more than surgical patients do. Taking care of surgical patients might expose one to surgical staff and the fluid resuscitation that an anesthetized patient requires, but I think either a fresh open heart on multiple gtts (which is rather cookbook itself) or very very sick medical patient who is sedated and on multiple pressors will give you a picture of the sickest of the sick.

Sure, you have your medicine patients who can't be extubated. They're usually transferred to an LTAC asap (where I work at least). I like mixed ICU, but if I had to ask myself which one would give the better experience it would be MICU since it is a catch-all that takes care of sick medicine patients along with surgical, cardiac, neurosurgical, and all other patients (open hearts aside) as overflow.

[Dranger]

Grass is always greener.

I work MICU and much rather do CCU or SICU. MICU has varied patients with some really big issues but is also more depressing IMO. Most of the patients in my area are get sepsis/resp failure/MODS from years of neglecting their bodies or they are simply reaching their 80s/90s in terms of lifespan. Rarely do I see a patient leave and never come back. The younger ones will be readmitted, many die or go to nursing homes. Honestly, it depends where you work. To be frank, if you work in a low income/drug infested/med non-compliance area you can guess what you are going to get....

With CCU and SICU you have better outcomes. MICU does provide a broad array of interesting cases and different specialties involved though.