MICU vs SICU-why the rivalry? Can't we all just get along?

[sassyrn333]

I am a new grad (11 months post hire), primarily assigned to work in a MICU, but I have volunteered to work in a pilot program whereby I train and work in both units. For some reason it is felt that the SICU nurses have stronger skills and my boss (who is over both units but WAS primarily SICU manager) thinks the new people are better off getting some cross training. I guess I'm curious if it is common for MICU nurses to be "weaker" when it comes to skills, critical thinking, handling equipment, etc. My own appraisal of the situation is that the MICU nurses ARE weaker, but I think its more of a unit culture of sub-par work...that and I work in the VA where the nursing union seems to protect a lot of incompetent people. To give a little more background, the unit I work on also went a while (years) without a steady manager, and then a while without any manager at all. And interestingly, it seems that our manager's beliefs have shaped that of her SICU nurses, because many of them are downright nasty to MICU nurses when they come down there. Or even worse, when we come down there to train they don't give us challenging cases, which defeats the purpose of our being there.

*Disclaimer: I am also a union MEMBER so please, fellow union camrades, refrain from chewing my a** for the union statement. I'm merely stating my opinon...take it fwiw, I am still a new grad :nuke:

[RN1982]

Personally, there really shouldn't be any sort of competition. The only difference to me between the two is well, the surgical part. I've taken care of MICU and Neuro ICU overflow patients and I feel I could work comfortably in both of those units. The only reason those nurses are nasty to the MICU nurses is because it's tolerated by the manager which is rather sad.

To answer your question, there are "weak" nurses and "strong" nurses everywhere....MICU, NICU, and SICU. The whole competition thing is rather childish.

[geekgolightly, BSN, RN]

A tech floated today to our MICU from SICU, and she was discussing her unit and asked me if the difference between the two units was that SICU takes "acute" patients and MICU takes "subacute, or not so sick" patients. Instead of keeling over, I explained that her unit took surgical patients and our unit took medical patients, and she asked "yeah, but doesn;t that mean you don't get the really sick ones?"

I explained the definition of acute, and subacute and then discussed the types of patients we cared for on MICU, sepsis, resp failure, acute MI, acute stroke, etc. I was floored, because obviously someone has been telling her these things.

[Ruby Vee, BSN]

personally, there really shouldn't be any sort of competition. the only difference to me between the two is well, the surgical part. i've taken care of micu and neuro icu overflow patients and i feel i could work comfortably in both of those units. the only reason those nurses are nasty to the micu nurses is because it's tolerated by the manager which is rather sad.

to answer your question, there are "weak" nurses and "strong" nurses everywhere....micu, nicu, and sicu. the whole competition thing is rather childish.

i have to agree. i've worked in both micu and sicu (and cardiac sicu and ccu). there are challenging patients in both units. there are excellent nurse everywhere, and there are "weak" nurses everywhere. the difference is in the unit culture -- and if micu has gone without any leadership for any length of time, no wonder they're regarded as weaker. they need their own manager!

[sassyrn333]

Thanks for clearing that up all. I kinda figured it was an idea that was coming from the top and shaping the culture of both units, I guess I just wanted to seek the opinion of more experienced nurses. YOU GUYS ROCK

[moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS]

I have found that both units have equally challenging patients and patient flow issues. The biggest ah-ha I had about the differences between the two units is the physican management models are completely opposite sometimes between surgical and medical issues.

[SillyStudent, ASN, RN]

In my first hospital, the thinking was exactly opposite... MICU was considered way more 'Acute'. I worked SICU at the time, and we were told that we were way less 'busy' than MICU nurses.

I work in MICU in a different hospital now, and it seems to me that MICU and SICU are different but equal. I don't have 4 surgical drains, a chest tube, and 3 dressings to change....but I might have an IABP, hypothermia therapy and 9 drips.

ICU Nurses work hard and have to be on their toes, no matter WHAT specialty.

[Chisca, RN]

Been there, done that, even got suckered into being the shop steward for my unit. My only advice is to not play the game, treat every nurse with the respect you would want. It may not change others behavior but you'll go home knowing you weren't part of the problem.

[RnM21]

Listen, from my experience and I am now currently in trauma/sicu, its all the freagin same. Sometimes nurses need to get off their high horses and realize we are all in the same boat, sinking and floating. Treat everyone as you would like to be treated and you will get along fine.

ray

[love-d-OR]

I want to begin my post by saying I have NEVER worked in a MICU as a RN. However, when I was deciding what ICU I wanted to work in as a new nurse I spoke to some of the nurses in both unit. The response across the board was that in the SICU doctors are up for doing more interventions and hence the patients become more critical, while in the MICU the care was mostly conservative and per one nurse " they are nursing home patients that come here to die!" On the other hand the MICU charge nurse at the time told me that if I was intrigued by pathophysiology the MICU was the best place because I would see the result of chronic diseases on one organ/system affect many others.

I would also say that it also depends on hospitals and their units. In my hospital we have abdominal transplant/genral surgery ICU, CTICU, CCU, neuro/neurosurgery/trauma ICU, PICU, NICU and MICU. So really the ones that end in MICU are mostly resp failure and trasplant rejects. The strokes go to neuro ICU, MI goes to CCU and the surgical patients got to the other ones.

At the end of the day, we are all doing a great job and that's all that matters

[MatthewRN]

My facility nips it in the bud and has a combined MSICU.

[cardiacRN2006, ADN, RN]

My facility nips it in the bud and has a combined MSICU.

Ours too. And I find the most challenging pt to be the medical pts, and not the surgical.