Multisystem PCU vs. Surgical PCU

[JFrancis5]

Hi community!

I am a new graduate and I just wanted to drop by and see if I could get some feed back from the community as I make some choices in the next couple of days. Specifically, I wanted to see what people's thoughts were about differences between Multisystem PCU and Surgical PCU as well as the the manageability of certain patient ratios.

I am a new graduate and I just received my first couple job offers of my career! They are all at the same hospital and two interviews that really stood out were an MSPCU and a SPCU. I have a lot of positives about both jobs and very few negatives.

THE POSITIVES:

1. Both are at the main campus of a nationally awarded hosptial.

2. Both are PCU which was the level of care that I worked at during most of my clinicals and practicum.

3. Both have very good GN programs with intensive education programs. I want to build a strong foundation and both will provide me with a solid foundation in time management, patient care, interaction with physicians, working on a team, and building assessment skills.

4. Both have UAPs and PCTs.

5. Both units have the possibilities to transition into night shift within the next 3 months.

6. Both units have a wide variety of patients and I will see a lot on these floors.

7. Both units have VERY sick patients.

THE NEGATIVES:

1. Both require me to sign a 2 year contract.

2. While I had a strong connection with the MSPCU during the interview and the main concern with this is that their patient to nurse ratio is 5:1 of very sick patients. This patient ratio is my biggest concern right now when considering these two options.

3. The interview on the SPCU was more brief and I had less of a connection but their ratio was 4:1 of very sick patients.

4. I have accept either job within the next 48 hours or wait until Nov 27 to work.

The questions I was hoping to put to the allnurses community are...

1. What are the significant differences to consider between multisystem and surgical?

2. What are people's opinions of PCU level ratios of 5:1 and 4:1?

3. What are some important points that you would encourage a new grad to consider when accepting their first job?

Thanks alot for the consideration and I appreciate the help!

JF

[Okami_CCRN, BSN, RN]

One of the things you have to think about is the patient population, usually a medical PCU which is what you described the patients will tend to be older with chronic health conditions that are presenting acutely ill (think acute on chronic liver failure/renal failure, etc).

In the Surgical PCU the patients tend to be younger with the surgery being their main health concern. These patients tend to do well post-operatively and move on to live good lives.

The ratio of 1:4 is pretty standard for a step-down PCU unit. However, what management says is the ratio and what actually happens is a whole different story.

Things you will likely see in medical PCU: BiPAP/CPAP, high flow nasal cannula, stable trachs/vents, wounds of all sorts (pressure/venous/arterial), GI bleed, pneumonia, sepsis; I think you get the picture.

In Surgical PCU you will see: all sorts of complex surgical patients; whipples, ex-laps, HIPEC, colon resections, ostomies of all sorts. These patients usually need aggressive fluid management, blood transfusions, and lots of ambulation.