Kbelle

Hello everyone! I posted a while ago about wanting to transfer from CVICU/SICU to the ED, and a couple weeks ago I finally applied. To my surprise, I got the job! No interview or anything, just an application and a job offer. I’m over the moon. I worked as an inpatient acute oncology nurse for close to two years (juggling 5 patients who at any given moment would be receiving blood products, chemo, and frequent neutropenic fevers) before switching to the ICU, so feel that I have good time management skills and my ICU was also a wealth of knowledge regarding critical thinking. Any advice for a new ED nurse switching from an ICU environment?

I’m glad to see we’re not the only hospital that deals with this LOL. We don’t call for things expected, such as a STEMI patient with a high troponin, since they were admitted with the critical values. The issue with the procalcitonin example is since it’s the FIRST time it has appeared as critical, we have to call. Any others after that we can document that the md is aware.

Hello all! I just want to vent for a minute. My hospital has a policy that new critical lab values have to be reported within 90 minutes. I work night shift, 7p-7a and have gotten cussed at (by one doctor) and ripped a new one by a few others for following this protocol. I work in a busy CVICU and always try and wait to see if anyone else needs the critical care doc before paging, but sometimes I just have to bite the bullet and page. The biggest lab value that seems to prompt this is always the critical procalcitonin. The patient is septic and we know that? Of course! They’re on antibiotics? They are! But for some reason the docs keep putting in the FIRST procalcitonin as an EAM lab draw! If I don’t call, I’m in violation. If I do call, I’m on the *** list. There’s no winning. If I didn’t have to call, I most definitely wouldn’t. This is an issue within all of the critical care units of my hospital, and if the docs have a problem with it I wish they’d take it up with administration who is writing the policy and not take it out on those of us who have to make the unsavory call in the first place. The other sore topic is the generic order to call for urine output of less than 30 mL/hr for two consecutive hours. Dayshift will go all day with borderline urines and not address the issues, and it’s understandable because the doctors are right there and not being woken up. Night shift then roles around and my outputs are 30, 25, 15, 10. I always try to fix the issue myself (flush the foley, bladder scan, flow track, check the creatinine and BUN, PRN albumin) but I call and get berated because “this has been happening all day and it couldn’t be addressed earlier?” For CV patients this is something we HAVE to call about. It’s all just so frustrating. I wish I could tell the docs that I don’t want to call them any more than they want to hear from me.

Hey everyone, I wasn’t sure where the best place was to ask this question, so please move if it’s in the wrong place. I’ve been a nurse for a little over 2.5 years, spending 1.5 years in acute oncology, and most recently a year in a SICU/CVICU. I thought ICU was what I wanted, however I’m finding it’s not what I expected and I’m not enjoying it that much. There are some ED positions open, and ED was always my dream throughout nursing school so I plan on applying. Does anyone have any tips for an ICU nurse transferring to the ED? I know it’s a completely different world and would love any tips anyone has to offer.

Thank you for the kind words!

Thank you so much! I feel I sometimes have a hard time converting from the task oriented side of floor nursing to the more critical thinking aspect of the ICU. Evaluations are coming up soon and I’m hoping to glean some insight from that

Hey everyone, and thanks for taking the time to click and read. I posted those in the critical care section but wanted to expand this topic. I recently switched to a SICU/CVICU unit after working on an acute oncology floor, specializing in oncology emergencies for around a year and a half. I’ve been in the ICU for close to six months now and I’m still so unsure of myself. I feel that I have definitely made progress, but doubt myself often. I have a wonderful support system, and my coworkers are extremely helpful, but I feel terrible when I ask questions all the time.   I was wondering if anyone had any words of wisdom to feeling more comfortable and confident in an ICU setting after working in a more acute/floor setting? I have been a nurse just over two years and welcome any and all advice.