psuICUbb

Hi! So I’m a nurse in a CVICU/CTICU at a level 2 hospital. I started 7 months ago and this is my first nursing job. I’ve been trained to take impellas, balloon pumps, CRRT, ecmo and so much more. Due to covid our unit was being transformed into the covid ICU (or so I was told) but when I started it was decided covid would be confined to the ED And 3 other med/surg floors and if they were an ICU pt an ICU nurse would float to take an assignment on that floor. Prior to covid patients with critical care/intensivist consults would be managed in our MICU and CT/CVICU. Once I started the head of critical care decided he wanted all of his consults confined to one floor and that was determined to be the MICU. Now, our CVICU does not get any sick patients whatsoever. The ratio is 2:1 sometimes 3:1 but these patients are rarely on pressors, sedation and aren’t even intubated. Occasionally one patient on the entire unit will be intubated but that pt goes to the most experienced. Our MICU has everyone intubated and sedated. They’ve started taking a lot of our patient population away from us all because of one doctor who didn’t want to walk down a flight of steps to manage patients. The CVICU has become a glorified step down unit. Majority of patients are aOx4 post cath, actively in withdrawal or requiring bipap, frequent GI bleeds. Occasional lung or CABG. All of our cardiac arrests go to the MICU, our ruptured AAA go to the MICU. But here’s the problem the MICU nurses don’t know how to care for them. They don’t have the training. If a patient is on an impella or balloon they try to lateral transfer it to the MICU. I received more training orientation and education than the MICU yet they’re getting the sickest patients. I hate my job. Like I said it’s a glorified step down unit and there’s so much animosity between the MICU and CVICU because they think they’re the best now. I don’t know what to do. Other nurses on my unit are mad as well and since I’ve started and all these changes occurred 30 nurses have quit from my unit. It’s currently staffed with new grads and travelers. I was offered a job in our MICU the same time as the cvicu but I didn’t take the MICU because I was told higher acuity patients go to the cvicu. Now MICU gets all the patients I wanted and was excited to learn about. I want to transfer but my manager has blocked all staff from transferring since so many nurses quit in the last month. What do I do? I am so sad about all of this.

Update: I picked the cardiac neuro ICU and I picked so wrong. Since I started and covid, covid is confined on 3 of our med/surg floors instead of the ICU’s and ICU RNs are being pulled to those units. The cardiac neuro ICU is no longer receiving critically ill patients and when it does it goes to a nurse with many years experience. Our most critical patients go to the medical ICU and they’re all intubated and sedated. My unit they walk talk and really don’t require an ICU bed any longer. I was taught all of the ICU skills but I never get to utilize or perform them. I’m so burnt out because I hate my job. What should I do?

I’ve just been officially offered two ICU positions. One is an adult med/surg ICU with an occasional pediatric ICU patient I’d be ACLS and PALS certified and we even have CRRT on that floor. The other is a cardiac neuro ICU (CNICU) it’s actually being transformed into the designated covid unit for now but still a lot of cardiac neuro ICU patients. My dream is to eventually be a CRNA once I get some more experience especially now that it’s ICU. Which job would be better for me to take??