I went from a general SICU in a level 1 facility with a large variety of patients (truama, neuro, sicu, cardiothoracic, picu, open bellies, open chests, crrt, balloon pump, etc) to a burn and pediatric truama ICU again at a level 1 facility. I would kill to go back to my last job. Burns, suck. Truama is better but I find that I'm losing my critical thinking skills. Truama is sick when the first come in, and then it's just a long drawn out sad process. I feel like most of the time I'm taking care of step down patients. I always loved truama at my last job, but maybe because I got to do all the other fun patients along with it. Having done what you are doing "trying to find the sickest of the sick" and now I'm stuck bored and frustrated, be careful with truama, maybe it's just my opinion but I felt a lot more challenged in a general SICU then I have in the pediatric truama ICU.