I choose it because the patient is MINE... I know every last bit of their history, I know all their labs, I understand our current treatment... where we're headed and how we need to get there.... I know what to monitor for, what to call for, what to question... what to put on my "laundry" list of things to add to treatment for the doc. I know every time I turn a patient and suction them and give oral care I prevent complications... I spend endless hours educating non medical families on multi-system failure , where we are-what we're doing... what I hope to see over the next 12 hours. I go head to head with any doc fighting for any new order that can improve outcomes... I read at work, at home and I study all the time to take better care of them.
On a floor, I do spot assessments, I know the important history, don't have a clear picture, am torn between many other patients, lack time to teach, rarely know labs, except if on anticoagulation or med therapy. Rarely have time to read through the chart, all the progress notes and the consults to see the true state the patient is in ... and frequently play catch up on labs, meds and tests without a concise knowledge of where were going.. this can't be done with 6-12 patients. If my floor pt. codes, I have to pull out the chart to give the coding doc the info needed.
Not trashing floor nurses in any way, they will always be in awe to me.... for me, I need to know it all, do it all and manage it all with the MD. Can't do this on the floor.
so, I'm a control freak, live and thrive in the ICU and it works best for me, on the floor, floating... I can't do less than I know... it makes for one hell of a night.