aurora119

They're closing our tcu unit, is what I just found out...

I see your point. Then the best action is to try see if it's possible to shadow or go see the unit, and then make my decision. I don't really want to make the decision on the spot, so I'm praying that management will allow me to go to the unit and observe before I have to make a decision on where to go.

Everyone's feedback so far has been nothing short of supportive and informative. I've done some research on TCU, but I still would like to have someone be able to sort of list out the main differences between that and medsurg. I know that ms is more fast-paced, dealing more with pt in their acute phase of illness, are generally unstable (tho not as critically unstable as icu), and pt stay is usually less than 3 days. But I would like to know some more of the key differences between that and TCU, because so far, my impression is that TCU has more patients per nurse, yet it's somehow considered 'slower paced' and 'less acute'? I also thought about patient load, and so I briefly thought about OR (one pt at a time!), BUT I want to keep getting chances to do skills like wound care, dressing changes, feeding tubes, etc that you would normally get to do in M/S (one of the things I absolutely LOVED during M/S), but putting it all together, it kind of sounds like TCU would be equally as acute as m/s?? And that is what my NM was concerned about, is that the floor's acuity level is not a good fit for someone like me, hence why they suggested a transfer to another unit? I'm sorry for all the questions. I just really want a clear picture of the key differences here. :S I am grateful for everyone's feedback on my previous questions. This thread's replies have helped me get some confidence back in myself.

How many beds does your TCU have? And generally, how many nurses are there on nights? I don't know which shift I would get, but is the rationale that nights might not be for new grads because they assume pt/residents require less interactions at nights, hence a greater patient to nurse ratio??

Thanks for the positive support and feedback! I didn't expect so much encouragement...I feel better now after reading everyone's input. Please keep it coming! To GM2RN: Is the 'routine' for TCU the same for medsurg floor? (like med passes and such?) I don't know what to really expect, so I would like to know more about the kind of patients you took care of in TCU. Did they have drains? Feeding tubes? Chest tubes? I know that long term antibiotic therapy is going to be something I'll likely encounter, but I really want to know what all else I'll be dealing with. I know that our TCU unit has less than 30 beds, if that helps with any information. How many beds did your TCU have, GM2RN?

What about transitional care? I was told that the pt acuity is generally less than the floor I'm currently in, it's like a SNF but a part of the hospital. I know that most likely means more patients per nurse however. Does anyone have any feedback or experience on TCU units?

Thank you for the feedback. I was told the expectations earlier, and their primary concern is that I'm not comfortable with the high acuity level of the patients they get up there. The ratio is typically 6:1, while I can usually do fine with 5, depending on each patient's level of care needed. I was told that they think a less acute floor would be better for me, and that's why they brought up tcu and hospice... But like KatieMI said, hospice might not be a good fit for a new grad with no exp... It just feels like a huge blow to me that this happened, but I appreciate their honesty. I'm just very unsure what to do. When I try to get help on something I'm not familiar with, it usually takes some time for the other nurses to come show me how. I think another area that was identified as an expectation by this point is that I would have gotten in the habit of looking up protocols and stuff on my own. I keep forgetting to do that, but now I definitely will make that a standard part of my practice. It's just my first instinct (and I'm not sure if this is a new grad thing or not) is to ask for help instead of looking up things on my own, which I guess I did too much of, and that's something my colleagues have pointed out to the NM, hence why this meeting occurred.

I'm new to nursing and I've been off orientation for about a month. I started out on a med-surg with tele floor, and so far, I have had shifts where the night went ok and then I've also had nights where I just feel overwhelmed. I have been taking about 5-6 patients, all different acuity. I have asked for and received help from senior nurses, but I recently been contacted by my NM and I was told that they feel that I may do better at a unit with less patient acuity, like hospice or transitional care. I'm still shell-shocked because this news came after a particularly difficult shift last night. I'm really scared about possibly not having a job anymore, because I'm new to the area (location-wise). I'm also very disappointed in myself and ashamed that I have not been progressing as well as I believed. I do love what I do and taking care of my patients and educating them, but I also get overwhelmed when multiple things need to be addressed at once, and I'm still working on prioritization and time management. I get mild anxiety before work, but once I get into the groove of my routine, then generally I can do fine. I guess I am just extremely fearful of what's going to happen to my job... like I said, I moved to this area, so I am unfamiliar with most other places here to work, and right now, I'm the only one with income. Have you ever been suggested to move to another unit? Where and did you take the offer? I am so torn between sticking it out, or going to the other units because I don't know for sure if they have job openings at this time... I'm just so worried sick, I don't even have an appetite right now after missing lunch... Also, can someone who is either in or has been in transitional care unit or hospice, and also had experience with medsurg, please explain to me the differences? I need to let management know very soon what my decision is and I am just so lost right now!