Seeking advice about switching from Psych to Medical ER or ICU settings

[jss1985, ASN, RN]

I actually posted this in the PCT forum last fall but got zero responses, so just trying my luck here.

I've been in this field for 11 years, I started as an EMT and then I became a PCT for an inpatient psych unit. I work 8 hour shifts, 5 days a week, 4-12. Union job. Right now i make about $50k/year.

I've been seeing some PCT hospital positions, particularly for ER and ICU that pay way more than what I make in Psych. I don't believe these are union based, however, according to indeed, pay for these particular positions are between $56k-$57k per year. This is close to what an entry level respiratory therapist or LPN makes here in NYC. These are also 12 hour shifts x 3 days a week (which would prove useful for work/life balance right now and later on, it would work with a nursing school schedule).

Sometimes I see them listed as ER Technologist for the ER and ICU tech for ICU, but they're all PCT jobs with PCT duties.

The only thing I'm worried about is the fact that, in my psych unit, we hardly do any bloodwork on my 4pm-12am shift. It's mostly the morning shift that handles the bulk of it. The last time I drew blood was maybe 2 years ago and I had missed the vein. Don't get me wrong, since I've been there, I have had many successful draws but I've also had plenty of unsuccessful where I missed the vein due to lack of repetition.

I am comfortable with everything else (Vitals, ekg, etc) except this. Being that these are medical ER and ICU jobs, I expect there will be tons more bloodwork and I am worried it might jeopardize my employment there. I mean I could buy one of those $300 venipuncture flashlights that you hold against the patient's skin perhaps(?).

I'm also concerned about ICU because I'm hearing a lot of negative things about it being very tough and dangerous to work in, perhaps that explains the high PCT pay for it?

Any suggestions? Would you still apply if you were me?

[Mavnurse17, BSN, RN]

I wasn't the best at IV starts when I worked bedside, but they didn't fire me for it. If you have skills that would be valuable to the unit, I'm sure they'd appreciate the help. And think of every opportunity to do a blood draw as an opportunity to improve your technique.... once you're in RN school your classmates will fawn over you being one of the only ones that can nail it.

[colli646]

If you are interested in transferring to another unit, I would say go for it, especially if it opens up different skill set opportunities. No one is great at anything without practice and if you work in a healthy workplace, other staff will be there to support you and help you in any way they can to make you better. Working in an ER is a great opportunity to master blood work skills. I am a new grad RN in the ER and us RNs and PCTs are constantly working together. I also would imagine you would receive a little additional training if hired. I say go for it and just be confident and ready to learn. You got this!

[jss1985, ASN, RN]

4 minutes ago, colli646 said:

If you are interested in transferring to another unit, I would say go for it, especially if it opens up different skill set opportunities. No one is great at anything without practice and if you work in a healthy workplace, other staff will be there to support you and help you in any way they can to make you better. Working in an ER is a great opportunity to master blood work skills. I am a new grad RN in the ER and us RNs and PCTs are constantly working together. I also would imagine you would receive a little additional training if hired. I say go for it and just be confident and ready to learn. You got this!

Thanks. Can you comment on the difficulty of working in ICU as a PCT/CNA? I keep hearing horror stories about it. And this hospital is paying top dollar $57k for ICU techs. I dont know if that dollar amount is a red flag or a good thing lol.

[bitter_betsy, BSN]

PCTs at my ER are not allowed to do IVs. We can straight stick and draw off of IVs but we cannot insert IVs. Don't let this stop you. Try. Working in an ER is VERY different than on the floor. We do things that they would never consider letting a PCT on the floor do (as in stop normal saline to let a person go to the restroom, stop beeping IVs if it isn't a controlled drug or Potassium or Mag or Nitro). We do A LOT of foleys.... and oddly clean up a lot of patients (like way more than I really want to). For whatever reason we seem to be the go to place for enemas. We also run to the floor when codes are called because the floor nurses are not accustomed to CPR and oddly aren't comfortable with running codes (we do them frequently so its "normal" for us and not "normal" for them).

I don't know what PCTs do in the ICU but again - ours don't have the same reign that we do. They are allowed to do vitals and patient care. Our ER is the only place techs do anything outside of normal CNA duties. Most of our ER techs also have their EMT license...

Ask. Just interview and ask. See if you can follow a shift or two.

[socal212, CNA]

Wow that is a LOT of money for a PCT to be making, in my humble opinion lol. I transferred from med/surg to the ICU as a CNA and kept my pay. I had friends who transferred from med/surg to be PCTs in the ER and they kept their pay as well. I can only speak for my hospital system (which is the largest network of hospitals in AZ) but PCTs in the ER are allowed to start IVs and insert foleys. They receive special training to do this. They often prefer to hire EMTs as they already have IV skills versus hiring a CNA who needs to be trained. Now, I work in the ICU. I am not allowed to start IVs or do anything invasive like that. Even if I knew how I'm pretty sure the nurses wouldn't want me starting IVs on their patients haha. Transitioning from med/surg to the ICU has been the best decision I made! I absolutely love it. My tasks mostly include setting up rooms, keeping the ICU stocked and making sure equipment is where it needs to be, doing temperatures and blood sugars, doing EKGs and assisting the nurses with patient care when they ask. I don't know of any ICUs in other hospital systems in my state that would let a PCT do blood draws or really do anything other than basic patient care, either. It's not horrifying or scary by any means. I thought my ICU experience was pretty typical for PCTs working in the ICU, but based off of your post the ICU you're thinking about sounds way different!