Should ICU get more pay than floor nursing?!?

elkpark · Oct 23, 2016

The requirement of med/surg for new nurses has long gone by the wayside. Many new grads are accepted into positions in all fields of nursing; therefore, med/surg is no longer where "neophytes" belong.

Besides which, the fact the med-surg is often recommended to new grads as a setting in which to get a wide variety of experience in no way means that all nurses working in med-surg settings are "neophytes."

Harveyslake · Oct 23, 2016

If you want nursing to be treated well,...you need to accept that better training should result in better pay. As it stands now,...a nurse is a nurse is a nurse. Just quit that thinking!

elkpark · Oct 23, 2016

If you want nursing to be treated well,...you need to accept that better training should result in better pay. As it stands now,...a nurse is a nurse is a nurse. Just quit that thinking!

None of us dispute that. We're just not buying your fixed notion that the only nurses with "better," "advanced" training are ICU nurses, and that ICU nurses are, by definition, somehow superior to all other nurses.

Harveyslake · Oct 23, 2016

None of us dispute that. We're just not buying your fixed notion that the only nurses with "better," "advanced" training are ICU nurses, and that ICU nurses are, by definition, somehow superior to all other nurses.

Well,...sorry to say,....despite your inferiority complex,....ICU nurses are better. More skills, more experience, more ability. Please let the whining stop and give me evidence to the contrary......

elkpark · Oct 24, 2016

Well,...sorry to say,....despite your inferiority complex,....ICU nurses are better. More skills, more experience, more ability. Please let the whining stop and give me evidence to the contrary......

How does a refusal to agree with you that ICU nurses are clearly superior to all other nurses equal an "inferiority complex"? You are the one who seems to be, to quote the Bard, protesting too much. But, as I said earlier, keep telling yourself whatever you have to to feel good about yourself ...

Harveyslake · Oct 27, 2016

Well,.....The fact remains that,....no matter WHERE in the hospital a patient goes bad,.......They end up in the ICU. There is a reason for that. I was having a conversation with a bunch of Residents, Attendings and Pharmacists yesterday. They didn't believe me when I said the Unit Nurses got the same pay rate as the floor Nurse. They went as far as to seek out my manager to confirm what I was saying. They were totally blown away by this fact and said that should not be the case because they rely on the Unit Nurses so much more than the floor Nurses to take care of complicated patients. If the Docs and Pharmacists think Unit Nurses should be paid more,......why do so many Nurses disagree???

Susie2310 · Oct 27, 2016

Well,.....The fact remains that,....no matter WHERE in the hospital a patient goes bad,.......They end up in the ICU. There is a reason for that. I was having a conversation with a bunch of Residents, Attendings and Pharmacists yesterday. They didn't believe me when I said the Unit Nurses got the same pay rate as the floor Nurse. They went as far as to seek out my manager to confirm what I was saying. They were totally blown away by this fact and said that should not be the case because they rely on the Unit Nurses so much more than the floor Nurses to take care of complicated patients. If the Docs and Pharmacists think Unit Nurses should be paid more,......why do so many Nurses disagree???

As an ICU nurse you may have 1-2 complicated patients, correct? Where do you work that floor nurses only take care of uncomplicated, stable patients? You mentioned that the floor nurses where you work call a rapid response for minor problems. Even if it is true that the floor nurses in your facility are not very experienced/knowledgeable/competent this is not the case in all facilities, so you shouldn't generalize your comments to all floor nurses. You are speaking as though you are an authority, yet from your own words you appear to have limited experience of the care provided by floor nurses in other facilities, and of the medical problems seen in med surg in other facilities.

elkpark · Oct 27, 2016

If the Docs and Pharmacists think Unit Nurses should be paid more,......why do so many Nurses disagree???

Since when do we care what physicians and pharmacists think about nursing pay?

You keep beating that dead horse, though -- you're doing a heck of a job.

Harveyslake · Oct 28, 2016

Well,....lets see. Recently, an RRT was called on the Tele floor. I dropped what I was doing, ran up 3 flights of stairs and was told the patient was in Vtach. Looked at the patient,....seems fine. Looked at the monitor and quickly checked the Tele box leads. One of the wires was frayed and causing artifact. Patient was fine. The patient was already packed up and ready to go to the Unit. In 30 seconds, I spared the patient and their insurance company a boat load of grief. A couple months ago, a code was called on the med/Surg floor. I dropped what I was doing and ran up 4 flights of stairs. The nurses and Residents where all milling about waiting for ME to arrive. The patient had gone unresponsive and was de sating. The Resident was barking orders for bipap, STAT. STAT labs, STAT CT of the head. The patient was a fresh post op facelift and otherwise healthy. I asked what meds she had been given recently. The nurse said 2 mg of dilaudid about an hour earlier. In the mayhem, I asked to be able to give Narcan. Residents ignored me. I asked the floor nurse to get some. I drew it up and again asked to be able to give Narcan. The Residents balked. I insisted and they reluctantly agreed. I gave a dose and 30 seconds later, ...problem solved. How much money do you think the equally paid ICU nurse just saved the patient, hospital and insurance company??? Experience, beyond even the 2nd year Resident's should count for something,...in a monetary way.

CCRN_CSC_0710 · Oct 29, 2016

Well,....lets see. Recently, an RRT was called on the Tele floor. I dropped what I was doing, ran up 3 flights of stairs and was told the patient was in Vtach. Looked at the patient,....seems fine. Looked at the monitor and quickly checked the Tele box leads. One of the wires was frayed and causing artifact. Patient was fine. The patient was already packed up and ready to go to the Unit. In 30 seconds, I spared the patient and their insurance company a boat load of grief. A couple months ago, a code was called on the med/Surg floor. I dropped what I was doing and ran up 4 flights of stairs. The nurses and Residents where all milling about waiting for ME to arrive. The patient had gone unresponsive and was de sating. The Resident was barking orders for bipap, STAT. STAT labs, STAT CT of the head. The patient was a fresh post op facelift and otherwise healthy. I asked what meds she had been given recently. The nurse said 2 mg of dilaudid about an hour earlier. In the mayhem, I asked to be able to give Narcan. Residents ignored me. I asked the floor nurse to get some. I drew it up and again asked to be able to give Narcan. The Residents balked. I insisted and they reluctantly agreed. I gave a dose and 30 seconds later, ...problem solved. How much money do you think the equally paid ICU nurse just saved the patient, hospital and insurance company??? Experience, beyond even the 2nd year Resident's should count for something,...in a monetary way.

You're a great nurse. No one is saying otherwise. The nurses and residents were in situations that made them uncomfortable and they don't have the training you do. Again, no one is saying otherwise. When I floated to med/surg I got my butt kicked. Ran around like a chicken with my head chopped off for all 6 patients. If I didn't have seasoned, amazingly skilled med/surg nurses working beside me it would have been even more stressful. Those nurses are GOOD. Managing to shower all 6 patients, get all their baths done, all their meds passed, some off to and back from cath lab often with sheaths, assessing a patient might become fluid overloaded and calling for an extra lasix dose (and definitely preventing an ICU transfer) without batting an eye...yeah, those nurses deserve the same pay as me.

LL2788, BSN, RN · Dec 20, 2016

I was a MS RN for 3 years prior to transferring to ICU. I took a 9$/HR pay increase. They are both stressful in their own way. But I did a 3 month training program before ICU, it was like a short nursing school all over again. The ICU has the sickest patients in the hospital and your decisions are immediate life and death. In MS the mental stimulation and decisions are not as critical, the level of acuity is not nearly the same and it's mostly discharges and admissions. HOWEVER you can get a patient who needs to be Intermediate care as a MS nurse and you need to be able to pick up early signs of deterioration before they become ICU status. When they begin to detoriate you play detective and care for them the best you can and get the patient to the proper unit and this can take up your time and be a challenging day on a MS floor. MS is about time management, basic nursing skills, prioritization, and customer service skills. ICU is all of those, plus taking the 3 month training, more autonomy, immediate life/death decisions, care of the patient and family after death, drips, vents, more lines, more complex illnesses, etc. the point is icu requires more skills and more liability. I never had a patient code in MS, it's called critical care for a reason. I think all critical care floors should be paid more ( and most hospitals and agencies usually do pay more ) not saying MS is easy but it's not as critical as icu. This includes cath lab, picu, nicu, and ER. Think about this: An ICU nurse can float to MS with no additional training but a MS nurse couldn't float to ICU without months of training.

William2 · Jan 3, 2017

"An ICU nurse can float to MS with no additional training but a MS nurse couldn't float to ICU without months of training."

^This