Should ICU get more pay than floor nursing?!?

ambiance · Mar 31, 2014

I have to agree with iluvgusgus about the fact that nursing is a privilege. It takes a special person to be a nurse whether it is on the floor or in an ICU. Although I know that it is not the case for everyone, but the priority reason for being a nurse should not be money. Truly, as a nurse you are able to help people while gaining experiences that you can use both in the work setting and in your personal life. Every type of nurse has their own difficulties or set-backs. I do not think that an ICU nurse should look down on a floor nurse or vice versa. A nurse is a nurse. There is something we can all learn from each other. The fact that we are nurses means that we have the potential to work in any setting and, correct me if I'm wrong, hospitals know that. Why do you think an ICU nurse can float to the floor and a floor nurse can float to the ICU? Simply because we are all nurses.

Here.I.Stand, BSN, RN · Mar 31, 2014

I have to agree with iluvgusgus about the fact that nursing is a privilege. It takes a special person to be a nurse whether it is on the floor or in an ICU. Although I know that it is not the case for everyone, but the priority reason for being a nurse should not be money. Truly, as a nurse you are able to help people while gaining experiences that you can use both in the work setting and in your personal life. Every type of nurse has their own difficulties or set-backs. I do not think that an ICU nurse should look down on a floor nurse or vice versa. A nurse is a nurse. There is something we can all learn from each other. The fact that we are nurses means that we have the potential to work in any setting and, correct me if I'm wrong, hospitals know that. Why do you think an ICU nurse can float to the floor and a floor nurse can float to the ICU? Simply because we are all nurses.

I agree with much of this and especially love what you say that we can all learn something from each other.

I beg to differ on the floating comment, though. A floor RN probably has the potential to learn what s/he needs to work in the ICU and may have the personality for the ICU, but s/he couldn't just float to the ICU and know how to care for the pt. Unless they happened to have an assignment w/ floor/stepdown "boarders" or else relatively stable and just needing more frequent neuro checks or whatever. I've never worked anywhere that floats floor RNs to the ICU. Likewise, the ICU RNs don't float to the floor b/c we would be completely overwhelmed w/ 7 pts and all that goes w/ it.

Here.I.Stand, BSN, RN · Mar 31, 2014

Often, pay ranges (one specialty/location getting paid more than another) has nothing to do with how "hard" a particular specialty is vs. another, and is all about supply and demand. If the hospital has qualified applicants lined up wanting to work in the ICU and they can't staff the med surg floors, they are eventually going to increase the wages they are offering for the med surg positions to make those positions more appealing.

Very good point!

francoml, ASN, RN · Mar 31, 2014

Okay so I truly apologize as I have offended many people and that was not my intent. After reading my post I see how that can be taken as rude and like I said I am sorry. At my hospital the 3/hr increase in pay is not based on experience but only on the fact that they need med surg nurses. I just think we should at least get paid the same. They always have incentive ($10/hr extra) or double incentive ($20/hr extra)!!!! I just wish I had the same opportunities to have those wage increases on my floor. Maybe I am a little bitter that I took a pay cut to work ICU. When I made the comment about just passing meds I was just coming off a shift on medsurg when that was all that I did. I know all the med surge nurses work very hard and I did not mean to sound like they were not as competent as ICU nurses. For real though I have med surg friends who make $22 base plus $3incentive for medsurg plus at least once a week get paid and extra $10/hr for incentive and at least once a pay period get paid the $22+$3+$20(double incentive) to equal $45 an hour not including any possible overtime that they are always offered! We graduated and started nursing at the same time and I have had over 150 hours of critical care class only to make $22/hr ! If you do the math that is a difference of $5920/month vs $3520/month or 42240/yr vs. 71040/yr Sorry if I am a little bitter about them getting paid more

Cook26 · Mar 31, 2014

Sounds like if they are needing help that bad on the floor then you would probably have the option to become a floor nurse. Lots of times in life a decision is to be made on whether you take a job you enjoy more or the job that pays more.

If you would rather be paid more, transfer to med/surg. If you enjoy what you're doing, don't worry about what they make. I know people who make much more than I do, but I enjoy what I do in the ICU. I get to constantly learn and that's what I really enjoy.

wooh, BSN, RN · Apr 1, 2014

I just wish I had the same opportunities to have those wage increases on my floor. ... When I made the comment about just passing meds I was just coming off a shift on medsurg when that was all that I did. ... I have had over 150 hours of critical care class only to make $22/hr !

First, want to make med/surg pay at your hospital? Transfer.

Only passed meds? Probably because they gave the inexperienced float nurse a cushy assignment.

And if you were paid while you were sitting in all those classes? What are you bitter about. You got paid for training that will make you marketable, and got to sit on your ass in class making $22/hr while your fellow nurses were busting their butts on the floor to earn only $3/hr more.

Quit whining. You could have it worse. You could be one of the many nurses who graduated when you did and are unemployed. Or could be the patient that you're making all those "life altering" decisions on. (Silly me, on the floor, my decisions are all just what I'm going to eat for lunch or when I'm going to take a pee break.)

mmc51264, BSN, MSN, RN · Apr 1, 2014

I am considered med/surg on an ortho floor. I may have 5 pts that are on PCAs, epidurals, I have to monitor pain Q2H, help ambulate, assess sedation scores, watch out for PE/DVT, pneumonia, ileus, n/v, monitor for pressure sores, stump site bandage changes, blood sugars, The assessment skills on a med/surg floor are no less important than the ones you have to make, we just have 5. Fell lucky, like another said, you are getting great education and not having to ruin your back or run yourself ragged for 12 hours.

PS I would not trade my ortho floor for anything

SHGR, MSN, RN, CNS · Apr 1, 2014

At my hospital the 3/hr increase in pay is not based on experience but only on the fact that they need med surg nurses. I just think we should at least get paid the same. They always have incentive ($10/hr extra) or double incentive ($20/hr extra)!!!! I just wish I had the same opportunities to have those wage increases on my floor. Maybe I am a little bitter that I took a pay cut to work ICU. When I made the comment about just passing meds I was just coming off a shift on medsurg when that was all that I did. I know all the med surge nurses work very hard and I did not mean to sound like they were not as competent as ICU nurses. For real though I have med surg friends who make $22 base plus $3incentive for medsurg plus at least once a week get paid and extra $10/hr for incentive and at least once a pay period get paid the $22+$3+$20(double incentive) to equal $45 an hour not including any possible overtime that they are always offered! We graduated and started nursing at the same time and I have had over 150 hours of critical care class only to make $22/hr !

Interesting. The tables are turned. I guess all those new grads clamoring for ICU in order to get into CRNA school, are willing to work for less pay, and your facility is responding to the supply and demand.

Med-surg nursing is indeed a specialty and has its own certification. It's nice to see that it is seen as valued in your workplace. I've never seen it as truly valued and respected anywhere.

esrunnuf · Apr 1, 2014

I actually have to disagree with you Here.I.Stand. It really does depend on the hospital. Some will float you. Some will not. Also to be honest with you, if you've worked in some of the hospitals that I have, upper management doesn't care whether or not an ICU nurse is going to be "overwhelmed" from working the floor. As ambiance put it "a nurse is a nurse." As you long as you have "RN" somewhere after your name, the hospital can make you work anywhere they please. Mainly because of two reasons. 1) There are no laws against it and 2) They sign your paycheck

esrunnuf · Apr 1, 2014

Okay so I truly apologize as I have offended many people and that was not my intent. After reading my post I see how that can be taken as rude and like I said I am sorry. At my hospital the 3/hr increase in pay is not based on experience but only on the fact that they need med surg nurses. I just think we should at least get paid the same. They always have incentive ($10/hr extra) or double incentive ($20/hr extra)!!!! I just wish I had the same opportunities to have those wage increases on my floor. Maybe I am a little bitter that I took a pay cut to work ICU. When I made the comment about just passing meds I was just coming off a shift on medsurg when that was all that I did. I know all the med surge nurses work very hard and I did not mean to sound like they were not as competent as ICU nurses. For real though I have med surg friends who make $22 base plus $3incentive for medsurg plus at least once a week get paid and extra $10/hr for incentive and at least once a pay period get paid the $22+$3+$20(double incentive) to equal $45 an hour not including any possible overtime that they are always offered! We graduated and started nursing at the same time and I have had over 150 hours of critical care class only to make $22/hr ! If you do the math that is a difference of $5920/month vs $3520/month or 42240/yr vs. 71040/yr Sorry if I am a little bitter about them getting paid more

Glad you clarified things. Paints a better picture.

Here.I.Stand, BSN, RN · Apr 1, 2014

I actually have to disagree with you Here.I.Stand. It really does depend on the hospital. Some will float you. Some will not. Also to be honest with you, if you've worked in some of the hospitals that I have, upper management doesn't care whether or not an ICU nurse is going to be "overwhelmed" from working the floor. As ambiance put it "a nurse is a nurse." As you long as you have "RN" somewhere after your name, the hospital can make you work anywhere they please. Mainly because of two reasons. 1) There are no laws against it and 2) They sign your paycheck

You're right! :yes: I could have put it differently; the hospitals I have worked at *chose* not to float ICU nurses to the floors...most of them, anyway. One did float us to the tele floor and to the BMT floor, but not the other floors. Where I am now, they float the ICU RNs to the stepdown units, other ICUs except NICU, and Burn. Lots of times the burn unit gives the ICU RN first dibbs on their BICU pts when we float there.

Part of it is the pt ratio issue; I want to say it's actually in our union contract that if they did float us, the ICU nurse can request a modified assignment. (I didn't think of that yesterday when I posted this.) Which would put the floor charge RN in a difficult spot, not to mention the other RNs who would be absorbing half of that 7-8 pt assignment. And then part of it is that the floor nurses are not able to be floated to the ICUs w/ no orientation.

But they never, ever float the floor nurses to the ICUs. If the SICU needs another RN, either we get one from the MICU or a float pool RN who's been oriented in the ICUs. Again that's what my hospitals have done.

**RosesrReder, BSN, MSN, RN** · Apr 1, 2014

Maybe you can help relieve the stress from some of those asked to pick up overtime each week, and pick some up yourself? Also, will give you a perspective of what other than passing meds they do.

Good luck