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Should ICU get more pay than floor nursing?!?

MICU   (53,128 Views 152 Comments)
by francoml francoml, ASN, RN (Member) Member

francoml is a ASN, RN and specializes in Critical Care at Level 1 trauma center.

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Should ICU nurses get more pay than floor nurses?

The answer is no.Rationale: The ratio in the ICU approximates 1:3 and the patients have more complex issues, and nursing is usually complex too, while floor nurses work with an approximate ratio of 1:8 patients with less complex issues, and tasks; the the only difference should be seen in the shift differential,experience,and educational incentives.

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Pepper The Cat has 33 years experience as a BSN, RN and specializes in Gerontology.

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I have no choice than to do my own IVs at night . We have no IV team nurses at night . We are also very independent because we have less resources . The day shift is a whole different story . They don't even try to start an IV line . Lol

I work days. I do my own IVs. I also do the complicated dregs like VACs because nights don't know how to, and don't even try to. I also get 5 pts washed, dressed, out of bed, give them their meds, help them with their meals, and so on and so on.

My pts may not be as sick as the ICU pt, but I work just as hard.

Why do nurses have to keep playing these childish games? ICU vs floor.Days vs nights. Enough. We should all be working as a team.

I am happy as a floor nurse and I am happy that there are other nurses who like ICU.

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hope3456 is a ASN, RN and specializes in LTC, Psych, M/S.

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And there's even some LTC nurses who make more than all y'all.

Them's the facts!

In addition to LTC, some of those "low skilled" nurses in state facilities, prisons, home health, hospice, ect are making remarkably good wages/Benny's while much encountering less mental/physical stress than acute care nurses

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I understand. I am a Medsurg nurse . I can have between 5-8 patients . I know is hard . I'm actually starting stepdown soon . I don't know how ICU nurses work , but I'll let you know when I get there lol . I always wanted to do ICU . I had to get my foot in the door and do Medsurg for a little while . I'm just saying the truth and what I've seen . I'm glad you start your own IVs !!!! Good for you !!!

I guess not all are the same. but then again , I'm a fairly new nurse so who knows ! Lol

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cdsga has 37 years experience and specializes in ICU, PACU, OR.

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Exactly-there is no standardized formula. Each institution each shift and each nursing skill set is different. So I guess the answer is to go where the money is if that is what is happening. No matter what unit you are on you never get paid what you are worth.

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ICUPrincessNurse has 5 years experience and specializes in Surgery, Trauma, Medicine, Neuro ICU.

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My hospital gives a "shift diff" to ED and ICU. Mostly because we had the worst satisfaction scores in the whole hospital!!

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cinlou has 37 years experience as a BSN, MSN, RN and specializes in Emergency and Critical Care.

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ESme12, thank you I was thinking the same. I was a critical care trauma ER etc. nurse for 35 years. When I first started working in the ICU we were expected to be able to float to the floors and care for the same number of patients that the floor nurses did. Back then we did get a stipend for our ICU skill set, but we were also expected to be able to float anywhere in the hospital with those skills and function at a higher level. That expectation is not there any longer. Many facilities do not require the ICU nurses to float to the floors and if they do they are assigned a lighter load of patients so they can manage the volume. The floor units try to be nice to those who float and not give them the heavy loads. Not everywhere but most places I have been. Times have changed. I have worked both places, and in a Level I trauma center where vents were on the medical floors. Those nurses work their butts off, while I took care of a couple patients in the ICU. Volume versus quantity and labor intense work. It definitely takes a different set of skills to work either place. You had to reorganize your way of thinking in order to see all your patients. I just had a conversation with my LPN students today about how difficult Med/Surg is. It is very labor intensive. The longer you work in ICU you forget a lot of basic med surg skills that are needed to care for medical patients. They don't get paid nearly enough. If you compare the CCRN to the MS certification I bet many ICU nurses would have a hard time passing the MS and vice versa. Thank God we have those who want to and Love working MS I couldn't do it long term. Another thought about the money is clinical ladders, shift differential, years of experience, certification, degree level. And if your facility pays MS nurses more well I just think they deserve it. Sometimes pay is increased for hard to staff areas as well.

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cdsga has 37 years experience and specializes in ICU, PACU, OR.

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There are now competencies that nurses must complete for cross-training purposes. That takes time, and if med/surg units are short-staffed, you'd be doing the training on your own time. That will usually not happen since people have lives outside of work and need rest.

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cinlou has 37 years experience as a BSN, MSN, RN and specializes in Emergency and Critical Care.

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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

I really don't take this as being offensive, I take it as a nurse who is frustrated with the inequalities. This is everywhere. More often than not nurse want off med surg because it is so labor intensive and the want to gain higher acuity knowledge. This makes it hard to staff med surg and so facilities are forced to offer incentives to work the areas. It used to be "we had to pay our dues" and work at least a year on med surg floors before we could transfer to specialty areas. This is not just paying dues but allowing new grads to learn basic skills and build a strong foundation in which to learn from. Hiring new grads into specialty areas costs a lot in orientation because it takes longer. Males entering nursing tend to be paid more than females for the same job. There are many inequalities within the healthcare field and others. Until nurses unite this will continue. Experience, should make the first big difference then certifications, degrees, shifts etc. When I worked per diem our pay was based on a point system that included all the above. Perhaps that is how the fulltime nurse should be paid as well, and perhaps in some areas they are. So much depends on the need the area of the country and the type of facility. I took a major cut in pay (about 15000/year) to become an instructor, but it is what wanted to do. Is it fair, I do not think so but most educators are paid less, this to teach our future. It is not any easier, less labor intensive but more brain work. Each area has their own stresses. Often we think people wok in certain areas because they are not able to work in the more prestigious areas, yet if we think about it most choose where they go because they Love that type of care. Thank God nurses have choices and their are those who Love to work in every different area What would our patients do without care providers

Edited by Esme12

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