Okay so I don't want to come off as rude or biased but I am pretty confused as to how my facility can pay medsurg nurses an extra $3/hr over what they pay me!
I know they work very hard but I work in a large level one ICU and I make critical life altering decisions on a daily bases. I have far more autonomy and with that comes more risk to my license. Don't get me wrong I LOVE my job and LOVE my facility but how can a nurse get paid more to pass meds on the floor than I do in the ICU. And before anyone makes any comments about the "just passing meds" remark, I have worked a few shifts on the floor and that is just about all I did was pass meds!
Is it like this on y'all's unit or is this specific to my facility?
I think they should. We respond to codes, Rapid Response Team's, Stroke Alerts, Trauma Alerts, etc in my hospital. Also there is no busier unit in the hospital than our ICU. We are required to do more education than everybody and we are required to hold more certifications than everybody and can take any type of patient. For these reasons I think we should.
Well, this argument is as old as time. The correct answer is yes, critical care nurses should be paid more than med/surg nurses. The only nurses that disagree have never worked critical care. If a code is called, who shows up, a floor nurse? If a patient is crashing do they get transfered to a med/surg floor? ICU nurses have a skill set far beyond anything a med/surg nurse possesses. Part of the problem in nursing is that nurses often accept the a nurse is a nurse banter from administration. The fact is, in just about every human endeavor, except nursing, the better your skills and training, the better your earning potential. When I get floated to the floor, the patients are well cared for. If a floor nurse gets floated to an ICU and has to take care of a real ICU patient, well,...the outcome would be less than desirable. Not knocking floor nurses in the least. They work hard too, however, let's be realistic. A neuro surgeon makes a lot more than a family practice physician because he has a different, more advanced skill set. The family practice Doc probably sees many more patients in a day and does a lot more paperwork than the neuro surgeon but the one with more advanced skills and training takes home the bigger pay check. Why should nursing be different??? Let the flaming begin! ������
The neurosurgeon is a highly educated and trained specialist who provides very specialized care, but the family practice physician treats a broad population with diverse medical conditions. They both fulfill different roles on the spectrum of care, just like ICU nurses and med-surg nurses. Neither is more valuable than the other; both are necessary and both have different skill sets. The neurosurgeon commands a higher salary than the family practice physician because of the longer time spent in training, and the relatively fewer neurosurgeons versus family practice physicians.
Good for you if you can comfortably manage a med-surg assignment. ICU nurses on this forum sometimes attest to struggling with med-surg assignments, but overall I am sure neither specialty can just step into the other's specialty and perform really well. Different specialties require different certifications. Presumably you find the ICU to be preferable to working in med-surg. With any clinical area there is specialized training, so it doesn't seem reasonable that any one area should be compensated more than another for this reason.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Well, this argument is as old as time. The correct answer is yes, critical care nurses should be paid more than med/surg nurses. The only nurses that disagree have never worked critical care. If a code is called, who shows up, a floor nurse? If a patient is crashing do they get transfered to a med/surg floor? ICU nurses have a skill set far beyond anything a med/surg nurse possesses. Part of the problem in nursing is that nurses often accept the a nurse is a nurse banter from administration. The fact is, in just about every human endeavor, except nursing, the better your skills and training, the better your earning potential. When I get floated to the floor, the patients are well cared for. If a floor nurse gets floated to an ICU and has to take care of a real ICU patient, well,...the outcome would be less than desirable. Not knocking floor nurses in the least. They work hard too, however, let's be realistic. A neuro surgeon makes a lot more than a family practice physician because he has a different, more advanced skill set. The family practice Doc probably sees many more patients in a day and does a lot more paperwork than the neuro surgeon but the one with more advanced skills and training takes home the bigger pay check. Why should nursing be different??? Let the flaming begin! ������
I've worked in ICU since 1982. And I've never seen ICU nurses paid more. Nor should they be.
Well, let's see, on a typical day in my ICU, I might be expected to:
titrate pressors like Levophed, Neo, Vasopressin, Cardene, Nipride, Esmolol. Titrate sedation and the like such as Propofol, Nimbex, Vecuronium, Ketamine, Pentobarbitol. Manage ventriculostomies, Camino bolts, ventilators, train of four, BIS monitors, hypothermia units and CRRT dialysis machines, A-lines, Swan Ganz catheters and shoot cardiac outputs. Closely monitor 2 patients on any and all combinations of above, chart, take patients on road trips, deal with families and physicians and STAT orders. Routinely use the rapid infuser and blood warmers, hang more piggybacks than can be imagined, draw all labs, code one patient while the other is circling the drain. 2 patients, actively trying to die is not unusual. If you don't know what all of the above are or what to do with it, you have no right to say Critical Care Nurses should not be paid, a lot more, than floor nurses.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Well, let's see, on a typical day in my ICU, I might be expected to:
titrate pressors like Levophed, Neo, Vasopressin, Cardene, Nipride, Esmolol. Titrate sedation and the like such as Propofol, Nimbex, Vecuronium, Ketamine, Pentobarbitol. Manage ventriculostomies, Camino bolts, ventilators, train of four, BIS monitors, hypothermia units and CRRT dialysis machines, A-lines, Swan Ganz catheters and shoot cardiac outputs. Closely monitor 2 patients on any and all combinations of above, chart, take patients on road trips, deal with families and physicians and STAT orders. Routinely use the rapid infuser and blood warmers, hang more piggybacks than can be imagined, draw all labs, code one patient while the other is circling the drain. 2 patients, actively trying to die is not unusual. If you don't know what all of the above are or what to do with it, you have no right to say Critical Care Nurses should not be paid, a lot more, than floor nurses.
Your response seems to be aimed at mine. In my decades in the ICU, I did all of that except the bolts and ventriculostomies. I took care of patients with right ventricular assist devices, left ventricular assist devices, biventricular assists, ECMO, balloon pumps, open chests and undergoing open chest explorations at the bedside. I not only did hemodialysis on my patients, I taught hemodialysis. I also taught balloon pump, VADs, management of patients on ventricular assist devices, drip titration and all combinations of my list and your list (excluding the stuff pertaining to Neuro ICU.). I was paid 50 cents an hour for precepting in one of my jobs, but not all of them. I think I have a right to say that critical care nurses are not necessarily worth more than floor nurses.
These days, no one wants to work in ICU to take care of ICU patients; they all want to get just enough ICU experience to be accepted into the graduate school of their choice. ICUs aren't difficult to staff. If Med/Surg units are difficult to staff, the pay may be higher. That's supply and demand. I'm sure not going to say they deserve less in Med/Surg. I've floated there, and those nurses work HARD. Harder than we do in the ICU, I think.
Well, let's see, on a typical day in my ICU, I might be expected to:
titrate pressors like Levophed, Neo, Vasopressin, Cardene, Nipride, Esmolol. Titrate sedation and the like such as Propofol, Nimbex, Vecuronium, Ketamine, Pentobarbitol. Manage ventriculostomies, Camino bolts, ventilators, train of four, BIS monitors, hypothermia units and CRRT dialysis machines, A-lines, Swan Ganz catheters and shoot cardiac outputs. Closely monitor 2 patients on any and all combinations of above, chart, take patients on road trips, deal with families and physicians and STAT orders. Routinely use the rapid infuser and blood warmers, hang more piggybacks than can be imagined, draw all labs, code one patient while the other is circling the drain. 2 patients, actively trying to die is not unusual. If you don't know what all of the above are or what to do with it, you have no right to say Critical Care Nurses should not be paid, a lot more, than floor nurses.
No-one would argue that your two patients are not demanding in terms of the amount of nursing care needed. But nurses on med-surg can have 6, 7, 8, 9, 10, or more patients. How are med-surg nurses' efforts less than yours? Yes, you have some specialized training, and so do nurses in other specialized areas. The reason you only have two patients is because of the amount/intensity of nursing care your two patients need. Med-surg nurses' time is spread across their larger number of patients. You haven't made a good case for being more deserving of being paid more than med-surg nurses.
I'm always amused when the same arguments I heard in the 80s and 90s pop up here.
I was a "lowly" MedSurg floor nurse in the 90s. Critical care staff routinely looked down their noses at us and doubted that we deserved to be called RNs (Real Nurses).
Until such time as they had to float to MedSurg. We always made sure they had the lightest, most stable team (A&O LOLs, pretty much independent, maybe a piggyback or 2, no admits, no discharges), which meant we had all the rest-admits, discharges, tests, procedures, fresh post-ops, peritoneal dialysis, anywhere from 6-8 patients each.
Every time, the ICU nurses ran around with that deer in the headlights expression, practically vomited at the thought of taking care of 4 people in 8 hours, and at the end of the shift, said "How do you do this every day?" before running screaming back to their beloved ICU and 1-2 patient load.
Don't get me wrong. We ALL work hard. Do unit nurses work harder? Depends on who you ask.
Well, let's see, on a typical day in my ICU, I might be expected to:
titrate pressors like Levophed, Neo, Vasopressin, Cardene, Nipride, Esmolol. Titrate sedation and the like such as Propofol, Nimbex, Vecuronium, Ketamine, Pentobarbitol. Manage ventriculostomies, Camino bolts, ventilators, train of four, BIS monitors, hypothermia units and CRRT dialysis machines, A-lines, Swan Ganz catheters and shoot cardiac outputs. Closely monitor 2 patients on any and all combinations of above, chart, take patients on road trips, deal with families and physicians and STAT orders. Routinely use the rapid infuser and blood warmers, hang more piggybacks than can be imagined, draw all labs, code one patient while the other is circling the drain. 2 patients, actively trying to die is not unusual. If you don't know what all of the above are or what to do with it, you have no right to say Critical Care Nurses should not be paid, a lot more, than floor nurses.
I don't know about you, but I do all of those things because it's what I want to do as do most ICU nurses. In general, nursing pay is a function of supply and demand, how many med surg nurses would like the opportunity to work ICU, vs how many ICU nurses would rather take 6 or 8 patients that aren't really that much less sick than an ICU patient? Based on that, it's actually med-surg nurses that should get paid more, us ICU nurses should count ourselves lucky we get paid just as much as they do.
So,...by that logic,...a short order cook should be paid more than a gourmet chef because they prepare many more meals in the same amount of time? A simple cell phone should cost as much as a smart phone because they both make phone calls, never mind that the smart phone can do so much more? Typical flawed nursing logic.........
I don't necessarily think a floor nurse should be paid less than an ICU nurse or vice versa. A new grad in the ICU should not be paid more than a seasoned nurse on the floor. Pay rate should be commensurate to length of clinical experience, certifications/licenses (as per facility), RN position on the unit (charge nurse, etc.) and differential pay on specialized units.
I've worked both the floor and the ICU. Considering that hospitals charge an arm and a leg for ICU care, and the ICU nurses are with the patient 24/7, I do think that ICU nurses should be paid a least a little more. I base this opinion on hospital revenue alone. Higher revenue = higher salary. The problem is that administrators and corporations bank top dollar $$$$(millions) while nurses get defensive and argue over an additional $2 dollars and hour.
I'm one of those California RNs that you hear about who makes 100k/year, and I still don't think any nurses are paid what they're worth. People come to hospitals for NURSING care. If that that weren't so, physicians would make rounds at home like the old days. Hospitals can't function without nurses. Period. All nurses deserve more pay. This is why I support nursing unions, regardless of my political beliefs.
I've worked at both unionized and non-unionized hospitals, and there's always a noticeable difference in working conditions and pay (in California at least)...
tnk11
17 Posts
I think they should. We respond to codes, Rapid Response Team's, Stroke Alerts, Trauma Alerts, etc in my hospital. Also there is no busier unit in the hospital than our ICU. We are required to do more education than everybody and we are required to hold more certifications than everybody and can take any type of patient. For these reasons I think we should.