Physicians are paid differently according to their speciality. We know that specialities such as cardiology and neurology can make considerably more than others.
So why do we pay all nurses the same?
Should ICU nurses titrating vasoactive drips, performing conscious sedation for GI procedures, stabilizing traumas, running IABPs, ECMOs, and recovering fresh hearts make more for the amount of autonomy and risk they face?
ICU nurse here. I agree that nursing isn't all about "working hard," and yes we are highly trained.
That said, I also agree with the PPs that other specialties do have their own areas. Labor and delivery? I'd be clueless. Their skill sets are a huge part of why most women/babies today survive childbirth. Public health? Their skill sets are vital to keeping the public well, and they are highly trained to practice nursing at a systems level. LTC/Geriatrics? The elderly are a vulnerable and an extremely important population, and their nurses are top-notch at assessing patients without the help of monitoring. Med-surg? They are so much better at patient teaching than I am, especially when it comes to discharge planning and readmit prevention than I am. Psych? Their skill sets keep their patients safe from themselves, and help prepare them for a healthy and productive return to the community
There is no way in hades I could float to one of those units and be competent. Why not -- I'm a highly trained ICU RN. It's because RNs in other specialties have different​ skill sets. Not less, just different.
I'm not saying it's easier to have two ICU patients, I'm saying it's roughly equal to having three to four times more med surg patients. In other words, your trade-off for having more complex patients is to have fewer of them- as opposed to being paid more to take care of them. Hope that clarifies things.
I've never met an ICU nurse who likes to float to med/surg despite the fact that they don't get paid more for working in the ICU.
It would be without a doubt unsafe to care for 5-6 ICU patients. I see your point though. I've worked medical surgical before, I do have surgical nursing experience and I floating to the floor is not something I enjoy. I'm used to having two patients I know absolutely everything about, not 7 I only need to the essentials about. My brain can adapt but it tends to want to continuously want data data data data .... data! Because that's what ICU is data data data continuously about two people as opposed summarized data about 7.
ICU nurse here. I agree that nursing isn't all about "working hard," and yes we are highly trained.
That said, I also agree with the PPs that other specialties do have their own areas. Labor and delivery? I'd be clueless. Their skill sets are a huge part of why most women/babies today survive childbirth. Public health? Their skill sets are vital to keeping the public well, and they are highly trained to practice nursing at a systems level. LTC/Geriatrics? The elderly are a vulnerable and an extremely important population, and their nurses are top-notch at assessing patients without the help of monitoring. Med-surg? They are so much better at patient teaching than I am, especially when it comes to discharge planning and readmit prevention than I am. Psych? Their skill sets keep their patients safe from themselves, and help prepare them for a healthy and productive return to the community
There is no way in hades I could float to one of those units and be competent. Why not -- I'm a highly trained ICU RN. It's because RNs in other specialties have different​ skill sets. Not less, just different.
I can see your point as well. I keep wanting to make the argument that as an ICU nurse I carry more liability than a floor nurse.
I was a floor nurse, most my liability was in the realm of discharge and teaching. Covering my a** that my teaching is adequate enough to prevent a readmission. That core measures were followed by the junior doctors. Correct discharge medications. Follow up appointments. Patient demonstrating competency in discharge care.
Could you please cite a source for this increased liability you keep referencing? I feel that if there were a significant increase in the number of nurses litigated against in ICU settings, the insurance for these areas would be more expensive. (As it is for the specialist physicians you reference in your first post) However I have only seen increased insurance rates for AP nurses and obstetrics.
Could you please cite a source for this increased liability you keep referencing? I feel that if there were a significant increase in the number of nurses litigated against in ICU settings, the insurance for these areas would be more expensive. (As it is for the specialist physicians you reference in your first post) However I have only seen increased insurance rates for AP nurses and obstetrics.
The assumption seems to be that with more critical patients, there's more things to manage and more things that can go wrong. Still, this is the nature of the job, and a nurse hired into the post will have had or will be getting the training to practice safely. I don't see that it demands extra compensation any more than a floor nurse having BLS certification.
Here.I.Stand, BSN, RN
5,047 Posts
ICU nurse here. I agree that nursing isn't all about "working hard," and yes we are highly trained.
That said, I also agree with the PPs that other specialties do have their own areas. Labor and delivery? I'd be clueless. Their skill sets are a huge part of why most women/babies today survive childbirth. Public health? Their skill sets are vital to keeping the public well, and they are highly trained to practice nursing at a systems level. LTC/Geriatrics? The elderly are a vulnerable and an extremely important population, and their nurses are top-notch at assessing patients without the help of monitoring. Med-surg? They are so much better at patient teaching than I am, especially when it comes to discharge planning and readmit prevention than I am. Psych? Their skill sets keep their patients safe from themselves, and help prepare them for a healthy and productive return to the community
There is no way in hades I could float to one of those units and be competent. Why not -- I'm a highly trained ICU RN. It's because RNs in other specialties have different​ skill sets. Not less, just different.