Sicu

I imagine different units treat different things, but in the SICU where I now work we see all sorts of surgical situations (obvious!) and we also get open hearts. We are not limited to surgical though, as we also get a medical case here and there (there is one other ICU in the hospital...Medical ICU).

So basically you are assessing that the surgical site is dry and intact as well as making sure there is no retroperitoneal bleeding? Do you have a lot of titrating of drips?

I imagine different units treat different things, but in the SICU where I now work we see all sorts of surgical situations (obvious!) and we also get open hearts. We are not limited to surgical though, as we also get a medical case here and there (there is one other ICU in the hospital...Medical ICU).

"So basically you are assessing that the surgical site is dry and intact as well as making sure there is no retroperitoneal bleeding? Do you have a lot of titrating of drips?"

No, SICU is not as neat and clean as that. In our SI we have everything from kidney and liver transplants to appy's that go bad and get sick. We do CVVH and ECMO. My record number of pumps for a single surgical patient is 21!!! That's a lot of drips to titrate. That patient was on CVVH and every pressor know to man. Also was Swanned and was on her way to ECMO, but never made it that far. We do CCO monitoring with (unfortunately) Abbott Swan-Ganz catheters. I don't know if you already made your decision, but if you haven't, I would encourage you to ask to shadow a nurse for a day. It may help you decide.

Faith

Thanks for the info. I was left a message by the nurse recruiter that she wants to make me an offer, but is out of the office today. So, Monday I will return her call and get the offer to work in the SICU. I think I am going to do it. It should be a diverse learning experience for me :) and a lot closer to my home.

"So basically you are assessing that the surgical site is dry and intact as well as making sure there is no retroperitoneal bleeding? Do you have a lot of titrating of drips?"

No, SICU is not as neat and clean as that. In our SI we have everything from kidney and liver transplants to appy's that go bad and get sick. We do CVVH and ECMO. My record number of pumps for a single surgical patient is 21!!! That's a lot of drips to titrate. That patient was on CVVH and every pressor know to man. Also was Swanned and was on her way to ECMO, but never made it that far. We do CCO monitoring with (unfortunately) Abbott Swan-Ganz catheters. I don't know if you already made your decision, but if you haven't, I would encourage you to ask to shadow a nurse for a day. It may help you decide.

Faith

Well, Faithmd, you must work with me, because everything you said is correct. I think we get a very wide spectrum of pts, and therefore a lot of diversity as far as what types of pts we care for. The type of pts you have in your unit depends on what ype of hospital center you're at: alarge University center will have all types of cases, and smaller community hospitals won't have so many (or any) transplants, CRRT, ECMO (never!!!) or things like that. I love our SICU cause it's always varied!

Our surgical did a lot of trauma, surgical and the medical leftovers. Just remember that no unit is any harder and any other (eventhough some would like to think so). Fluid fluid fluid in SI, dry dry dry in CT.

So basically you are assessing that the surgical site is dry and intact as well as making sure there is no retroperitoneal bleeding? Do you have a lot of titrating of drips?

Unstable SICU pts almost inevitably end up on pressors. Lots of drips. You get heads with ventrics, open wounded bellies with wound vacs and associated risks (sepsis, sepsis, sepsis, hemorrhage, sepsis). We get IABPs, VADs, CVVH- you name it. SICU is much faster paced and more unpredictable than MICU, and much more variety than CTICU. You will learn alot moving from such a specialized environment to SICU. The CVRR nurses at our hospital are super cocky but all they do is fresh CABGs whereas in the SICU that is just one in a repertoire of MANY MANY different pts you will learn. I have taken care of heart transplants, ventrics, open flaps s/p CABG, open bellies, traumas, I mean you name it. I wouldn't trade this experience for the world. One of the fellows in my program who's father is a CT surgery PA came out of nursing school dedicated to the idea of CTICU. Her father convinced her to try SICU (against her will at the time) and now she raves about where she is too! Now if your local hospital is a small suburban one where all the interesting cases get flown away from the ER to a larger teaching hospital then you might get bored.

I agree with variety in the SICU. We see it ALL! I mean even OB patients that took a plunge on the table (docs nicked something... lose alot blood ..becomes symptomatically unstable and crashes ) they send them to us for care. As mentioned earlier, we get tons of overflow....lots of Trauma, Neuro with ICP caths , camino bolts, and lumbar drains. Our patients are usually OMF, ENT, vascular, thoracic,transplant ( livers and pancreas....can be very , very sick patients...likely to be on so many drips and requires alot of care, usually are 1:1 ) We do alot of CVVHD and do a few bedside OR procedures when patients too unstable to go to OR. They bring the OR set up to us...for belly wash outs with vac dressing placements. I just started 8 months ago and am learning sooooo much. IT's definetly NOT routine by any stretch of the imagination. Glad I chose SICU.

AWWWWWWW....SICU, LOVED IT...DRAINS,DRIPS AND DRESSINGS....AND OF COURSE DYNAMICS:)

I currently work in the CTICU 50 miles one-way from my house. I have interviewed for the SICU at a hospital much closer to my home. Can someone give me insight into the SICU and what it has to offer? I just don't want to leave my job for a job I will hate (for the sake of shortening my commute).

Tina