Step Down ICU transfering to Medical-Surgical ICU

[CowboyMedic, DNP, APRN, CRNA]

I was wondering if anyone has made a transition from a Step Down ICU unit to a traditional Med-Surg ICU unit. We receive all of our patients from MSICU, Burn ICU, and CVICU that have been cleared for Step Down. Most of our patients are too sick for a med-surg floor but not sick enough for ICU. We have constant cardiac monitoring, manage patients on vents that have trachs, and we do some drips (mostly heparin, amio, sometimes cardizem, but never pressers, insulin, fentanyl, or diprovan). I do have experience with drips as a paramedic on long distance transfers. Just wanted to get some advice on what to expect from someone that has made that jump. I will have the same manager since she runs both the MSICU and SDICU.

[Nalon1 RN/EMT-P, BSN, RN]

I started in a very basic IMU (no trach/vents, but a lot of drips and such) for almost 18 months and then transitioned to ICU (a general ICU, a lot of everything except trauma, was a 12 bed ICU, medium size local hospital), and was not a big stretch for me. Learning a little more about vent patients, more complicated drips and paralytic/sedation were the biggest adjustment for me, and not a big one at that. I found many times it was easier having 2 vented/sedated patients than the walkie/talkie IMU patients.

If your comfortable in your current position, I would say go for it. I found my past medic experience really helped my critical thinking.

[CowboyMedic, DNP, APRN, CRNA]

Thanks. I had already accepted the position before I posted this. Will start MSCIU orientation at the beginning of next month due to having to finish out my current schedule. I have been pulled from my unit before to work in CVICU. Had a very stable pt that was vented, and on insulin, heparin, fentanyl, and propofol drips.

[CCRNdude]

I did this and did fine. You have a leg up on brand new nurses since you already know how to be a nurse. Now you just have to be coachable and learn how to be an ICU nurse. The ICUFAQ website was invaluable for me. Just go to work and have fun.