Stepdown/PCU or ICU?

[Scarlettz, BSN, RN]

Hello everyone,

I have about 3 years experience in Med Surg ICU stepdown nursing and most recently 2 years nursing in ICU. I have both my PCCN and CCRN. However, I would say that the hospital I work in now seems more like a stepdown ICU with the exceptions of certain drips (vasopressors and paralytics) and intubation with ET tubes. I have only did CCRT once and I would not take another CCRT without further training. We very rarely get IABPs and I have not had a patient with one. 

I am interesting in traveling. Do you it would be better to start my first travel assignment on a PCU/stepdown floor or an ICU? The stepdown I worked on was 3:1 but every now and then 4:1. We would get stable vent/trach patients. 

I am worried if I do ICU I won't be prepared for IABP or CCRT. I am thinking maybe staying here and training with a nurse doing CCRT first. However, we don't get CCRT super often either especially now that Covid had slowed down.

 

[Nurse Alexa, MSN, RN]

For me, I appreciate the ratios that ICU has versus Stepdown and since the care is similar I would honestly take that into consideration.

Most ICU's do not have balloon pumps and the senior nurses on the unit will assist you with CRRT and other devices.

An FYI, as a travel nurse - they are USUALLY are not going to give you the most devices patients with devices. That wouldn't be safe. And you are able to refuse your assignment if you feel like you are not prepared to take care of that patient.

All food for thought to assist in you in making a good decision. Hope this helps xx ? 

[Angelica May]

Nurse Alexa said:

For me, I appreciate the ratios that ICU has versus Stepdown and since the care is similar I would honestly take that into consideration.

Most ICU's do not have balloon pumps and the senior nurses on the unit will assist you with CRRT and other devices.

An FYI, as a travel nurse - they are USUALLY are not going to give you the most devices patients with devices. That wouldn't be safe. And you are able to refuse your assignment if you feel like you are not prepared to take care of that patient.

All food for thought to assist in you in making a good decision. Hope this helps xx ? 

Absolutely. I'm sure that different hospitals use different brands, models and generations of devices. I can't imagine that the unit you work on will have you take those devices, and if they do, I can't imagine that they will have you take them without solid training.