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tele experience 'not good enough' for MICU?

hi all-looking for some feedback from ICU RN's--MICU in particular.

I am looking to transition to MICU, however the MICU mgr seems to think I need to go 'get med surg' experience first. My background is telemetry for over 2years with Med/Surg overlfow. Some examples of my pt. population: post partum w/RAF, post sx w/RAF, complete heart block, heart failure/ ARF, heart transplant w/complications medically managed. gtts i've worked with: dopa/dobutamine lasix, bumex, milrinone, natrecor, dilt, some chemo, chest tubes, post OHS, cabg, post cath. sepsis. GIB sorry-not to bore you. i guess I can "backtrack" to med surg, however reading posts on here in which new grads are working all sorts of units, I am kind of insulted. I do not get post sx patients regularly--about every other week.

My question--what did I miss by not work med-surg? I have telemetry cert/ACLS. That seems to count less than a hill of beans

to the mgr. should I step away from a monitored unit and work m/s? I have no issue with working m/s as it wasnt available when i started at the institution. i figured i would get the gist of med surg from tele as these pts have mult.co-morbidities.

sorry so long. appreciate the feedback

Sounds like you'd be better off looking at a CICU.

I think the manager is being overly picky, you'd probably do fine in an MICU, but I can vaguely understand her reasoning. You never really got to deal with the basic cases you'll see in MICU like COPD, pneumonia, EtOH'ers, etc. and how they look on both the not-so-bad end and the patients who shoulda just gone to the MICU instead of the GPU.

I went straight to the MICU after graduation but I did 2 years of work as an extern on a med-surg unit, so I got to see the evolution of those patients when they get worse. That's probably the only perk I have over you, you already are going in with telemetry experience and a good understanding of the heart.

thanks for the reply. I was wondering if I should just keep it in cardiac and look for CTICU/ CCu positions. what your saying makes sense re: evolution of the types of pts on m/s. i figured with having some m/s overflow would help. we only get 'ethoh-er's with 'holiday heart' you know, the 'occasional' can of beer types. i haven't had pts w/ the dt's or in DKA per se.

CrazyPremed, MSN, RN, NP

Specializes in Telemetry, ICU, Psych.

I started on Tele then moved to an MICU/CCU. I have worked with nurses that have moved to the MICU from tele and from med/surg and the tele nurses usually fare better. Although you may see more MICU diagnoses on a med/surg floor, your day to day activities will involve more of what you see on tele. While my med/surg counterparts were learning how to read strips and 12 leads, I was taking ACLS. While they were being introduced to basic drips, I was titrating multiple pressors. Working on a tele floor, we tended to be more involved in the codes on my floor, instead of defering many things to a rapid response team.

With that said, there are things that I am not familiar with, like traches and oncology patients. Non-cardiac surgery and long term nursing home patients are somewhat new to me. These are things that the med/surg nurses seem to be much more familiar with. Honestly, I think that it is much more difficult to have to learn strips and hemodynamics from a non/tele background. I think you will be more than OK, and you should not switch to Med/surg just to get the experience.

CrazyPremed

My typical day-to-day is not telemetry focused. Yes I run a strip from 2 leads every 8 hours, get 12 leads PRN, do CVP's, etc., but if the patient's rhythm is a nonissue for the most part and they are more long-term (nursing home patients as you said) then a med-surg background helps a lot and telemetry helps you none.

In my mind, I bet the manager is thinking you can teach someone telemetry, get them to take ACLS, etc. You cannot, however, give them hundreds/thousands of hours of med-surg experience.

I personally think tele is great experience:) Of course I worked in tele for about a year before coming to the Trauma ICU. I don't know why that manager would think that tele is not good enough:eek: but whatever. Good luck

I don't see much difference in the background of tele vs. medsurg. If the manager doesn't think you will succeed, I'd look for another unit because they will probably be looking to nit pick everything you do rather than encourage you and help you out.

Tibbymc

Specializes in ED, ICU.

I have 2 years of tele and went straight to MICU. My mgr thought tele exp is better than the regular floor. I think it's easier to learn the different illnesses you've never encountered before rather than come into an ICU not knowing how to read strips. Tele patient's tend to be more sick anyway so again I think it's better experience for you than the floor. Good luck :smokin:

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