Tell me about ICU/Step-down Nursing (please!)

[Annath]

Hi there!

I just accepted a position for nights on a Progressive Care Unit as a new grad (busily studying for NCLEX!)

I've always loved the idea of working with critical/acute patients. I love organizing my day, prioritizing, and getting to really exercise my brain.

I'm interested in what the typical day to day (or in my care night to night) is like in a higher acuity setting.

My nursing school clinicals were almost entirely in Med Surg, with only a handful of days in the ER/ICU.

My instructors suggested that I'd enjoy critical care, which is what led me to explore those options.

I'd love any perspective you might have, or things you wish you'd known going in.

In case you're curious, I'm currently enrolled in an RN-BS program, and hope to become an NP (adult gerontology) eventually.

[jalarsen1]

I LOVED my first RN job as a night nurse on our "Surgical Intermediate Care Unit". It was the SICU step-down or progressive care.

I will say I was, like most new RNs, a deer in the headlights. My school, and I'm sure others, did very well to prepare me for the NCLEX, but the actual job required me to learn as I went.

CLING TO the leaders on the unit. Ask questions! Literally never stop asking questions! I'm a CCRN certified nurse in our SICU now, and I even created a website (shameless plug: JimLorificen-RN.com | SICU to CRNA) to answer all the questions I still have.

If you're hungry to learn, then critical care is for you...med surg would bore you! If you're content to just 'work a job', then I would find another path.

[Annath]

Fantastic! I'll definitely check out your website!

Hungry for knowledge describes me perfectly! I actually just bought myself a copy of the Merck Manual so I could learn a little more about diseases and pathology than we covered in school.

Of course, it's sitting unopened until I pass boards!

[sasrn0988]

I worked PCU/step-down for about a year before I transferred to ICU. The patients I saw were more med surg/trauma since that was the unit that I primarily worked on. I would see trauma patients (we are a level 2 trauma center) and I would see patients who were BiPAP/CPAP dependent (who needed to be intubated if they couldn't handle non-invasive) and I would always see afib patients, sepsis, alcohol withdrawal, CHF etc. There were specific gtts we could do on PCU before they got upgraded to ICU. Overall, it was a good experience as a new grad, but it definitely varies between hospitals!