The difference between Med-Surg nurses and ICU nurses

TazziRN, RN · Jun 19, 2008

Critical care nurses do tend to be more laid back. I've seen MS nurses float to the ER and be blown away by a) how much autonomy we had and b) how "Whatever" we were.

uscstu4lfe · Jun 19, 2008

Ah yes! I forgot to mention the "whatever" approach the ICU nurses had. THEY ARE VERY LAID BACK PEOPLE. I specifically remember an incident where a patient in the ICU became combative and was trying to pull out his breathing tube... Well admist me, another guy, and another nurse holding this guy down and the nurse drawing up some medication to calm him down, they still managed to talk about what they had for dinner the previous night at the same time! lol

TazziRN, RN · Jun 19, 2008

It's a different world, and for that reason many critical care nurses cannot work the floors and vice versa. When I left the ER I didn't even bother trying another unit because I knew I'd get my hiney canned in a month. Instead I went to home health.....another autonomous position.

Tait, MSN, RN · Jun 19, 2008

2/3 pts vs 6 pts. That is my rationale for being the "hawk-like" RN. Plus sending a pt to the unit means I have to do an admit at 3am!

BookwormRN · Jun 19, 2008

In our ICU, it's usually 1-2 pts per RN, and those Pts are right in front of the nurses desk.

On my Med/Surg unit, depending upon how busy we are, 4-5 (maybe 6) on PMs and 8 on NOCs per RN. These pts are on three different halls with a centrally located nurses station. I run my tail off!!! and try to keep an eye on everyone...don't forget the phone calls I'm paged to answer just as I get to the far end of the hall the farthest from the nurses desk!

Yup, I'm hawk-like, because it is my butt and license on the line.

sundowners2 · Jun 19, 2008

My experience has been that ICU RN's tend to encounter alarming situations on a daily, even hourly basis. If my pt. had a low sbp on the floor when I was an intern, my first thought might have been "tx to the unit." Now that I work as an ICU RN, my first thought is "MAP of 65? Gravy."

RNsRWe, ASN, RN · Jun 19, 2008

Hmm, anyone see the potential for an ICU vs M/S mud toss?

I actually have noticed this tendency myself. And you know what we say? Those of us on med-surg tend to say "the ICU nurses that float here can't handle our patient load (4-5 days, 5-7 eves, 8-10 nights); they're lost with that many to remember. They miss doing stuff". The ICU nurses tend to say "the med-surg nurses don't have to keep 1-2 critical patients from coding every day. They don't have to know as much as we do".

The med-surg nurses DO tend to be more nit-picky over the details (so we CAN make sure we don't miss dressings, meds, etc on a patient overload). And the ICU nurses DO tend to be more laid-back; RRT activity is more common on their floor than ours. OTOH, lol, our job is to make sure we don't HAVE RRT activity :)

But you know what? SWITCH those two nurses, and you might have something entirely different (in my opinion). When those ICU nurses float to my med-surg floor, they are frequently harried and behind-the-8-ball; getting report from them can be a nightmare of "I don't know, I didn't get to that yet". And when some of our med-surg nurses float to ICU, they frequently look at us like "why are you worrying over those details?? It's no big deal...."

Interesting that it goes on elsewhere, too!

sk3bruce23 · Jun 19, 2008

I really think that you have to look at the pt's that the ICU nurse has at that moment. Yes we may only have 2 or 3 pt's but our acuity is much higher and when we come across a problem it is big and something that does happen for us on a daily basis. Take my pt last night, on the vent cvp monitoring, 9 IV's infusing, ngt to suction, bilat knee replacements, bronchoscopy at the bedside, arterial line to monitor pressure, and the family and docs making new orders. My other chest tube, pca morphine infusion, picc line, decresed o2 sats, heart rate in the 140's with a temp pf 103.

This is typical for me, so am I running around ...... yes at times. Though, when I am not running I am watching my monitor which is showing me everything I need to see right then until I do my assessment every hour or two depending on current status.

I do not think that you can compare Critical Care RN's and Gen Med RN's. Both have crazy assignments and can at times both become very busy. I think you have to respect both positions and fully understand what each do.

leslie :-D · Jun 19, 2008

why are the 2 even being compared?

icu = higher acuity, fewer pts

med/surg = less acuity, more pts

where is the commonality?

leslie

yeSICU · Jun 19, 2008

I think a lot of it has to do with access to information. You can feel a lot more comfortable when you have a pt or two hooked up to the monitor and know every facet of their being. You can throw a drip up if you need it and there are residents there at your disposal. Plus you deal with the abnormal so often that you don't really get freaked out by much after awhile. lol. I also think when you have 6-8 patients there isn't much room for being laid back. You have to stick to your schedule if you are going to get all of your job responsibilities accomplished.

RNsRWe, ASN, RN · Jun 19, 2008

why are the 2 even being compared?
icu = higher acuity, fewer pts
med/surg = less acuity, more pts
where is the commonality?
leslie

I think the OP was just wondering about a personality trait difference that seems to exist between nurses in different units.

I suppose you could also look at the personality types who work detox, psych, OB, and wonder about them, too!