What is the difference?

Jennyc00 · Aug 13, 2013

I currently work on a tele floor in Texas. We have a 5-1 nurse patient ratio. We cannot take patients that need insulin drips, BP med drips, and who are generally not fairly stable. I believe our general rule is 2 failing body systems help to qualify the patient to our progressive care unit. This is the only unit between tele and ICU as a patient progresses to further deterioration. Progressive care is 3 pts at my hospital, others might have 3-4 per nurse. In a nutshell if I can't safely (as safe as we get in the crazy world of nursing..) watch a patient with four others they are shipped off to progressive care. I tend to do more task oriented stuff especially getting elderly up to the restroom, blood sugars, changing incontinent patients where progressive care do more interventions with BP, etc.

hope this helps. Other larger hospitals have several levels of progressive care before ICU.

If it were my choice I would take the higher level of patient care if you can get a lower ratio. Pain meds and potty breaks hourly sure do eat away at my assessment and overall quality of care with five versus three.

Kaligirl02, ADN, BSN, MSN, LVN, RN, APRN, NP · Aug 13, 2013

Oh ok thanks a bunch! Would you say you have learned a lot being there?

turnforthenurse, MSN, NP · Aug 14, 2013

Progressive care is defined as a critical care area by the AACN but on the lower end of the acuity spectrum (ICU being higher, obviously). I used to work on a progressive care unit and was there for 2 years and I learned a lot. Our ratios were 4 patients : 1 nurse. Everyone was monitored. Basically it was the ICU stepdown unit at my hospital. We could take some drips - dopamine (only up to 5mcg/kg/min), cardizem, amiodorone, heparin, lasix, integrillin, octreotide, and NTG (titrate for chest pain only, not blood pressure). We couldn't take insulin gtts because our policy is to recheck the blood sugar Q30min and with our patient ratio sometimes that wasn't always possible; therefore, those patients always went to ICU where there was a 2:1 ratio.

RaeRiddle · Sep 6, 2013

I am a new RN in our PCU--I have been there for a little over 6 months. I'm not sure what the difference is between the two tele's you are looking at. We are fairly specifically post-cardiothoracic surgical step-down. We will take other patients when our census is low or as overflow from telemetry or ED when we need to. We do drips such as insulin, dobutamine, heparin, lasix, amiodarone, etc. Our ratio is generally 4:1, and all of our patients are monitored. I believe on a regular tele you do fewer drips and the ratio is a little higher because the patients in general are a little less complicated.

It has been a difficult road for me, but I don't think a new nurse needs to avoid the PCU. Working on the PCU gives you a really good introduction to the ways comorbidities impact your care and decision-making for your heart patient. I think that can be a great stepping stone toward ICU.

Kaligirl02, ADN, BSN, MSN, LVN, RN, APRN, NP · Sep 6, 2013

Thank you!

cardiacfreak, ADN · Oct 1, 2013

My PCU unit is a ICU step-down unit also. Not only do we take cardiac gtts and post cardiothoracic surgeries but we are also a certified stroke unit so we get all TIA/CVA pts that are not a candidate for TPA. I am feeling a little cheated however because our day shift takes 4-5 pts and night shift 5-6. I think starting on PCU will make you a great ICU nurse

loveRNlove · Oct 1, 2013

Im on a PCU unit as a new grad and have learned so much. I would recommend it to anyone looking for great experience. Its a steep learning curve but well worth it. Many of our workers end up transferring to ICU after they have PCU experience, so it would probably work out the best for you. We have 4:1 ratio with occasional 3:1 depending on their gtts and acuity. We take post cardiac surgical patients, chest pain patients, pre/post pacemaker patients, pre-heart cath patients, and any CHF/resp failure/ or patients with arrhythmia's needing gtts or closer watching than regular tele floors. We take amio, insulin, dopamine, dobutamine, cardizem, nitro, natrecor, heparin and other anticoagulant gtts. We have temporary pacemaker wires and chest tubes. Basically we take more gtts and higher acuity patients then most tele floors! Goodluck!

Kaligirl02, ADN, BSN, MSN, LVN, RN, APRN, NP · Oct 3, 2013

Oh wow! I didn't get the job :-( but it's ok! I have a second interview for an ER position and I think that would be good experience as well. I am a bit bummed though... But any experience is good experience right?

Once again thank you so much for the information. Hopefully this can help another newbie.

Amagoo · Oct 3, 2013

Sorry you didn't get the job. But thank you so much for starting this tread. I am thinking of leaving the Operating room and the PCU and ICU are the two places I am looking to transfer to. So it's nice to get information on the PCU.

SubSippi · Oct 4, 2013

I work on a tele unit that is treated like a progressive care floor, as our hospital doesn't have a designated PCU. We get some very sick patients, but they don't need to be on cardiac drips. We do take patients on insulin drips, heparin drips, and the occasional morphine drip and nitro drip (titrated for chest pain only). We also get patients who are on long term vents and who need continuous O2 monitoring. The problem with my floor is the ratio is 5-6:1, which can be very difficult, especially for a new grad like me.

Don't shy away from progressive care just because you're a new grad, but make sure to find out about ratios. Personally, I would prefer sicker patients with smaller ratios. I enjoy my job for the most part, and would consider staying much longer if it weren't for the ratios. If I had 4:1 ratios I would stay on this floor for years!

Also ask about the length of training you'll get for each place, and if you would be able to receive more training if you feel like it's necessary. I only got six weeks on my floor, and I was apprehensive about starting on my own at that point. I'm lucky enough to have very helpful and patient coworkers, so it's worked out fine, and I have learned a lot, and will learn a whole lot more.

Apply for both, just in case, but if you are given the choice go with progressive care, especially since you want to end up in the ICU.