What are the stress level ranking for these units?

Libby1987 · Dec 11, 2014

Coming from a home health perspective and patient feedback, most complaints would come from ortho where not only are there always pain issues but also attention issues. I rarely hear complaints about unit stays, the issues there would be from family complaining about things like lack of communication and then mostly pertaining to MD's. I imagine it must have a lot to do with ratios.

mmc51264, BSN, MSN, RN · Dec 11, 2014

I have been an ortho nurse for 2 years and I love it! I know others that float into our unit usually don't like it, but not all. Everything is relative and what you know.

calivianya, BSN, RN · Dec 11, 2014

I'd say ortho is the worst of that list. Floated there a few times as a CNA and put it on my "never, ever, ever; will live under a bridge first" list. Everybody is in pain, everyone needs their pillows fluffed, almost everyone is alert and oriented enough to know that it took you 20 minutes to get to the room after they pressed the call bell, etc. That kind of stuff stresses me out. I will take high acuity patients who are very sick any day over needy ones. I really respect the people who can do ortho successfully without losing their minds.

tara07733 · Dec 11, 2014

My mother in law recently had a knee replacement and I went to visit with my husband and a couple other family members. I remember sitting there thinking these nurses and CNAs must besaints for what they had to out up with from my husband's family and also my mother in law, who was playing the part of a martyr. And everyone was an armchair nurse/MD. I feel it really went beyond advocating for a family member.

It really made me second guess going to school to become a nurse.

ontheway2crna · Dec 12, 2014

Tele or CVICU floors will have codes everyday or almost everyday. I work with a former CICU nurse who could not take that stress and now works in neuro icu. Neuro icu is stressful because you could have pts trying to climb out of bed all day, who are combative and violent. Neuro checks are every hour and it can take a long time to get a neuro check on a pt if they are very sick and sedated, and then you have to transport them to CT or MRI , on a vent ( with RT) and with all their lines and drips if they have a neuro status change. Ortho, at least at my hospital, is less acute than a general M/S floor, our ortho floats had a difficult time keeping up on the M/S floor I worked on. I hate mobilizing pts, I know that is awful to say, I think I would least enjoy mobilizing pts screaming in pain who are being uncooperative because they are in pain, I do not envy PT/OTs at all. I would also not enjoy jumping up and down on chests every shift either.

mmc51264, BSN, MSN, RN · Dec 12, 2014

I had no idea that ortho had such a bad rep!!! makes me sad b/c I love it.

firstinfamily, RN · Dec 12, 2014

I think all are stressful, is there a lot of post-op blood products being given on an ortho unit? ICU and Neuro ICU, CV Surgical and Med tele are all stressful at their own levels of nursing care that needs to be provided. I would rate orth as the least stressful, but most physically demanding with lifting pts. CV, Neuro, and ICU are all a high level with frequent monitoring, high level medications etc. Med-tele would be an average unit with mid level stress depending on the patient load. Good Luck in finding your niche!!

applewhitern, BSN, RN · Dec 12, 2014

I will say Neuro ICU is probably the most stressful, as patient's can go south quickly. Cardiovascular surgery is very busy the first day. Some nurses like the fast-paced environment, with constant titrations, etc., but some find it too unpredictable. Everybody is different; every employer is different.

Anna S, RN · Dec 12, 2014

The work isn't stressful, usually it's caused by your co-workers.
The unit I work on is generally considered a very "light, easy specialty". I have more stress there than any other job I've ever had. It's the co-workers and poor management.
Staff only stay because of the shift schedules and the fact that you very rarely run the risk of being injured there.

I agree completely!

I just left a job where the staff to pt ratio was the best I've ever had. The work was not a problem- it was very poor mgmt and hostile work environment which caused me to leave.

kgoode0919 · Dec 12, 2014

I would hope that the ICU would be more stressful. I work in Ortho and it is not a cake walk. We have surgery days where we crank out about 25 fresh post ops to the floor. I have come on at 7p and had to deal with receiving 9 patients within an hour (to several nurses) as charge. On days you could discharge 5 patients and get 5 fresh post ops all before your 12 shift is up. Every 2 hours your ice packs need to be changed on those new post ops. Our patients can not be toileted alone; someone has to stand with the patient the entire time. Our unit is to never use a bedpan unless it's a hip fracture or pelvic fracture on bed rest. Patients look at me like I've grown a second head when I tell them they have to get up and use the bsc right after sx. If you have a pt on traction, it must be released q2h to check for neuro and skin integ status. PRN pain meds are given around the clock (sometime even q1h). These people are in a lot of pain. All the cervical fusions must be checked q2h for tracheal shift, difficulty breathing/swallowing...I give a lot of blood on my unit. When hanging the unit you must stay at the bedside for at least 15min to assess for adverse reaction and of course this doesn't include the time with paperwork, getting blood from lab, prep etc. All pt must get oob day of sx or at least dangle at beside. I am constantly bladder scanning and straight catching patients. We receive patients from pacu a lot who are barely stable to come to the floor and end up transferring a lot to ICU later for symptomatic hypotension that just doesn't improve. I have patients faint often, go into afib with rvr etc. You must always assess for compartment syndrome in all patients. Fractures like to throw fat emboli from time to time. Over sedation happens. DVTs/PEs happen. I have to walk the joint replacements q1h until 8p. It's physically, mentally and emotionally draining. I could go and on...

Lev, MSN, RN, NP · Dec 12, 2014

Can someone please rank the stress level of these units for me?
I think Ortho would be the least stressful, but here are the units
1.Orthopedics
2. Telemetry connected to trauma with helicopter pad (sounds stressful already LOL)
3. Cardiovascular Surgery
4. NeuroICU
Ortho will pay about $2 less than all the others. I bet it is less of a headache too. I don't care a whole lot about the rate of pay since I would like to start out on a unit I can build without quitting.
So can someone rank these in order of least to most stressful?

OP,

I think the best bet for you would be to shadow on each unit if possible. Find out about nurse to patient ratios, if there are CNAs, observe staff and management interactions. Don't be afraid to ask questions but don't ask how stressful the unit is. They all are! And you don't want to turn anyone off...

Esme12, ASN, BSN, RN · Dec 12, 2014

LOL sounds like all of nursing is hell and can have a high turn over rate. I need to find another career. Nursing is truly underpaid, overworked, and zero respect depending on where you work.
Thanks for everyone's input and hope you work in a place where you are satisfied.

That's about the size of it. I do think over all we are respected. But I would rather take a sick post open heart with 13 drips that 6 ortho patients. Neuo ICU is a tough one too...they are either sedated and intubated or confused and diagonal in bed. I think ALL tele units are stressful and busy.