Which ICU do you like and why?

[Sav101, BSN]

I worked in a neuro ICU for a year and hated it, those patients were tough to handle! I am approved to transfer units. I want to stick with critical care. What ICU do you like the most and why?

[SillyFever, ADN, BSN, RN]

I have only done one ICU, so I can't speak for others. However, I used to work in a mixed medical/surgical ICU and I really liked it. It was a mix of everything from cardiac, GI, neuro, respiratory, etc. I will say though we got a lot of overdoses/withdrawals there which was my least favorite. I think I would have preferred if I was in the SICU (surgical - only) instead just because I liked post-op critical care. Now I work ER which is a whole different world, but am thinking about doing pediatric ICU or Peds ED down the road. Good Luck!

[jv503]

Hi! I had the opportunity as a new grad to experience basically every kind of ICU in a rotation as part of a critical care internship over an 8 month period. I currently work in the cardiovascular ICU. What I love about it is the variety in high and lower acuity. Sometimes we have someone who doesn't appear too "sick" in hypertensive emergency but they are on a nitro drip and obviously high risk. Or a post STEMI patient who most of the time has a successful outcome but you have to be ready for anything. But you can also get patients on an aortic balloon pump or ECMO and have 15 drips running. I know a lot of people in cardiac surgery facilities also love the surgical cardiac cases-- I'm hoping to work somewhere like that for my next move. 

Medical ICU was good for consistent work with ventilated/sedated ARDS patients, complex care with renal and hepatic patients, but also quite a bit of overdose and withdrawal patients as mentioned above. They get a ton of CRRT which I'm a bit jealous of haha. 

Surgical/Trauma (combined in my facility) was my favorite for a while. I like the relationships you can build with the surgical teams. And there's a ton of variety from breast flaps to open abdomens. Surgeons can be super picky (for good reason). There are also often q1hr assessments like pulse checks, pupil checks, etc. The trauma side is amazing because you'll never have two cases that are identical. From my experience there, the difficult part is that a lot of these trauma patients experience a ton of pain and at least in my facility there are some rowdy folks who come through especially the GSWs! Keeps it interesting.

The burn ICU is really unique. Those patients can get so sick and their pathophysiology is so fascinating to me. Wound care is brutal, and with open skin you are just altering every part of your nursing care. There is a lot of pain in these patients because current practice avoids heavy pain meds and sedation. Pediatric burn cases are just so difficult. You often get to accompany these patients to the OR. Burn resuscitation is super interesting. I didn't love it because it just feels too specialized for me and there aren't enough high level burn facilities out there for potential transfers eventually. 

And you know plenty about neuro it sounds like! haha, and I have to agree with you there.