Why do unit nurses have bad reps?

kadokin, ASN, RN · Aug 23, 2005

You know what? We are all nurses and we should all get along well - I see this all the time and it is not just Unit Vs Floor nurses, it ranges from same unit different wings, same floor different shifts, same hospital different floors, same company different facilities, it all depends on what attitude you put across. Just get focused here - remember when you met those minimum requirements for your license the state did not issue that for you be a B***H, look down on floor nurses, nor make judgments on personal behaviors but to practice nursing to the best of your knowledge.
I am an ICU nurse and I don't look down on floor nurses neither am I a "female dog"
David

Word!

Focus on pt care. If things seem tough for your unit, wing, shift, etc., now, remember, you will have your lulls too and try to help those that are intheweeds when it happens. We ALL have our trying/impossible times. If you can help out when you aren't having one, you will make friends who will do the same for you. To quote a previous poster(don't know if it was this thread or another), the grass isn't always greener on the other side, it's just different grass. Teamwork, folks, that is the ONLY way to get the job done.

sinders1 · Aug 24, 2005

I also come from surgical floor to the ICU and I still visit and have lunch with my ol friends and I like to think that they can come to me and not worry about feeling inadequate. I have great respect for the nurses that can juggle 10 pt load, Cindy

There should be no need for the "holier than thou" routine, and there is really no excuse for being a general crab. But - having said that - ICU is a different world, as are most specialty units. This certainly adds to the attitude differences. ICU nurses are notoriously detail oriented, they generally have just two patients to care for. Those two patients get ALL their attention. ICU nurses also have a different sort of relationship with the MD's and with the other hospital departments. A couple of easy examples come to mind. In my experience in several ICU's - small hospitals - big hospitals - it is fairly common for nurses and docs to be on a first name basis - they work more collaboratively than on the floors (generally) - they spend much more time together. Other hospital departments also seem a little more responsive to requests from ICU. Work on a floor and demand immediate delivery of something from Central Supply? Won't usually happen. Work in ICU and do the same thing? Better results. Just the way it is. I worked as a float nurse for a few years and was able to observe lots of this, over and over and over. I worked in ICU for many years and saw it from that angle too. I think ICU's do have an attraction for certain types of people. So what was I thinking in going from ICU to Home Health? Lots of control to none? I don't know. Its an interesting change and an interesting contrast. Phew - I gotta wind this up. When you transfer to ICU, your views WILL change because you will see some things from a different perspective. You can still be nice though! :)

sinders1 · Aug 24, 2005

Its the competetive nature of nurses, sadly, to disdain the other unit. .
I've always been known as 'Deb the NICE ICU nurse.' :)
Thats because I haven't forgotten my roots...which were medsurg....and I floated out on occasion to make sure I wouldn't forget...LOL!

right on deb

SheriLynnRN · Sep 4, 2005

I just finished my third week of orientation in ICU. My preceptor's evaluation notes, which I thankfully got copies of, indicated that I was a "good nurse" and that I obviously knew what I was doing when it came to hands on pt care, but that I needed to pick up the pace when it came to documenting and checking off orders. She stated that I was "thinking like a floor nurse". I took that to be a bit dirogatory. True, my year of juggling 7-8 pts did teach me to complete all of the tasks that needed to be done before I sat down to chart and check off orders (I always look at them soon after they're written to make sure there aren't any stats, etc.) but focusing on my pt before my documentation didn't seem to be what she was looking for. Just wondering how you all handle the balancing act between timely charting and spending time at the bedside?

hrtprncss · Sep 4, 2005

don't listen to her, chart at ur own pace when ur done with ur patient care, it's just everyone has preferences when they chart, i do it right after i see a patient, some nurses wait until the afternoon when everything slows down to start charting their assesments on the computer. all in all congratulations.

IseeuCCRN · Sep 12, 2005

welcome to the world of icu...the toughest job you'll ever love. :uhoh3: I have been a 'Unit" nurse for about 18 years now...time flies! It's funny you should mention the "B" word...A friend just told me today that when she mentioned working in the ICU during her school rotation in the ED, thats the same message she got....I don't know why some are perceived as Holier than thou? All I can say is the stress level runs very high and I think we put up a protective wall that helps us cope...now I realize that the stress runs high everywhere in nursing...esp. lately, I have only the upmost respect for the "floor Nurses" .. the turnover is incredible..I'll take my two half dead patients over a block of semi-dead ones anyday!! Like ANYTHING in life...be who you are...but be strong- the expectations run very high...critical thinking skills are learned and earned...take time to get to know your new teamates and try not to go into it with any preconceived ideas of who they are...remember, the got your back. Truth be told- we honestly do have a number of *B--H's in our unit....it take all kinds doesn't it. Focus on your patients....not on a reputation....I wish you well!

I will be transferring to ICU from general surg next week. When I told one of my co-workers (whom I respect) that I was going to the unit, she said "Just promise me you won't go up there and turn into a B***H." I asked around my unit and got the same type of response. I have not had many interactions with our ICU nurses, so I don't have much to go on, but my co-workers seem to think that unit nurses are holier-than-thou and that they all look down on "floor nurses", talking down to us. I realize that these are opinions, and are in all probabilty, stemming from isolated incidents, but I just wanted to get some perspective on what you all thought of this.

IseeuCCRN · Sep 12, 2005

Dude, a quarter of a century?! I only have 18 under my belt...is there life after 20? Truth-be-told...you catch more bees with honey than vinegar...some of my work mates may beg to differ....a wefting of zoloft would be indicated on many days... I am a firm believer in not burning bridges.

I remember when I was a med-surg LVN being upset with a float from ICU. She would only take four patients. The other RNs had 10 that 3-11 shift. When the dinner trays came she was still looking up lab results. I passed trays to her patients as she looked over charting to be sure the low K+ of two days before was treated. It was.
Now that i've been a critical care nurse for a quarter century I can relate.
I hope to find the right balance because I can't bring myself to refuse to float even though our contract does not require me to go the med-surg. (We do have to go to tele). I am terrified having to rely on an LVN I don't know. Those I've worked with before whose competence is often superior to mine - great!
Being rushed can make a person seem mean. Some people are rude. Some don't feel well or are worried. Mostly it is probably misunderstandings.

gassrn · Sep 18, 2005

I have not really ever posted in this forum, but read it often.. The subject of ICU nurse vs FLOOR nurse seems to be a never ending conversation of opinions so I will give my experience. I originaliy was a respiratory therapist first before I became a nurse and had a chance to work with all areas of nursing, now I am a trauma ICU nurse with about 4.5 yrs experience. I feel like a floor nurse has a different kind of talent and skill than I have. They can prioritize and deal with awake alert ,sometimes oriented pt, and cover an emergency and answer questions to multiple family members along with delegate tasks to cna, ect. and run circles around me in time management. However you have that floor nurse float to a unit and ask them to take a "stable" intubated pt with only 1 or 2 gtts or manage a swanz and their level of anxiety would go up dramaticly. To me it boils down to treating people with respect and treating them how you would like to be treated weather it be pt, co-workers, or family. I tend to give the nurse the benifit of the doubt if it seems they are short or rude with me, there are some really bad days, however ICU or Floor, if I feel they are putting the pt in danger, I will speak my mind to them in a respectful way. All in all just dont make a pre-judgement on someone else' s opinion or experience. Best of luck and have some fun if you can. PS I cant spell sorry!!

misswoosie · Sep 18, 2005

And that could be said about anyone at anytime, it's not exclusive to the floor nurses:rolleyes:

This comment isn't directed at anyone in particular.I am an RN in UK with 8 years ICU experience.I thought I would like to come and work in USA but now I'M not so sure.

On ICU in the UK an RN only looks after 1 patient. However

We frequently only have 7 RNs on duty for 6 patients with perhaps 3 in private rooms.(No aides OR LPNs)

We (once more experienced)manage all the ventilator settings without orders from MDs -often the docs have never worked on ICU before

We manage CVVHD for our patient

We manage ALL the monitoring/monitors

We clean beds and equipment and floors(housekeeping not allowed to)

Frequently we have a shortage of equipment

I wonder how this compares to your work in ICU?

geekgolightly, BSN, RN · Oct 1, 2005

That's true, a separate thread might be appropriate as it did get off topic (including my response to her being off topic as well) but I think she did intend to be relevent to the topic in the whole idea of ICU nurses having bad reputations.
Just yesterday I had two nurses snap at me on the phone when I called about sending them up patients from recovery and it reminded me of this discussion.
I try not to take it personally (as it is not uncommon to get treated badly by the floor nurses whenever they are getting yet another patient which I understand) because I remember how awful Med/Surg could be and that's why I had to get out of it and try to give credit to those who stay in it.
But the OR was winding down and we had hardly any cases remaining with plenty of nurses with open slots so I asked this nurse if he was ok with me bringing up a patient to him and he said "I don't know why you people bother asking, it's not like we have a choice, you do what you want to anyway."
I explained to him briefly that sometimes I can't hold patients for long because the OR is backed up and waiting for my slots to open as it is but whenever I can be flexible with the floor, I try to be and was able to hold off bringing up his patient until things settled for him. The patient wasn't anxious to get to his room either so it worked out fine.
I was supposed to go to lunch but instead stayed with my patient for an extra hour before sending him up and hung some meds that were coming due and drew labs so that he wouldn't have to worry about that either.
You know what? He didn't care. He told me upon arrival that he was so far behind that it really didn't make any difference to him if I'd sent the patient when I was originally supposed to or that I kept up on his labs and floor meds that I was able to get out of the PACU pyxis. He said that I "didn't do him any favors as long as I was still sending him a patient at all."
That of course, is not the first or tenth time that's happened to me but I still try to help out the floor whenever I can even though roughly half of the floor nurses in my experience are either indifferent, ungreatful, or still manage to find something you did wrong or forgot to do.
The other half that are appreciative are still worth it even if I only made their bad day a tiny bit better.
When I worked Med/Surg, I would have been happy to have a PACU nurse give me an extra hour to get caught up and not have meds and labs due upon arrival to the floor because many did little more than push pain and nausea meds in my mind in those days, then rush their dirty and bloody linened patients up to my floor because many didn't believe in changing linens or gowns either.

bless you! i totally appreciate it when ICU or PACU nurses do what you have described. you are a gem.

pepcidcomplete · Oct 2, 2005

This comment isn't directed at anyone in particular.I am an RN in UK with 8 years ICU experience.I thought I would like to come and work in USA but now I'M not so sure.
On ICU in the UK an RN only looks after 1 patient. However
We frequently only have 7 RNs on duty for 6 patients with perhaps 3 in private rooms.(No aides OR LPNs)
We (once more experienced)manage all the ventilator settings without orders from MDs -often the docs have never worked on ICU before
We manage CVVHD for our patient
We manage ALL the monitoring/monitors
We clean beds and equipment and floors(housekeeping not allowed to)
Frequently we have a shortage of equipment
I wonder how this compares to your work in ICU?

misswoosie....you should be right up there with mother theresa, and

be 'knighted' by the queen. :rolleyes:

in the usa you would be quite bored.

bluesky, BSN, RN · Oct 2, 2005

in the usa you would be quite bored.

I have housekeeping and respiratory therapy but I would trade those perks for a guaranteed 1:1 ratio any day.