Working both med surg and icu

[LittleRN5678]

I've been working on a med surg floor for about a year. I have the opportunity to work in the ICU in the same organization. It would be in a different hospital though. My reasons for wanting to switch are--1) curiosity, as med surg is all I know; 2) feeling unsafe caring for 6 pts who are med surg but pretty involved; 3) feeling a "no one cares" attitude on my floor, lack of professionalism on my floor.

It may be a grass is greener on the other side situation. I love my med surg patients but lately I've had issues with techs/lab/sitters not following my instructions and with 6 pts, I can't devote the time I want. People say I'm too perfectionist.

I know these delegation issues won't end in the ICU, but experienced ICU nurses have told me they think I would be happier in an enviornment where details are more important (not that details don't matter in med surg--they do! I just tend to watch my patients like a hawk, and end up doing most of the work I delegate myself anyway, because there's an attitude on my floor of "with 6 patients, we can't be perfect"--but some patients still need strict i's and o's! Patients need to be turned! Vitals need to be done on time--and accurately!).

I'm not sure if it's me or the med surg environment (writing this, I think the former). I don't want a bad few shifts to change my whole career path. I also don't know anything about the ICU--vents, drips, etc. I would miss my med surg Pts-I love talking to patients and families. I love the pace of 5 pts--not 6!

In a perfect situation, I would still retain my med surg job full time, let the ICU team train me, and work Job 2 for them.

my questions are--has anyone ever worked med surg and critical care together for the same facility? I wonder if HR would even let me (and this is if the ICU will hire me, train me, and let me work 1-2 shifts a week, highly unlikely).

Is it unprofessional for me to shadow in ICU without telling my current manager? Is it rude to shadow if I'm only doing it to see that I'm happy where I currently am? I don't want to waste the ICU manager's time.

[JKL33]

Is it unprofessional for me to shadow in ICU without telling my current manager? Is it rude to shadow if I'm only doing it to see that I'm happy where I currently am? I don't want to waste the ICU manager's time.

To your first question: No.

Second question: No. What could waste people's time would be for you to not think this through carefully. If the ICU manager is willing to let you shadow, you can certainly say it is what you are interested in and so you'd like to gain a better understanding of what goes on in the ICU. Nothing wrong with that.

[Castiela]

I shadowed in icu on my own time while I was working in med surg and it was fantastic because I got to see the assessments, rounds etc. It also ended up getting me hired because it showed at I was dedicated and truly interested in ICU.

I would recommend working full time in ICU initially so you have a chance to consolidate. I found it to be a steep learning curve going from med/surg to icu and I'm still continually learning things. It's funny, because I still felt to my old ward every now and then and I find myself feeling less safe with a higher patient load because I now know more things and I'm trying to apply my critical care training to the ward patients but there just isn't time, which makes me feel anxious.

The other thing I find with icu is that you develop a really good rapport with the patients and their families because you get to spend more time with them. Communicating with a vented patient can be interesting... I am terrible reading lips, much less when they have a tube in their mouth but it's pretty rewarding when you figure out what they want and you see that look of relief in their eyes.

[ILUVERNSG, MSN, RN]

Shadow the ICU- it sounds like it could be a better fit.

You will get at least 6 months of orientation and lots of critical care classes.

There will be a very steep learning curve and it will feel like you are starting over.

If you're up for the challenge you might really like it. The patient ratio will be 3:1 or 2:1 if the staffing is good.

I would not recommend working your stressful med surg job and ICU at the same time. You need to focus on becoming a critical care nurse. Choose one or the other.

Now go for it!

[Accolay]

What kind of ICU would you be going to? If you really like med/surg than the MICU might be a good fit, be advised that it can be the same patient population that you're seeing on med/surg, only sicker. Sometimes you don't get the patient interaction but you can sometimes talk with families more. If you're going to more of a trauma or neuro or even SICU type of deal then know there can be a lot of sad stories and death.

ICUs are busy, but in a different way than med/surg. You'll be juggling different things. Know that NAs/techs/sitters can be lazy anywhere. Probably your facility wont let you work on two units at the same time, but check with your policies...maybe you pick up shifts if you want to? Maybe your float pool trains on the ICUs?