I did 10 months on the step down unit before transferring to ICU. I think that while I learned alot on the step down unit, it also taught me to be afraid of the ICU. I transferred to the ICU as that is where my heart was and have never regretted it.
My husband went to nursing school and hired directly into ICU. I think he would have never stayed in nursing if he'd been required to be a med-surg floor nurse first. His desire was to be a critical care nurse.
We hire new grads directly into our ICU. We closely monitor them and give them a very supportive 16 week orientation. We teach them our prioritazation and skills that will be very important for their patient care.
In my opionion, floor nurses are taught to be afraid of doctors, follow orders and not to think critically. I've precepted many nurses in different hospitals in different states. When I've told many nurses who were transferring from the floor to call a doctor for a problem and to ask the doctor does he want us to give a bolus, hang hespan, give CaCl, and or transfuse a couple of units of blood. I usually receive a shocked look and the question "You want me to tell the doctor what to do?"
I'm not saying floor nurses can't/won't talk to doctors, provide good patient care or not have critical thinking skills. They just have a different type of nursing than ICU. I don't know the things you learn on a floor is that valuable in the big scheme of taking care of critically thinking patients. The drive and heart to give your all to that patient for every shift you work is what is important.
CVICU, NTICU, MICU:rose: