High patient acuity, large homeless population, amazing ED attendings.
I signed on the Neuro/Tele floor Jan 2022. The staff and management on the floor were amazing. All friendly, quick to jump in and help, and all knowledgeable. Ratios varied from 1:3-4, occasionally 5. I extended into the summer of 2022 and was placed on the COVID/pulmonary floor. Ratios there were always 1:5 on nights. I spent majority of my shifts during the extension floating to other floors, I probably worked less than 10 shifts on that unit. Staff there could be cliquy at times but also helpful and jumped in when needed. Each floor I went to always had PCAs who were very hands on and helpful. Charge does not usually take patients unless the unit is really understaffed, this only happened once when I floated. I can provide a list of all the floors I worked along with normal ratios. 2J (MedSurg): 1:4-5, one time I had 6. 3J (Med/Tele): 1:3-4 3H (Neuro/Tele): 1:3-5 6H/J (Ortho): 1:4-5 6T (Trauma): 1:4 8R (COVID/Pulmonary): 1:5 9R (MedSurg): 1:4-5 11R (Cardio/Tele): 1:3-4 13R (Cardio/Thoracic Transplant): 1:4-5 15R (Colorectal): 1:4 I also floated to the 3rd floor women’s oncology unit. Ratio was 1:4, no special cancer treatments were done during my shift. The staff made sure to give me patients within my scope and helped if there was something that I didn’t know. ED Hold for one shift, the ratio was 1:5. Was told to only take the patients waiting for admission, ended up with a few discharges and patients not getting admitted. I was with a bunch of newer ER nurses who told me they had just come off orientation 1-2 weeks before. They tried to help when they could, but it is a busy ER and people aren’t always around when needed due to their own patient load. ED is not my preference, so it wasn’t one of the best shifts for me.
Staff very friendly and helpful. Physicians vary depending upon who is working. Some are really good, others are eh. At night, most of the time it’s the residents and NPs on call. We all know how residents can be. NPs are often hard to get orders from because they claim the day team doesn’t like it when they put in lots of orders for them to change, or order certain things without them knowing. After bugging them for a while you can sometimes get what you need. I always made sure to document to CYA, which sometimes gives them the push they need as they see I’m charting my findings and that I notified them without orders. :) Floor nurses wear Navy Blue, and PCTs wear maroon. In the ED nurses wear black and PCTs wear Navy Blue.
I worked in the CTTICU. Very high acuity. Will pair devices, not uncommon to have one patient with impella/balloon pump & CRRT and a second patient also on CRRT. Providers are very unprofessional and management is not helpful. I was staff for 8 months- the unit is not traveler friendly, and not supportive to staff or new grads. Terrible team work and hardly any support.
Worked in the CTTICU for two years. Yes the acuity is high, and yes they pair devices (CRRT + IABP, etc.) but in my experience there was a phenomenal working relationship with both management and providers on the unit. The manager Addalee pours her heart into the unit and you can’g ask for much more from a leader. New grads are supported and given ample education opportunities to learn and grow in the role. Coming here as a new grad myself, was a great place to start and gave me a solid foundation.
I worked in the CTTICU for 8 months and it was the worst experience ever. The workload unreasonable and difficult, no support or teamwork from other nurses or techs. Providers would demean and bully nurses. There was absolutely no sense of teamwork. They treated new grads and new hires as idiots but were unwilling to support or adequately train new staff. They act like they’re the best of the best and maybe their surgeons are, but I’ve worked at much better and higher acuity CVICUs. Their turnover rate is ridiculous, no one stays for more than a year or 2 if that. Even the manager has only been a nurse for 6 years. They would all the time run out these incredible and experienced nurses because of how awful it is. When I asked about their turnover rate in interviews I was told “people only leave because of school.” Which is not true at all. People leave because of the workload, environment, leadership and most importantly the providers. Just awful. Everywhere else in the hospital seems good (especially the ER). Just stay far far away from 4 Roberts.
I worked CTTICU as a traveler back in 2022. I know this probably seems like a long time ago, but things have not changed from what I’ve heard. When I was there, the staff was horrible to travelers, the ratios were unsafe, and they showed no support when you asked for help. I would float to their emergency department and honestly preferred floating there. The emergency department staff were great! Just avoid 4 Roberts at all costs. Also, they may pay more, but it’s because it’s SO bad. They are also not very up to date with evidence based practice, having protocols that are extremely out of date.
Working at BUMC’s ED is very difficult due to the high patient acuity but it has solely made me a better nurse because of it. We are held to a high expectation by management to have precision in a fast past environment. The staff has incredible team work and I have rarely found myself to be alone in any sticky situation.
Loved this unit. Lots of amazing nurses willing to help and teach! Great unit culture!