Should I take an SICU position or stay on medical surgical. Have never worked critical care but can't do 8-9 patients anymore

Yes!

You can always look outside the Acute care environments. Pharmaceuticals, clinical trials, physician practice, public health etc. Unfortunately, pay may be less

Ahhh, I remember my med-surg days! 8-9 is a bit much to handle! I'm betting you're not in a state with required safe staffing ratios. I transferred to Maternal-Child after a few years doing med-surg, best move ever! Some people thrive in med-surg .. I wasn't one of them! Fortunately, nursing does provide an opportunity to change specialties without changing your profession, or even work place.

The question for you is, do you have an interest in SICU? It will be an intense working environment, but in a much different way. You'll have different education / certification requirements, so you'll want to check into that and get as many of those as possible before transferring. You'll have a much better chance of transferring to any department if you've already taken the initiative to get certifications in advance .. ie: ACLS, critical care classes, etc. Maybe ask if you can shadow someone there to see if you'd actually be interested in it. Maybe talk with their manager about this and let them know that you're interested, but don't want to "waste" resources in transferring, getting required classes, getting settled on the unit, only to discover that you hate it! By shadowing, you could follow someone around in their day, get a bird's eye view, talk with the staff and get a feeling for how you'd potentially fit in, or not. I'm sure they'd appreciate your interest and willing to see if it's for you before committing to it. Good luck and Godspeed in finding your 'perfect' niche! Okay, Nothing is 'perfect', but you get the drift! 😜

i would just have them give them nutritional injection options for dietary services but there is always the health team prescribing for a medical discharge with it