the skill mix for icu and general-ward (med/surg) patients are very different.

in a sedated icu patient, there is less "interaction" with the patient; the techniques are mostly passive.

the situation is so very different in a general-ward copd patient with acute exacerbation for whom we may need to be tactful in communication (and even to a certain extent "charm" for the irascibly breathless patient) in order to elicit cooperation.

and for the new graduates who enter the work force, they are always the ones getting rostered for weekend and night duties, so they need to be able to work with icu patients.