Did I make the right decision?

  1. I recently finished my final preceptorship in the CCU and will be graduating on June 10. Yippee. During my rotation I had a lot of nurses asking me if I would be coming to work in the unit after I graduated. The nurse manager of CCU/ICU asked me three times if I would consider coming there after graduation. I told her I wanted to do some medical floor time first before I can the units to work. She seemed to be respectful of that decision although I later found out she called one of my professors and wanted to know how they could change my mind. I think I made a good impression on them <maybe flattering myself> :-) or else they just wanted another warm body to fill the void.

    My question is this.....Did I make the right decision be passing up this opportunity? This particular CCU is very busy with open hearts and seems like it might be a bit tough for a new nurse. I know one other student who has done it, but my gut tells me not to jump into something so tough. My plan for the last several years has been to get some time on a medical floor so I could become a well grounded nurse and then move onto critical care. I really want to stick to my plan.

    What do you of my decision? Would you have done such a thing straight out of school?

    Thanks for you advice and time! :-)

    Marc
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  2. 11 Comments

  3. by   Katnip
    Only you know the right decison. If your gut is telling you not to go to CCU, then listen to it
  4. by   marieparn
    Quote from mspringer
    I recently finished my final preceptorship in the CCU and will be graduating on June 10. Yippee. During my rotation I had a lot of nurses asking me if I would be coming to work in the unit after I graduated. The nurse manager of CCU/ICU asked me three times if I would consider coming there after graduation. I told her I wanted to do some medical floor time first before I can the units to work. She seemed to be respectful of that decision although I later found out she called one of my professors and wanted to know how they could change my mind. I think I made a good impression on them <maybe flattering myself> :-) or else they just wanted another warm body to fill the void.

    My question is this.....Did I make the right decision be passing up this opportunity? This particular CCU is very busy with open hearts and seems like it might be a bit tough for a new nurse. I know one other student who has done it, but my gut tells me not to jump into something so tough. My plan for the last several years has been to get some time on a medical floor so I could become a well grounded nurse and then move onto critical care. I really want to stick to my plan.

    What do you of my decision? Would you have done such a thing straight out of school?

    Thanks for you advice and time! :-)

    Marc
    Marc,
    Always listen to that "gut feeling" It is your inner voice guiding you. I graduated at 40 years old May 2003. I too was offered a position in our ICU after thinking it over for a week or two I decided to take a position in our Telemetry unit. I listened to that inner voice and I have not regretted one day. I took some flack from people when I turned down the position in ICU but I wanted to work with patients not just monitors (no offense to icu nurses) but from what I have seen there are one or two patients and alot of monitors. I would much rather take the five or six patients and the telemetry monitors. I feel that I make more of a difference in my patients lives and am able to do alot of education to my patients. It is wonderful to be able to teach a patient what Atrial Fib or What a Pacemaker or ICD does have them appreciate someone taking the time to educate them in people terms. I hope you make the right decision for you without pressure from anyone else. Good Luck, Marie
  5. by   IamRN
    Quote from marieparn
    I took some flack from people when I turned down the position in ICU but I wanted to work with patients not just monitors (no offense to icu nurses) but from what I have seen there are one or two patients and alot of monitors. I would much rather take the five or six patients and the telemetry monitors. I feel that I make more of a difference in my patients lives and am able to do alot of education to my patients. It is wonderful to be able to teach a patient what Atrial Fib or What a Pacemaker or ICD does have them appreciate someone taking the time to educate them in people terms. I hope you make the right decision for you without pressure from anyone else. Good Luck, Marie
    Confused here ????? ...What do you mean,
    but from what I have seen there are one or two patients and alot of monitors.
    I work SICU and we have a monitor (some w/several hemodynamic waveforms) to each patient. Are you talking about the different waveforms?

    I feel the need to clarify something...a monitor, or any piece of equipment, is just a tool. Not the entire picture of what is happening to the patient. You will learn that on the tele floor... the monitoring will be only one more tool for you and not tell the entire picture of what is happening to your patient; PEA for example! The patient is the most imortant factor! Not the machine Even if the monitor was showing my patient is asystole, I would not first call a code until I checked my patient first (and check in another lead!).

    The ironic thing about your comment is that I decided to jump into ICU after feeling like there was no way I was really accomplishing my personal goals as a nurse. "I" felt like a paper/pill pusher because I didn't feel I was spending the quality time with my patients (No, I don't feel that is what floor nursing is, that is just how "I" felt about myself. Having done many years of floor nursing, I have great respect for those who choose to practice as such ) It happened more than I care to think about, that one of my tele patients went down hilll and the other five or six had to fend for themselves because this one required all of my attention. I am much more comfortable knowing exactly what is going on w/my two critically ill patients, than feeling like I am letting my other five or six patients down.

    And time for teaching, well there was a department for that. Sure, I did teaching as I went, new meds, etc. (we all do it at different levels w/o realizing it), but there was absolutely no time for any in depth information There was videos for that....and the reason the videos were developed was due to the time crunch and patient load we already carried.

    To the OP, yes, go w/your gut instinct. Personally the many number of years I spent in tele, med/surg, step-down units was an invaluable resource of experience. Do new grads do well in ICU's, sure they do, but I can't comment on what their learning curve. Best wishes!
  6. by   marieparn
    Quote from IamRN
    Confused here ????? ...What do you mean, I work SICU and we have a monitor (some w/several hemodynamic waveforms) to each patient. Are you talking about the different waveforms?

    I feel the need to clarify something...a monitor, or any piece of equipment, is just a tool. Not the entire picture of what is happening to the patient. You will learn that on the tele floor... the monitoring will be only one more tool for you and not tell the entire picture of what is happening to your patient; PEA for example! The patient is the most imortant factor! Not the machine Even if the monitor was showing my patient is asystole, I would not first call a code until I checked my patient first (and check in another lead!).

    The ironic thing about your comment is that I decided to jump into ICU after feeling like there was no way I was really accomplishing my personal goals as a nurse. "I" felt like a paper/pill pusher because I didn't feel I was spending the quality time with my patients (No, I don't feel that is what floor nursing is, that is just how "I" felt about myself. Having done many years of floor nursing, I have great respect for those who choose to practice as such ) It happened more than I care to think about, that one of my tele patients went down hilll and the other five or six had to fend for themselves because this one required all of my attention. I am much more comfortable knowing exactly what is going on w/my two critically ill patients, than feeling like I am letting my other five or six patients down.

    And time for teaching, well there was a department for that. Sure, I did teaching as I went, new meds, etc. (we all do it at different levels w/o realizing it), but there was absolutely no time for any in depth information There was videos for that....and the reason the videos were developed was due to the time crunch and patient load we already carried.

    To the OP, yes, go w/your gut instinct. Personally the many number of years I spent in tele, med/surg, step-down units was an invaluable resource of experience. Do new grads do well in ICU's, sure they do, but I can't comment on what their learning curve. Best wishes!

    To each his own I guess. I think you misunderstood my comment. I do not want to spend my time with one patient and several monitors. I.E. ICP, Tele, drips, pawps, vents. etc... I know that monitors are pieces of equipment and the patient tells the true story, but I decided I want a patient that is not hooked up to several monitors that are constantly alarming. I decided that I wanted patients that were coherent and not so close to death on a daily basis. I am sorry that you did not have the time to teach your patients and had to leave that to videos. we also show videos but I go back and am able to answer questions by the family and patient. AgainI believe to each his own, what ever one feels comfortable with. I know for myself I made the right decision in not going to ICU.
  7. by   IamRN
    Quote from marieparn
    To each his own I guess. I think you misunderstood my comment. I do not want to spend my time with one patient and several monitors. I.E. ICP, Tele, drips, pawps, vents. etc... I know that monitors are pieces of equipment and the patient tells the true story, but I decided I want a patient that is not hooked up to several monitors that are constantly alarming. I decided that I wanted patients that were coherent and not so close to death on a daily basis. I am sorry that you did not have the time to teach your patients and had to leave that to videos. we also show videos but I go back and am able to answer questions by the family and patient. AgainI believe to each his own, what ever one feels comfortable with. I know for myself I made the right decision in not going to ICU.
    Oh most definite! ...to each his own. We each have different talents and expectations. I just couldn't help commenting because your comments struck so close to home.
  8. by   Tweety
    Congrats on graduation and congrats on the job offers. It's very flattering that they would offer this job to you.

    What do you want to do. Is CCU where you want to work? If it is, it's not necessary to have floor experience, take the job. If you're a bit unsure, then go to the medical floor, get that experience, get some skills that are less focused and make up your mind later.

    Good luck!
  9. by   mspringer
    Quote from 3rdShiftGuy
    Congrats on graduation and congrats on the job offers. It's very flattering that they would offer this job to you.

    What do you want to do. Is CCU where you want to work? If it is, it's not necessary to have floor experience, take the job. If you're a bit unsure, then go to the medical floor, get that experience, get some skills that are less focused and make up your mind later.

    Good luck!
    Yea, I would like to end up in ICU/CCU as a floart between the two someday, but I feel there is some experience to gain on the floor so I am going to go there for a bit. Maybe just a year or less, who knows, but when I fell ready I think I will know. For now, that's the plan.

    CCU was a lot of fun and I learned tonnes of stuff. I used to work in the computer field so I loved the monitors and getting to use my hand at the same time. I really liked taking the Swan-Ganz numbers and trying to interpret tele rhythms.

    Cheers,

    Marc
  10. by   Tina CTICU RN
    Hi! I graduated and went right into recover post open heart & thoracic patients in the CTICU. It is definitely challenging, but I have learned so much in one year. I do not know if you will learn quicker or learn more by first going to the floor. I would say if your goal is to work in CCU, then jump in there! You may surprise yourself.

    Tina :angryfire

    Quote from mspringer
    I recently finished my final preceptorship in the CCU and will be graduating on June 10. Yippee. During my rotation I had a lot of nurses asking me if I would be coming to work in the unit after I graduated. The nurse manager of CCU/ICU asked me three times if I would consider coming there after graduation. I told her I wanted to do some medical floor time first before I can the units to work. She seemed to be respectful of that decision although I later found out she called one of my professors and wanted to know how they could change my mind. I think I made a good impression on them <maybe flattering myself> :-) or else they just wanted another warm body to fill the void.

    My question is this.....Did I make the right decision be passing up this opportunity? This particular CCU is very busy with open hearts and seems like it might be a bit tough for a new nurse. I know one other student who has done it, but my gut tells me not to jump into something so tough. My plan for the last several years has been to get some time on a medical floor so I could become a well grounded nurse and then move onto critical care. I really want to stick to my plan.

    What do you of my decision? Would you have done such a thing straight out of school?

    Thanks for you advice and time! :-)

    Marc
  11. by   MelRN13
    I also went into CCU immediately following graduation, and it was the best choice I have ever made. But, I also worked as an LPN on a tele floor before becoming an RN, so I had a little more background knowledge. Whatever you choose to do, best of luck.
  12. by   Mais-Rose
    Quote from mspringer
    I recently finished my final preceptorship in the CCU and will be graduating on June 10. Yippee. During my rotation I had a lot of nurses asking me if I would be coming to work in the unit after I graduated. The nurse manager of CCU/ICU asked me three times if I would consider coming there after graduation. I told her I wanted to do some medical floor time first before I can the units to work. She seemed to be respectful of that decision although I later found out she called one of my professors and wanted to know how they could change my mind. I think I made a good impression on them <maybe flattering myself> :-) or else they just wanted another warm body to fill the void.

    My question is this.....Did I make the right decision be passing up this opportunity? This particular CCU is very busy with open hearts and seems like it might be a bit tough for a new nurse. I know one other student who has done it, but my gut tells me not to jump into something so tough. My plan for the last several years has been to get some time on a medical floor so I could become a well grounded nurse and then move onto critical care. I really want to stick to my plan.

    What do you of my decision? Would you have done such a thing straight out of school?

    Thanks for you advice and time! :-)
    Marc


    I entered CCU right out of school. I loved it, but it was very hard and stressful. I spent only 10 months there. Now, I had other things going on in my life at the time, so that may have added to my stress level. I know people tell New Grads that they should get Med/Surg experience before they specialize, and that may not be a bad idea. I think it makes you comfortable as a nurse, sharpens your critical thinking skills, and you get familiar with a wide range of cases. Well, today our critical care floors are kind of like Med/Surg. You get overflow patients, as well as Cardiac patients with secondary diagnoses. So I do not think it is of great necessity to start out on Med/Surg. I must admit though, that if you are learning CCU, then it would be of benefit not to have to also learn general nursing. You therefore can give your focus to your specialty. Think, if you already have a background in general nursing, then you can do that with your eyes closed, so to speak, and you can give the most of your attention and effort to life-threatening cardiac issues. Makes sense? However, If tele nursing or CCU is your goal, then I say go for it. Just prepare yourself to give it all you've got. Don't be afraid to ask a lot of questions, and ask them again if you're not sure. One other thing. Bear in mind that Med/Surg today is one of the most demanding floors there is. What with the Nursing shortage and high patient/nurse ratio.

    I though I'd share that with you.

    I'm going to sep out on a limb here. All in all, you finished nursing school, so I believe you may be able to handle anything else.

    Best wishes whatever choice you make.
    Last edit by Mais-Rose on Jul 9, '04
  13. by   cd48x
    if it's what you want, roll up your sleeves and go for it.
    it's a big challenge...if you feel it's not what you expected, you can always try another field. i have been in critical care 17 years.
    it was my goal in nursing. i had to work in a couple of areas before i knew it was my call.
    every nurse is needed. allow your heart and gut to take you where you need to be. i wish you the best! :wink2:



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