Help, I got a tough choice to make

purplegal · Aug 30, 2017

Wish I had four jobs to pick from.

Sounds like 3 of them require some cardiac/heart rhythm knowledge. How familiar are you with that? Or how much would you like to learn it? Your interest and current knowledge in that could be one way of narrowing it down.

kaylee. · Aug 30, 2017

It depends on what you are interested in and where you see yourself in the future. If you see ICU in your future then the stepdown would be the best place to go. Also you will want to make sure they offer a good orientation. You will get critical patients that end up transferring to ICU, and the patients that are higher acuity.

The other 3 units seem similar in that u see a mix of conditions, ie general med-surg. The ortho/neuro may b a little different, and depending on the stroke status of the hospital, you will get the stable stroke pts.

So its really up to u, what sounds interesting. Also really compare the management and the vibe you got on the unit. This ends up playing a role, as Im sure you know.

What are you leaning towards?

KeepinitrealCCRN · Aug 30, 2017

i would agree cardiac step down is your best bet. you will most likely learn the most. it does really depend what your step is after this if you even know at this point but the cardiac step down unit will give you great experience and allow you to almost go any place. good luck!

dream'n, BSN, RN · Aug 30, 2017

My choice would be the 3rd floor because it sounds like you would get a good mixture of patient diagnosis' with some telemetry thrown in. The transplant floor would scare me more than a cardiac step-down, but that's just me. And personally I don't care for Ortho (alot of the work is running around giving constant pain medications) or Neuro (lots of lifting, it's a sad floor to me with lots of strokes and total care patients with TBI). This is all my opinion and there are other nurses that enjoy Ortho and Neuro.

morganm_0819 · Aug 30, 2017

I really like the heart, it's always fascinated me. I sadly would have to relearn a lot of it though since o don't have much in the experience of it. I definitely wouldn't mind learning about it though.

morganm_0819 · Aug 30, 2017

I kinda keep leaning towards transplant, but I'm not sure. I haven't really though too much of ICU, it always made me nervous though in school and I struggled with it back in school, so I'm scared I would struggle for with it now.

The 3 types of med-surg floors would give me 8 weeks of orientation, while the step-down would be 12.

dream'n, BSN, RN · Aug 30, 2017

I kinda keep leaning towards transplant, but I'm not sure. I haven't really though too much of ICU, it always made me nervous though in school and I struggled with it back in school, so I'm scared I would struggle for with it now.
The 3 types of med-surg floors would give me 8 weeks of orientation, while the step-down would be 12.

All just my opinion, but I think floor 3 would give you an all-around nursing base without the focus on cardiac (like floor 2), but still learning telemetry. Floor 1 sounds like it doesn't know what in the world to be. Transplant patients are a specialty of there own without all the rest thrown in.

Emergent, RN · Aug 30, 2017

If you prefer to start with a lower acuity at first, I would personally choose choice three. MedSurg with the telemetry and some cardiac. There's nothing wrong with staying in your comfort level, and then moving to something more intense later.

Many years ago I went to acute care after working in a nursing home. I started out on a medical floor, I later did ICU in a small hospital, telemetry and cardiac step down in a bigger one, plus I did a lot of floating to ortho/ neuro. Now I work in the emergency room. I wouldn't have even considered that 20 years ago.

scuba nurse, BSN, MSN, RN · Aug 30, 2017

Are they all at the same hospital? I would pick by which hospital I would like to work at the most, going by commute, shifts, benefits, pay...etc..

morganm_0819 · Aug 30, 2017

All but the 3rd option are at the same hospital. Choice 3 is at a different location but under the same company as the other 3 options.

Ruby Vee, BSN · Aug 30, 2017

Okay, I'm new to this site, so I hope I'm submitting this correctly. I am really hoping to get some perspective on a tough choice I have to make. I have been a nurse for a little over 2.5 years, but all my experience has been in psych. I've decided though to leave psych, although I love it, to go med-surg,because I feel like I could learn a lot of skills I haven't gotten due to only being in psych. With that said, I recently applied to a few positions at a hospital and all 4 of my interviews went well, so the ball is in my court in as to where to go.
First floor I applied to was med-surg with telemetry capabilities that is the transplant floor. They see a lot of bad kidneys and livers and these patients have either received a new organ already, needing some observation post surgery before going home, or on the list to see receive a new organ.
Second floor was a cardiac step-down unit, seeing patients with a-fib or from cath lab. One example the nurse manager gave me was perhaps a patient post CABG, once they are off the vent. This one seems a little overwhelming perhaps to me, considering I don't have any med-surg experience so I've thought of shying away from this.
Third floor is a med-surg floor with telemetry capabilities the mixture is med-surg with cardiac patients.
Fourth floor is an ortho-neuro floor a friend of mine set the interview up with. She had told me there are a lot of bad backs and hips, and the floor received ESRD overflow from the transplant floor and stuff the ED sends up (COPD exacerbation, stomach pain).
I feel like I could really gain good experience which ever floor I go with but I feel stuck as to where I want to go. Any advice would be deeply appreciated.

Since most of your experience is in psych, I'm guessing you don't really KNOW which patient population really calls to you. Hence applying in four different areas. You just want to leave psych and get some "hands-on" experience. If this is true, then it doesn't really matter which of the four jobs you choose. That said, did you get a chance for a tour of the floor, to meet some of the staff or to shadow? Which manager did you feel the most comfortable with, like the best? Which floor "felt" best when you toured it or met the staff? Which floor offers the most orientation or the most planned orientation? Did you meet any of the preceptors? Did you like or feel comfortable with them?

At this point, I'm advising you go where you feel most comfortable/best liked/like the best. You'll get a great learning experience from any of the patient populations, but the teamwork of the staff and how comfortable you are with your manager, preceptor and orientation plan will make or break your experience at the bedside.