Hi, folks. Just wanted to get some feedback from new and experienced nurses on this one.
I've just started my 400-hour clinical immersion in the PACU and LOVE IT. It was what I wanted and applied for, and so far it seems like I have found my niche. I have a long way to go, but it's a journey I will enjoy, at least through the end of school: it appears that most PACUs won't hire new grads. My preceptor said that if I could find a hospital with a residency or strong orientation program, that might be the exception. I know there might be other exceptions if I do a great job, but frankly, right now I'm just trying to get through this last year of school and will revisit that in the fall when I get ready to graduate.
Here's the question, though: what IS the best route to the PACU? Or any other specialty, for that matter? When I look at the experience of the PACU nurses I've met, it varies widely. Some worked med-surg, MANY worked ICU, others were on special units like cardiac or in the ED, and a few came from LTC. I'm not here to debate the advantage of getting experience before working in the PACU
(I debated that in a previous post!), but I'm a bit frustrated at the apparent lack of a "track" to enter this or any other specialty area.
Nursing as a profession struggles with the issue of a single educational path (AD vs. BSN vs. direct entry MSN like mine). I think this issue is just as important. When a person decides to become a cardiothoracic surgeon, the path is clear: 4-year college, 4 years of med school, general surgery internship and residency, then specialized training in CT. If the person wants to be a nephrologist, the path is school, then internal medicine residency, then fellowship in nephrology. Very clear, very cut and dried.
In nursing, there either is an optimal way to get the experience necessary to work in a specialty area or else it doesn't matter. When some folks tell me that new grads CAN work in the PACU and everyone else recommends a different path to get there, I start to wonder if this is tradition, or people thinking their path is best, or if there is some basis to it. Yes, I'm looking for the evidence base. I'm more than happy to work in the ICU for a year if it will in fact be the best preparation for me to work in the PACU.
If there is a better path, I want to be on that one. But how do I know? ASPAN has developed a position statement regarding the AD vs. BSN issue, but I can't find any such document delineating the best way to become a perianesthesia nurse!
This isn't limited to PACU. What about the NICU? As a mom of a former preemie, the idea of a new grad in the NICU is horrifying, yet a classmate of mine is doing his immersion in the NICU and I think he'll be brilliant. What would best prepare him for a career in the NICU--adult ICU? Pedi? OB/nursery? Or just being in the NICU with a strong mentor and preceptor? One area that does seem to follow a specific path is RNFA; one starts as an OR nurse with scrub and circulating experience, CNOR, then a preceptorship with a surgeon, etc. Why aren't there more paths like this?
In my opinion as a student, having more clearly delineated professional pathways would simplify matters for those interested in specialties. It seems that many nurses meander their way into their current specialty, which can be a wonderful process full of rich experience. However, I know where I want to go, but I don't know quite how to get there.