Any direction on areas of nursing I should consider?

[schade1]

I'm just starting my accelerated BSN program. I'm having a hard time envisioning myself as a nurse, because there are so many kinds of nurses, that I just don't know where I'm going to fit in. I'm looking for some suggestions as to which kinds of nursing experiences I should seek to experience while in school, so that I can find the right fit for me.

I've taken heaps of personality tests and am an ENTJ (definitely type A). I've worked in molecular biology labs, for pharmaceutical companies, and reviewing research for 8 years. I don't want to stay in research or work for pharma.

I know a lot about vaccines, infectious diseases, immunology, genetics. I know how to read and interpret a lot of different kinds of labs. I know a lot about drug interactions and metabolism. I know a lot about thyroid issues and cancer. I have no problems making decisions and stay calm during emergencies. I work really hard (like sprinting hard) and then peter out too soon. I mean I can't sustain my pace for more than two days. My boss says I do the work of three people in half the time. I'm terribly anal about documentation and I write too much. I have a lot of experience writing standard operating procedures. I have interpreted paternity tests, western blot results for Lime's Disease, all manner of lab results, medication interactions, helping people understand risks and what it will be like to be a bone marrow donor, describing what someone should expect is going to happen for various surgeries, describing why a doctor has prescribed a drug, and helping friends figure out if their symptoms are due to their condition or a drug side effect. People call me or ask me to go to their appointments with them, I research their issue, and then we talk. They like to hear it from me, because I am their friend, I do my research, and will not describe anything I don't know. Generally, people seek my help because their doctor doesn't have the time to teach them everything they would like to know about their condition. I do enjoy teaching people about their condition. Also, I have quite a few Vietnamese and Japanese friends who like to discuss alternative medicines, but don't want to discuss it with their doctors. I research these and provide them with evidence for or against and discuss whether or not they can incorporate both approaches (AHRQ AND NCCAM are good sources). I always tell them to discuss everything with their doctor - I'm don't counter what the doctor has suggested. Only once have I suggested the doctor was wrong; the doctor did not read a positive Lime's Disease result correctly and I told them to get a new doctor. They did and I was right.

I'm very petite - so am a little worried about physical handling of large patients. I don't EVER pass the buck though.

I expect too much of people who work for me and I tend to think a lot of people are not very smart - it's the ENTJ thing - I can't help it. People who are not self starters drive me insane. If I say, "This is now your task to complete every week;" I don't want to have to tell you to do it every week. I just want it done. I'm terribly logical. Good math and critical thinking skills like a lawyer.

My personality tests results show that ER nursing and ICU nursing might fit. I know I would like travel medicine/infectious disease (as in planning vaccines for travel internationally - not traveling around the country as a nurse).

Does anyone have any other suggestions for things I might not have thought of? Do you know any nurses that sound like the kind of person I am?

[schade1]

I did consider an MPH, a JD, and a PA. I found that nursing seems to offer the most career paths. Options are appealing. You are right, public health may be a good fit. Maybe I'll seek an experience in that arena, while I'm in school.

I think people maybe missed what I was asking for. I was hoping for suggestions on areas I might try to seek out learning experiences while I'm in school, that might then turn into a career goal for me after school. Sorry - maybe this post will make things more clear.

I think we get clinical hours in five basic specialties during school, one of which is ER. I'm excited to see what it's like and to see if I have the stamina. I may be able to ask for clinical experience in areas that are not in the ones they are offering. I think the areas are labor and delivery, pediatrics of some sort, ER, rehabilitation, and ICU. Any suggestions?

Comments regarding stamina: I can work part time. I'm not sure if part-time work is common. I prefer it. I know I won't have the pick of any job I want after school and will likely have to work nights etc. That's OK.

It's definitely not all about me. I'm giving up a lot to go to nursing school. I will make substantially less and will be starting over at 40. I've moved all the way across the country, away from family and friends, and uprooted my family to go to school. All this, because I want to learn something practical that can actually help people. I don't feel like my work has meaning in research - anymore anyway. It feels administrative, at this point.

I was a couple weeks from being on the beach in Chennai, India during the tsunami, where all those people died (it didn't all happen in Thailand). I couldn't change my flight and went there. I wanted to help, but don't have practical skills - only some knowledge. I was told leaving and not taking up a hotel room that could be used by a nurse or doctor would be the most helpful. There was cholera and malaria after the tsunami and I didn't have enough meds to cover me for India and my next destination. They had been using my room for refugees when I arrived. I left - I felt horrible leaving. I've never felt more useless. Since then, I have had a very strong desire to learn skills that can be used - really used - under any circumstance anywhere. So, I've quit my career and am going back to get another bachelors degree in something useful.

I do volunteer. I helped organize a free healthcare clinic that treats about ~4000 people in one weekend every year. This was very rewarding and drove me to want to learn practical skills even more.

I am a leader, but do not want to manage people. I can manage large projects, but don't want to have to delegate too much, or rely too much on others doing their part without micro-management. If they don't need micro-management - I'm great. It's hard to describe here. I am hard to work for - I needed to spell out my downsides in order to get good suggestions - but I'm not hard to work with. Hope that makes more sense. I was trying to explain so that no one would suggest that I seek to move into management, because of my personality. Been there, done that, don't like it.

Anyway, any supportive folks with other suggestions? I greatly appreciate everyone taking the time to have read my book ;-)

[LoriRNCM, ADN, ASN, RN]

PRN might be a good fit because you can pick your hours a little better, be part time if you want, or if you are PRN at more than one hospital you might be able to get lots of hours. I am planning on PRN for a while untilI get my BSN and trauma cert.

[schade1]

Thanks Lori,

That is a good tip for when I'm done with school. Maybe PRN would allow me to test out different areas of nursing, as well.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

Thanks Lori,

That is a good tip for when I'm done with school. Maybe PRN would allow me to test out different areas of nursing, as well.

Although every facility is different in their requirements, a LOT of places require that you have at least 1-2 years clinical experience before being given a PRN position. Some go as far as to calculate the hours that you have worked since licensure if you are new in to the field. As a PRN/FLOAT/AGENCY nurse, you will be expected to just fall in line and go to work.

As a nurse of many, many years with only three of those being as an RN, I tried to get a prn job that was less than 20 miles up the road. The hiring manager didn't care that I had more than 20 years experience working as an LPN plus 1 1/2 years RN expeirence as a float nurse plus 1 year as an agency RN on med/surg floors at hospitals that more than quadruples their little one story place. She said that I had to accept a fulltime position making $7/hr less than my LPN for a year before being allowed into a PRN position even though my actual worked hours far-exceeded the BON explanation of the number of hours required to equate to fulltime. There is no wonder that such a small facility is still in need of nurses. Being that I still had my current PRN position, though much farther away, I politely declined to be used for my experience for $20/hr less than my present pay. (Even one of the agencies that I had worked for, for 2 years as an LPN, told me that had I not already resigned my position with them, they were going to have to let me go because the hospitals that the staff required that documentation be provided to show 2 years experience in the discipline being considered.) My 2-yr mark as an RN was over a year ago and they started calling immediately.

This is not to burst your bubble, but instead, to forewarn you. After school and the NCLEX, you might have to suffer through a position that you DON'T want for a year just to gain the experience needed to be able to call your own shots.

Now, my sincere apology to you because after first reading your initial post, I thought, here comes another arrogant, self-serving, I-can-do-your-job-better-than-you student nurse with all the answers. But when I read your clarification post, I really felt for that confident-yet-powerless individual in that particular situation. And to be told that the only thing you could do to help is to leave, well, I know it gave a lot of perspective on what was truly important in life. So, for my rush to judgment, I am sorry. And I wish you well in nursing school and beyond!

[Fireman767]

I want to chime in about how your past comes into play

You do need to understand nursing has scopes of practice. regardless of your role before nursing, if interpreting the result is not in the scope of practice you can't do it. Im an EMT outside of nursing, and I know to diagnose a patient in 30 seconds and start treatment, however nursing has things we must do such as assessment and health history. The second you try diagnosing a patient with a medical diagnosis its over. your past history of what you did before nursing, if its not in your scope of practice then its useless to you now.

If a doctor makes an error you report it to the charge nurse, they decide what to do. If you speak up to the nurse and give him/her any indication that your saying their wrong, that doctor would probably request you switched off their patients, and if that doctor is liked (which usually they are) the unit would be less likely to give you hours or let you go. If the charge nurse says drop it and you mention something to the patient or let something slip or say something wrong you open yourself up to a world of legal issues, and your not an MD, you cant say what you want all the time.

All this said, i feel as though the MPH is a better route for you than nursing. You seem to want power and wide opportunities. You have options with an MPH, where as with nursing, your going to take a pay cut and more than likely work much more than you did before. You strike me as one of those people set in their ways because you think you have all this knowledge and experience and that worries me. Nursing is ever changing and it's not a top of the food chain job, infact were towards the middle when their is MD, PA, NP, etc.

On a side note

Also, maybe your friends and family ask you for advice, you need to be cautious. Your not a doctor, your not even a nurse yet. Research only goes so far and i think of it the same as WebMD, everything you selects lists every option including brain tumors and cancer. The doctor usually has been doing it longer and is better than someone researching. Your not Dr. House, you shouldnt be giving away medical advice. Especially if something goes wrong, your liable to be sued, and you have no defense, no title to hide behind and if you get your RN and someone sues you from years ago for any advice you gave, it may fall under medical malpractice and may take your RN away.

[eyesopen_mouthshut, CNA]

Have you made any contacts at your previous job that could point you in the right direction?? If you worked well with people and you networked, chances are you might be able to use that to your advantage in order to find a nursing career suited to you.

Have you thought about military nursing or anything like that? You could be stationed somewhere that deals with a lot of infectious diseases and with your experience in lab work you'd be a great asset. Just my thoughts... But in school, research, volunteer, and shadow as much as you can.

Sent from my iPhone using allnurses.com

[lamazeteacher]

Like many people with OCD, you have been many places and done many things; and know yourself well.

When you see a challenge, even though it could be more than you can handle alone (such as having your own physical limitations for lifting a 300 pounder, you see yourself achieving that, without assistance. That puts you at high risk for injury, unless there's a Hoyer ar hand....

You've taught people many things, but don't realize that they retain only 20% of what they hear - and that's if they're well and bright, unencumbered by pain or anxiety. Your ethical tendency and insistence upon honesty leave acceptance of human frailty in doubt. Your retention of information is laudatory!

So I think you're best suited for the OR or surgical recovery areas. Surgeons have similar attributes, but as others have posted, as a nurse you are not to be their critics. There are some really lousy surgeons who aren't outnumbered by superior ones. It would not be up to you to criticize their failings, or you'll find yourself being the type of traveling nurse you don't want to be! While I'd like to have only super achievers in nursing, I've seen too many who have little warmth, allowance for limitations, and lack forbearance for others' intellectual and emotional limitations when "caring" for their patients.

We agree about how important the correct diagnosis is for their wellbeing, and there are limitations in our role in that regard. We are not there to police doctors, and need to take heed of doctors' needs to stay in practice, so they don't destroy other doctors who might influence hospital boards hazarding the good they can do for patients. Looking at end results is very important in healthcare. Your completeness keeping accurate records would go a long way in the surgical and recovery arena.

Fortunately there are occupational safeguards in place to help you avoid overdoing your physical capacity in hospital work, and you shine as a member of a team. If ever that's important, it's in the Operating suite!! You'd be perfect for teaching OR techs after getting surgical experience under your belt, too.

If I've learned anything in 50 years of successfully practicing in many areas of nursing (OB, teaching expectant parent classes, Public Health, Employee Health, Infection Control, and Home Health), it's that having an occupation that emphasizes personal well being is extremely important. Be sure that you take vacations, have time off for recreation, and most important of all, a pension!!! Throughout your career, it's of utmost importance to be true to yourself, as you have been in describing your capabilities. Be sure of your facts, and aware of your enemies.

[Hockey Lover]

I would suggest getting experience on a Medical floor while working your way to a Doctorate in nursing... I can see "nurse practitioner" written all over you! However, please use the time on the floor to enhance your...people skills.

[SENSUALBLISSINFL, BSN, RN]

To the OP I wish I can give you suggestions, but as a new graduate I am not in a good position to give you great ones, but I will try.

Nursing; as you will soon find out, it is like no other education you have obtained, and the same goes with the working atmosphere from what I read on here. Sometimes, we will be forced to work with people that will make us wonder how on earth did they make it to the floor. Also, from personal experience though you may have a favorite specialty that you make want to work in, you may not be afforded this when you graduate. NICU or ICU have been my favorite units, but after a year of being an RN, I have still to find a job and at this point, any unit to start getting experience will do .... sigh....saddly. Depending on the area you live in, it may take quite a bit of time to get a job, and when you do, it may be in any unit that you were able to find a job, as the market is really not so great.

From what I read, I think a position as an NP may be suitable for you. In the meantime continue volunteering. You will eventually find your place.

Good luck.

[green34]

I would suggest getting the basics down in med-surg and then moving into infection control. However, I would recommend getting at least 1 year of experience. My ex's mom moved straight into infection control and some nurses do not take her seriously.