Medsurg/ Tele vs ICU vs Float Nurse

[mikkie1317]

Hello Dear Fellow Nurses

I am a soon to be new graduate nurse. I am conflicted between these specialties med-surg/telemetry, ICU and Float. I have 8 years experience as an LVN and i have always been fascinated by the Heart, Lungs and Kidneys. As an LVN I have attended several seminars regarding pathologies of these organs. I have no acute experience. Throughout my career as an LVN I inserted only one IV but hung IV's for the RN's that worked on the floor that was in 2007.Since 2008- present I have worked in Long Term care and presently I work in Home health. My goal as a future new graduate is to get the most nursing skills in 3-5 years then move on to be an NP. I enjoyed my clinical rotation in the med surge unit, but at times I feel as if it is refereshing my skills. At times I feel that ICU will improve my nursing skills. I am so confused. I have spoken to nurses wh have worked on all these units and most of them recommend that i float as a new graduate in all these units and after 1 or 2 years floating i decide. but floating has its disadvantages.

[dudette10, MSN, RN]

No acute experience=don't float, in my opinion.

This is my worry: new RN with admittedly few acute care-type skills, learning a facility, learning the charting system, learning the doctors, learning how to adjust your practice with discharges, admits, people unstable, and orders coming in fast and furious? You and your patients deserve a proper orientation with someone beside you for a few weeks.

It could be a shorter than usual orientation because you have been a nurse for quite some time, you already have assessment down pat, you can implement a nursing care plan in your sleep, the meds are not new to you, a medical plan of care isn't new to you, and you have an efficient med pass.

You could always join the float pool after a couple months. And all this might be my cautious nature talking, but you have to determine if its something you can handle off the bat.

As for the other choices, whatever floats your boat!

[Ruby Vee, BSN]

Hello Dear Fellow Nurses

I am a soon to be new graduate nurse. I am conflicted between these specialties med-surge/telemetry, ICU and Float. I have 8 years experience as an LVN and i have always been fascinated by the Heart, Lungs and Kidneys. As an LVN I have attended several seminars regarding pathologies of these organs. I have no acute experience. Throughout my career as an LVN I inserted only one IV but hung IV's for the RN's that worked on the floor that was in 2007.Since 2008- present I have worked in Long Term care and presently I work in Home health. My goal as a future new graduate is to get the most nursing skills in 3-5 years then move on to be an NP. I enjoyed my clinical rotation in the med surge unit, but at times I feel as if it is refereshing my skills. At times I feel that ICU will improve my nursing skills. I am so confused. I have spoken to nurses wh have worked on all these units and most of them recommend that i float as a new graduate in all these units and after 1 or 2 years floating i decide. but floating has its disadvantages.

Floating is a specialty in and of itself, and if you don't have acute care experience, you aren't in a position to be able to float successfully. I'd advise Med/Surg or step down experience if you think you might want to float in the future. After that experience, then try ICU. But try to get as varied experience as possible. If you've worked in the cardiac stepdown, try the Neuro ICU or the SICU rather than CCU. After three or four years of acute care experience. you'll be able to float.

[Concerto_in_C, BSN, RN]

I work in med-surg/telemetry but my cardiac cases are "lightweight" cardiac cases...they will have a run of PVCs occasionally and they could be in chronic A-fib, but if we have a truly worrisome heart rhythm then we ship them to the true cardiology units where the nurses have expert knowledge of unstable heart rhythms. I like med-surg a lot; most of my patients are true surgical cases, s/p appendectomy, lap cholecystectomy, lots of bowel obstruction cases and so forth.

When in doubt, start in med-surg. You can always transfer somewhere else. It's a lot better to start slow, than start fast and screw up. If you screw up, if you get fired or resign from ICU you can have problems in future job searches because recruiters are malicious in this economy and they will hold that against you.

Even in med-surg you see a fair number of nurses who don't work out and have to leave, so it is by no means an "easy" unit. It's a great unit to learn the basics and see if you even like nursing (you'd be surprised how many people realize it was not what they had expected).

ICU is very hard...leadership can be very heard on new people, resignations and terminations happen all the time...zero tolerance for making mistakes that jeopardize the patient.

There are lots of openings in our ICU units and nobody gives a hoot. I'm sure they get pounded by applications from new grads who don't realize what they're getting into.

Our med-surg nurses will almost never transfer to ICU. The last time we had such a transfer must have been 3 or 4 years ago. Our nurses will transfer to PACU or the new Cancer Center they just opened up, but generally everybody avoids ICU like the plague.

Good luck.

[mikkie1317]

Thanks Guys, I do appreciate the advice. I spoke with my nurse mentor and she said"when in doubt, go for med-surge, You can never go wrong with that choice".

[Ruby Vee, BSN]

Thanks Guys, I do appreciate the advice. I spoke with my nurse mentor and she said"when in doubt, go for med-surge, You can never go wrong with that choice".

Sounds like your nurse mentor is on the ball! Good luck with Med/Surg!