Advice: Finding my niche. OR to ER

[mickeyrose912]

I am a new nurse working in outpatient surgery. I am in a 6 month orientation from January to July. I am being cross trained in Preop, Postop, Blood Transfusions and possibly endoscopy. I have completed pre and post. Been doing transfusions for 2 weeks. I am months ahead of schedule.

I hate to say it, but i am bored. I get up and drag myself into work in the morning. Because of this, i keep questioning nursing/the area i am in. I thrive in a fast paced environment and love to learn. The nurses on my unit are very knowledgeable, and love to have me, but they are all about to retire. I just feel like i don't belong there.

I have always wanted to work in the Emergency Room/trauma center. I worry that working on this unit is hindering my skills and making me lazy. In the preoperative setting most of my patients are stable. Many of my blood patients are seconds from being in the ICU (4th stage cancer, WBC of 2, wbc of 150, rbc of 2 etc.) but still stable enough to get there on their own.

I am thinking of continuing to get my nursing basics down and transferring to the ER after a year. How do you think the transition into the ER would be? Thoughts? Should i go to Med Surg? ( i would rather not)

Also, how do you know when you find your niche? My gut just tells me the ER.

Thanks in advance for any advice or constructive criticism!

[HouTx, BSN, MSN, EdD]

I applaud your desire for career development. But the statement about your patients being "seconds from being in ICU" but "still stable enough to get there on their own" is not congruent with current practice. It would appear to reflect a lack of understanding of today's acute care environment. Trust me, anyone who is sick enough to merit ICU definitely could not get there under his/her own power. MedSurg patients are sicker than ever these days - including those lab parameters.

Are you already applying for acute care jobs? If not, this is your first step. Keep an open mind - you'll probably have to accept less than your 'dream job' just to get your foot in the door. Chances are, it will be in MedSurg because that is the most challenging clinical environment for staff nurses in any hospital... and the one with the highest turnover rate. It's a great training ground, particularly if it includes Tele. If you can demonstrate a successful transition into MedSurg, it will improve your chances of moving into a more intensive setting such as ED.

Best of luck on your career move. Keep us posted on your progress.