Alternatives to Med-Surg

[Joe NightingMale, MSN, RN]

Hello all-

I'm a new grad on a big, busy med-surg unit at an inner-city charity hospital. I've been here 6 months and plan to work at least another 6 month, but then I'm planning to leave before I burn out or develop bad habits. I'm planning to go to another, better-equipped hospital, but I'm not sure what specialty I should go for. I'm looking for something less crazy than med-surg. The things I don't like about our floor include:

1. Very high turnover, sometimes 12 patients admitted and 12 discharged. I work on nights, and we average about 1 admit per RN per shift. Makes it harder when you constantly get new patients.

2. Wide variety...trachs, G-tubes, TPN, blood transfusions, heparin drips, colostomies, major wounds, pre-op prep, etc. Not a bad thing when learning, but I would prefer to focus on a narrower specialty as I think I could get a better sense of mastery and more confidence.

3. Very "heavy" patients, ie complete care. Overwhelmingly our patients are admits from nursing homes, bedbound with wounds and MRSA and incontinence and a million meds. Also we get quite a number of drug-addicted "frequent flyers".

So, what I'm looking for is a floor that will have a narrower range of conditions, allowing me to specialize. And fewer admits and complete care patients. I've been thinking about critical care, ortho, tele, rehab, and surgical.

I've seen or heard of examples of all of these types of floors that fit my criteria, but I've also seen or heard some more negative things about these same types of floors.

So I was wondering what you here think.

Thanks.

[mustlovepoodles, RN]

I think with a year of med-surg under your belt you'd be in a good spot to jump off into a specialty. What are you interested in? Adults? Kids? If you're not loving the chaos of your workplace, I would think that ICU might be a good match, but ER would not. Are you interested in oncology? That's a very rewarding field that leans heavily on med-surg. How do you feel about cardiac? Labor & delivery? How about working in an HIV clinic? You can also find all these specialties in peds.

[86toronado, BSN, RN]

First of all, cool name!

Secondly, I thought I'd just throw in there that if you don't like the high turnover, and prefer to get to know your patient's a little bit, you might like acute rehab. Patients are usually there for a matter of weeks instead of days, and still have acute problems, but are a little "better" than they need to be to stay on a med-surg unit.

[PostOpPrincess, BSN, RN]

What a fantastic floor to learn on.