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Discussion

Am I Crazy?

I am about to graduate from an ADN program, I just finished my practicum on the ICU floor, I already have a nursing position lined up after graduation with the same system but at the smaller med/surg unit near me. For the past 2 weeks they keep asking me to switch to their floor and cross train to the ER (I'll also have my ACLS by the time I get my license) I keep telling them not right now, don't get me wrong, I absolutely looooooved ICU & ER and plan on going down the critical care path, BUT I just really feel that while I could do the job now, I could do the job ALOT better after a year or so on a med/surg floor, I'm extremely pleased and flattered that they want me on their unit as a GN and brand new RN, and I guess I'm better on the floor than I thought I was. But even the docs say I'm crazy to want to do med/surg but where else am I really going to get good at time management? Time management with 2 critical patients has been very easy for me, but 5-7 medical patients is a whole new ball game that I want a few innings of for experience. My hubby really doesn't care which position I take as long as I'm happy with it, part of me feels like I'd be bailing on the unit I already agreed to work on (I am currently their unit clerk so I have a good relationship with the managers, DON, nurses and docs already built) darn loyalty bone lol So my question to experienced nurses is, am I crazy to not jump at the offer and opportunity or is my brain right in saying do med/surg for a while which I also enjoy?

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I think it is possible to go to the ICU or other critical area right from nursing school. However, that said, you must have a solid orientation. Sometimes what happens is that if you are an extern, tech, etc BEFORE you graduate from school and have RN behind your name, then they take more for granted and sometimes do not give an adequate orientation.

I would say go with the med-surg. Good luck.

Do what ever you feel like doing and what you think will make you happy!

Best of luck with your choice!:nurse:

I went to ICU/ER right out of nursing school and I tell you, it was the best thing for me. I feel like I am learning so much about the disease process. I feel like I am doing holistic nursing because in ICU the ratios are so good. 3:1 max. I can actually read and understand the labs, I can look up the meds, I take care of my patients solely for 12 hours. I feed them, bathe them, walk them, treat them, talk in depth to their Drs about them ... I know so much about them and their conditions and I learn so much every shift.

Our ICU and ER are a team effort and we mingle staff amongst the 2 depts. So even though I am assigned to ICU and that is my main sched, we fill in ER holes in their sched and vice versa. So i also get that great fast paced exp as well.

I know alot of my instructors told me Med Surge was the best place to start, but I feel like I am learning so much more than my classmates that went to a Med Surge floor. Plus I dont know if my ADD/OCD could handle an 8 pt med pass!!!

Best of luck on what ever path you chose, but dont count out ICU just yet, think about it. I could not be happier.

I totally agree with racingmom-4. I went into Peds ICU right after graduation (had been a unit secretary there for 8 years). I did my school preceptorship there also.

My OCD tendencies would not allow for a much higher ratio of patients. Another RN was razzing me about how I wasn't happy that my patient was off center in her bed and she must be centered. I get antsy if it's 0910 and all my 0900 meds are given.

We are in the process of cross-training with our Peds CVICU. Prior to this, we would get floated to any peds unit, including the neontal intensive & progressive areas. Being given 4 patient just about blew my mind on the peds floor!!!

You sound like an intelligent, together person. You also come across as one who does have good time management if you are doing 3 ICU patients. Out max is generally 2:1. I love total care aspect of the ICU!

At the end of the day, do what's right for you. I knew what I wanted and I did it and don't regret having little floor experience at all.

Go with what you believe will make you a stronger nurse. The hard thing with this topic is, everyone's ICU/CVICU/ER is different. At my first rural hospital our ICU took on Cardizem drips and insulin pumps, rarely had more then one to two beds filled and was generally the most boring place when I was floated down to orient. Could I have worked down there as a GN? Probably, the acuity was not very intense. (My point is I could tell you "yes ICU is so nice", because in THAT hospital it was less work then my current M/S floor!)

Now on my current Complex Tele Med Surg floor we handle all those same patients and more, people don't go to CCU unless they are really going down fast. I get a six patient load on nights, I get 100% hands on time with my patients and I love it.

So my advice is this, look at your ER/ICU, and go with your gut. Make sure you think it will be a safe place for you to learn your skills, and if you decide in the end that you need that year on Med-Surg then go for it. It is your career, you sound like a person who really knows themselves, so don't doubt yourself.

Best of luck!

Tait

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