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Am I being "dumbed down" in my current dept?

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by proudnurseRN proudnurseRN (Member)

1 Article; 5,072 Visitors; 187 Posts

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I don't know if I'm looking for advice, others that have experienced this, or just rambling... but here goes.

I'm smart. Now I don't mean to brag about it, but it is what it is. I'm not trying to say that makes me super-nurse by any means. However, I graduated in May 09' with a 3.96 (stupid French class) and studied half the time that others did. I passed NCLEX with 75 questions and under 30 minutes. I know my nursing stuff. At least book wise. Or at least I used to. Here's my situation.

I work a general medical floor that specializes in ortho-uro-neuro. I have worked here since May 09' I chose this unit because I personally don't think new grads should work ICU, ER, critical care units to begin with. Now I realize there are some new grads that make excellant nurses in those specialities, and I'm not downing you. It was important to me though to get my basics together before worrying about needing even more hands-on knowledge.

The other day I float to a telemetry floor and I am way out of my element. ECGs look like a paper with scribbles. Chest pain protocals? Angio-caths? Where to these leads go? I am thrown off guard, out of my element, and truthfully kinda scared. Fortunately I have good nurses by my side, interpreting ECGs and writing notes on my patients.

The problem is, I could do this a year ago. While I don't consider myself an expert in any sense at my current job, I do consider myself proficient. Another important consideration is that I'm looking at going into a NP or PA program in fall 2011.

So, do I stay where I am comfortable, with co-workers and patients I really do like- a good unit with decent management, or do I move on... to increase my knowledge base and refresh my memory on those things learned? Or do I go into unknown water and hope for the best. If I move on I'm looking at an ICU type setting, as I cannot do Peds often. That eliminates the ER.

I keep remembering a discussion I had with one professor... telling her that I studied for a test 2 hours beforehand. That I could study for hours and hours days before, but I really did my best with retaining information and applying it when the pressure was on. Her words were "that makes for a great ICU nurse"

Any suggestions or advice is greatly appreciated.

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1,718 Visitors; 41 Posts

As a new grad who went straight into ICU (shame on me!;)) the only advice I can offer you is that you seem like a smart girl, you seem to have it together, with a 3.96, you should be able to figure out whether or not you should stay in your unit or leave. :twocents:

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1 Article; 5,072 Visitors; 187 Posts

As a new grad who went straight into ICU (shame on me!;)) the only advice I can offer you is that you seem like a smart girl, you seem to have it together, with a 3.96, you should be able to figure out whether or not you should stay in your unit or leave. :twocents:

Touche, my friend.

So some honesty here. I hate change. Particularly when you go from good to the unknown.

However, I know I need more diffuse experience to further my education and be a better provider, no matter what decision I make regarding NP or PA. However, I also think that maybe even being an NP or PA may not be what I want either.

Quite frankly, I need to figure out what I want to be when I grow up, and was just wanting opinions, advice, stories, whatever anyone has to offer.

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mh356 is a BSN, RN, EMT-B and specializes in NeuroCritical Care, Neurosurgery.

4,388 Visitors; 53 Posts

Can you try telemetry or a step down unit? It would be good to get some critical care experience before starting NP school. Sounds like you are comfortable in your unit but might need some new challenges to keep things fresh. Or think about certification in a specialty or getting your ACLS. There are alternatives to the ICU setting if you want something different. ;)

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1 Article; 5,072 Visitors; 187 Posts

I think if I'm going to jump, I might as well go all the way. Right now the only thing I've considered is ICU. (keeping in mind that this is a mid-level ICU in my hometown. Much more to learn, but still not too high acuity. No speciality areas except cardiac really.

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ukstudent specializes in SICU.

8,659 Visitors; 805 Posts

First you need to figure out what it is you want to do. NP and PA are based on very different models of care. NP programs are specialized but can be done part time. PA are generalist and can specialize after graduating but are full time studies. Does your career plans make it important that you do ICU or not. If you want to be a FNP then ICU is really not necessary.

If you are going the PA route in 2011 then please don't go. It takes a lot of effort from the staff to train a nurse, it takes more than a year to know what you are doing, by which time you would have already left.

Please remember that when we graduate as nurses we are all generalists. We all know a little med/surg, a little ortho, a little peds, a little ob/gyn, a little tele, etc. I know that if you put a fetal monitor strip in front of me now, that it would not mean anything to me. That doesn't mean that I should go to L&D.

So think about why you want to go to the ICU. Has it always been a goal, is it part of your career path? If so go. If it's because your ego got bruised from not being comfortable on the tele floor then it is probably not a good idea.

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1,137 Visitors; 29 Posts

Yes you are braggin' and people that are smart don't brag... A 3.9 gpa doesnt mean you are smart, you might have cheated or you just study for exams without really knowing your stuff... And your post doesn't make any sense either, with a 3.9 gpa you should be able to figure out what you want to be when you grow up.

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juliaann has 1 years experience and specializes in ICU.

12,191 Visitors; 634 Posts

Yes you are braggin' and people that are smart don't brag... A 3.9 gpa doesnt mean you are smart, you might have cheated or you just study for exams without really knowing your stuff... And your post doesn't make any sense either, with a 3.9 gpa you should be able to figure out what you want to be when you grow up.

I really don't think that's very fair to the OP. While he/she probably didn't need to include the EXACT GPA ;) I think it's fine if they want to give us a little insight into the type of person they are. To imply they might have cheated is really pretty rude, considering how much time and work goes into nursing school - even if you are a smart cookie.

He/she is just looking for some outside opinions, and has gotten a few good ones. There's no need to be insulting.

Just because someone has a good GPA means they can't evaluate options for the future, and be a little undecided/not know "what they want to be when they grow up" just yet? I'm in some serious trouble then...

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Moogie specializes in Gerontology, nursing education.

1 Article; 22,272 Visitors; 1,796 Posts

I

I work a general medical floor that specializes in ortho-uro-neuro. I have worked here since May 09' I chose this unit because I personally don't think new grads should work ICU, ER, critical care units to begin with. Now I realize there are some new grads that make excellant nurses in those specialities, and I'm not downing you. It was important to me though to get my basics together before worrying about needing even more hands-on knowledge.

The other day I float to a telemetry floor and I am way out of my element. ECGs look like a paper with scribbles. Chest pain protocals? Angio-caths? Where to these leads go? I am thrown off guard, out of my element, and truthfully kinda scared. Fortunately I have good nurses by my side, interpreting ECGs and writing notes on my patients.

The problem is, I could do this a year ago. While I don't consider myself an expert in any sense at my current job, I do consider myself proficient. Another important consideration is that I'm looking at going into a NP or PA program in fall 2011.

So, do I stay where I am comfortable, with co-workers and patients I really do like- a good unit with decent management, or do I move on... to increase my knowledge base and refresh my memory on those things learned? Or do I go into unknown water and hope for the best. If I move on I'm looking at an ICU type setting, as I cannot do Peds often. That eliminates the ER.

I keep remembering a discussion I had with one professor... telling her that I studied for a test 2 hours beforehand. That I could study for hours and hours days before, but I really did my best with retaining information and applying it when the pressure was on. Her words were "that makes for a great ICU nurse".

First of all, I don't agree with posters who are telling you that you're "smart enough to know what you want to do". I think you are smart in asking for feedback and for admitting that you don't know it all! I'd be concerned if you were coming on here and saying that you thought your experience in telemetry was a walk in the park because you already knew everything.

I don't think you are being dumbed down in your current position; you are, however, experiencing the phenomenon of skills building in nursing, the process by which a nurse progresses from novice to expert. You have moved past the novice stage and are moving from being a beginner to become more proficient. You may be feeling a little unchallenged because you aren't learning anything "new". I also hear that you are concerned that you are getting too settled into a comfort zone and are interested in challenging yourself. I also hear that you want some ICU experience but that you're afraid that you've lost the knowledge you had and that you would be starting from square one. Yes, you will go through the novice to expert cycle again---you will do this many times in your career, every time you change your floor, every time you get into a new role.

I get the feeling that you're unsure about NP or PA school. As other posters have said, there is a huge difference. I get the feeling that if you go into either program before you have had a chance to work ICU, you may regret it. Yes, you can always work ICU as an NP or while you're in school, but since you aren't real sure yet of your goals, why push yourself into starting a program before you are ready? The experience would also make you a more well-rounded practitioner and it may open the door to something you have not previously considered, like becoming a CRNA.

Patricia Benner is the nursing theorist who came up with the theory of skills acquisition in nursing, and she has published a book about the novice-to-expert phenomenon. I strongly suggest you read it as you will see yourself in her words of wisdom.

And you know---if you are happy where you are, if you do feel sufficiently challenged and don't want to try anything else at this point, it's okay to stay where you are. You do have plenty of time to make a decision before going back to school and you also have your entire career ahead of you, so although you may be putting pressure on yourself, there really is no rush.

I think you are very wise as well as smart and you have the potential to do whatever you want. Please feel free to PM me if you would like to discuss this off the board.

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826 Visitors; 6 Posts

the best thing you can do for your career is get used to change. constant change that challenges your thinking. so many nurses freak out if they have to float from one floor to the other with basically the same kinds of patients. i heard a nurse in the cafeteria complain that she had to go help pass meds on the floor instead of getting flexed off. is she kidding? in this economy, she is complaining that "has to" get paid 40 plus dollars an hour to pass meds while just about every other profession is losing their jobs!

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1,137 Visitors; 29 Posts

I think the op comments are rude...He/she should learn to be sensitive...Don't rub your gpa on people's face...He/she is trying to say people with a gpa

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5,612 Visitors; 310 Posts

First- take a bite of humble pie.

Second- no unit is going to dumb down anyone. You are simply becoming more proficient in the care of that type of patient. If you want to expand, then go elsewhere. But realize, going elsewhere isn't necessarily a step to being 'smarter' but rather an opportunity to gain more experience in caring for a different population.

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