career advice

Ruby Vee, BSN · Apr 23, 2004

I've heard that it is safer (to prevent burn out) to start in MedSurg then step up to Critical Care. I want to be a critical care nurse when I graduate, but I don't want to get burned out. So, do you think I should start in med surg first or go right to critical care?
BSN2004NSU

Start in med surg. Learn how to assess a patient, how to communicate with patients and family members and how to work with the physicians. Learn how to put in a Foley quickly with the patient DTing, how to look up a medication while answering the phone and charting at the same time . . . . learn what nursing is like. After a year or so, when you feel competent with all of the above, then look into critical care.

If you already have the basics down, you can concentrate on learning the specifics of critical care. Your transition will be easier, your coworkers will trust and respect you more. And you won't be as quick to burn out. Really.

BSN2004NSU, BSN, RN · Apr 23, 2004

Thank you so much for your advice. That's what I had planned on doing, I just heard some of my classmates saying that you don't do things as precise when you step up to critical care...but I plan on precising my skills in medsurg.

ksrnstudent · Apr 23, 2004

My advice is to get a nurse tech position in your local hospital in ICU while finishing nursing school. I was just hired on at my local hospital working in MICU as a nurse tech. I have two more semesters to go before I graduate. I am able to perform skills I've learned in nursing school at my job. I think having the experience before you graduate will help prevent burnout. Just my humble opinion! :)

Renee' Y-Y · Apr 23, 2004

I would advise finding a critical care internship at a large teaching hospital...if critical care is what you really want to do...most of them are highly structured & you would get the additional instruction as well as precepted critical care clinicals.

BSN2004NSU, BSN, RN · Apr 23, 2004

Thank you both for your advice. I really thought about the nurse tech position because they are looking for techs at our big hospital. Thanks a lot!

BSN2004NSU

SickleMoon · Apr 23, 2004

Hi BSN2004NSU,

You've gotten some good advice so far--hope it helps you make the choice that is best for you. Let me add this: "Burnout" is almost completely under your control. Sure, they can slam you with long shifts, less-than-desirable work environments, etc, but it all boils down to how YOU handle it. Your best defense against burnout is to stay healthy, not just physically but mentally. Don't "live" the job. Have outside interests that you enjoy--hobbies, friends, something that allows you to get completely away from the job. It's hard to do at first, especially in a new environment because there's so much to learn so fast, but don't let your job hijack your life. Achieve a balance that works for you. You'll definitely have your ups and downs, as with any career, but the downs will be a lot shorter and easier to survive if you have a way to let off steam outside work.

Good luck and have fun!

BSN2004NSU, BSN, RN · Apr 24, 2004

I'll definitely keep that in mind sicklemoon. I didn't realize that it is under MY control. One thing I don't want to do is to bring work home with me.

EmeraldNYL, BSN, RN · May 10, 2004

Excellent advice SickleMoon. I started in the ICU and love it, but you have to be willing to go home and read about things that you saw that day or don't understand. You also have to be willing to ask lots of questions. At times it is very stressful and you WILL feel overwhelmed-- after 8 months I still don't feel completely comfortable. My recommendation is to make sure you get a long orientation with preferably one primary preceptor, and don't work any overtime in the first few months.

Havin' A Party!, ASN, RN · May 10, 2004

Also wanna thank everyone for contributing, since I'll likely face the question in the future.

Personally leaning towards the second option, as I'm significantly older than BSN. Otherwise, believe the first route is the way to go.

Dinith88 · May 12, 2004

In my opinion, the best ICU nurses (especially new ICU nurses) are the ones who've worked step-down prior to their transfer( miniumum of 2 years or so ). Step down (again this is just my opinion) is the 'boot-camp' of nursing. If you can work there and succeed, you can work anywhere and succeed. They've got 4-5 patients, are ACLS trained, know their cardiac stuff hands-down(ideally), and deal with critical care-type patients. Because of this, when they move to ICU their focus is more 'narrow' in regards to what they need to learn. At my place of employment, step-down/IMCU nurses occaisionally float to ICU, and are required to provide a nurse to the code-team when code-blue's are called.

martiforlife · May 19, 2004

I recently graduated from nursing school myself & I have always had a passion for critical care. When I asked this question of my peers and family (being RN's also) they advised me to start in med-surg. Unfortunately for them I decided that it would be more of an advantage to start off in critical care. Part of what helped me make that decision is that I had an opportunity to get over the ICU-jitters by working as a student tech in the SCVICU. After doing this for two years I learned that no matter where you start it does not make you any better or worse of a nurse than the next person. No matter where you go it will be a different learning experience. You have to consider your goals in for the next few years now whether or not you'd like to go back to school or become a CCRN. If critical care is what you desire I say go for it. Hope this helps your decision.