Confused & a little discouraged?

[gennn19, BSN, RN]

Hello everyone,

I'm a nursing student going into my senior year this fall. This summer I've had the wonderful opportunity to do an externship at an orthopedic hospital in NYC in which we get to rotate every week to a different unit. This is the first time that I've gotten so much exposure in a hospital as I've been going 5 days a week for almost a month now. So far I've been at the outpatient clinic, pediatrics, ortho/neuro med-surg, and PACU. Soon I'll do more med-surg, OR, and ICU. Lately I've been thinking so much about what specialty I want to choose after graduation and I'm feeling very overwhelmed.

My dream since high school has been to be a CRNA and I know I'll need ICU experience for that. However, I wanted to go a slightly different path and work at the PACU first to get to learn about anesthesia this way and then move on to the ICU eventually. This was reinforced by my time at the PACU. This hospital even has a PACU training program that is co-directed by the same nursing educator who directs the externship I'm currently in, and I'm almost sure she'd have no problem helping me get in when I graduate (we're basically guaranteed RN jobs here as new grads).

My dilemma is-- throughout every unit I've floated to there is always a handful of RNs who tell me to do med-surg before specializing. But I really don't feel that med-surg is for me. Med-surg rotations in nursing school were OK but they were not my favorite. However, experiencing med-surg now has shown me that I truly do not like this type of nursing. I know that it is important to get your feet wet and learn to prioritize, give meds, manage time, and learn lots of clinical skills that I wouldn't get to learn in the PACU or ICU, but just the thought of being a med-surg nurse drains me. I am afraid that if I do a PACU training program and then go to the ICU I'll be lacking the skills everyone praises med-surg for and I am also afraid that I won't be a good nurse if I skip the med-surg experience. I really do want to be a great nurse and learn as much as I can before CRNA school

[i also really enjoyed pediatrics and I actually would not mind pediatric med-surg but I feel that the medical problems in pediatrics are probably kind of different from adults/geriatrics (e.g. kids don't normally have a ton of co-morbidities in conjunction with acute medical problems) but I could be wrong.]

I'm really feeling confused, torn and discouraged.

Sorry for the super long essay. Any input would be greatly appreciated.

-Confused nursing student

[Lanesmama]

Genesis:

In nursing school, I was like you. CHF? Ugh... another pneumonia patient? Blah. Give me the good stuff. I remember clearly thinking "all you nurses telling us med surg is where to start... don't know anything."

And I followed my *dream* of being an OB nurse. Well, that ended up definitely NOT being the nurse so wanted to be. Being the new girl, I was blessed to work postpartum most of the time (blech!!!!) skills? Forget about them! I was a glorified CNA. When I left, I *got* to go to a nursing home. Yay me! Still didn't get to do much.

I finally decided to listen to the annoying voices in my head. I took a position in surgical/trauma and pediatrics. We also get overflow medical. And guess what?! I LOVE IT! I get to use my brain. I get to do really awesome things like burns, wounds, packing, my insertion,.... ETC.

I know there are people alive today as a direct result of me being a good nurse. That feels amazing. 2 1/2 years later, I know there's still so much to learn here. Do yourself a favor and listen to those annoying voices. Find a unit that isn't med/surg all together.

Good luck.

[gennn19, BSN, RN]

Lanesmama-- Thank you so much for your input. I agree it's a good compromise to not work med-surg all together. I had no idea choosing a specialty would be so overwhelming!!!

Any other input by anyone would be greatly appreciated.

[RNGummy40]

Dear genesis1930,

Congratulations, you have a very UNIQUE opportunity to pick from a variety of nursing fields to start at in your practice. Not every nurse has that opportunity, so take a moment and enjoy!

Your concern over choosing a medical specialty versus med-surgical nursing I find interesting and yet I think you may have a, "birds eye view," trying to make this decision.

When I graduated from nursing school, I immediately entered a psychiatric nursing position. I worked with patients that pushed buttons, and tested the limits of nursing care. I have always believing in holistic nursing and while I managed their psychiatric needs I never ignored their medical needs. Med-Surg nursing teaches a nurse how to say, "STOP," how to say, "This is not evidenced based care." Med-Surg nurses tests the nurses' limit in managing patient care. Med-Surg nursing handles a variety of nursing care issues (wound care, cardiac care, psychiatric care, neuro, addiction, oncology, ortho, surgical) and assists the nurse in planing interventions and prioritizing care.

My Med-Surg nursing made me a better psychiatric nurse and while I specialized I did not loose vital skills, but build a solid clinical foundation.

I am not saying your should not specialize but I am pointing out the importance of Med-Surg nursing. You don't have to build these and other skills only through Med-Surg nursing, but the stakes are higher, and the impact of your decisions when you specialize have a greater significance on your nursing practice. Good luck, enjoy each moment, allow your self time to learn, and much success.

[gennn19, BSN, RN]

RNGummy40 Thank you for your input. I do consider myself very lucky! :)