Does it feel to everyone else that many newer nurses glamourize the ER and ICU?

[The0Walrus]

I'm curious. Most of the people I went to school with want to be ICU or ER nurses. They've never worked in the ICU or the ER but that's all they want to do. I told one girl who refused to work anywhere else other than ICU to go into a nursing home if she needs a job. She refused it and it took her a few months to finally go into a nursing home. She quit after a month because of her standards. It's the same thing when it comes to med surg and psych nursing. It feels like many newer nurses look down upon any other nurses other than ER and ICU.

Another girl I know said she's wanted to work as a psych nurse forever, but when she was offered the ER position and psych position she took the ER position. I asked her why she chose ER over psych and she said she knows ER better. Now she complains about the work load from a trauma 2 hospital. I asked her why she didn't just transfer into psych since it's what she wanted and she didn't really give me a concrete answer just basically that she's stuck.

Does it feel that way to anyone else? When it comes to ER/ICU it feels like they only respect those specialties. Thanks!

[LibraNurse27, BSN, RN]

Med/Surg is a great place to learn, but it can be stressful because of the bad ratios. Some alert and oriented patients are wonderful, but others are demanding, and are stable enough they can walk out of their rooms to ask for stuff! You have to be tough and organized for both Med/Surg and critical care, and have a high tolerance for stress, but I guess different types of stress.

On M/S I was stressed by the time management, lack of response from MDs, and some pt's behaviors. I was stressed when a pt went downhill and my other pts were neglected while I dealt with the rapid response/transfer. I did like being able to pass the pt off to the critical care team.

In Stepdown I'm stressed by more acute patients, multiple drips and IV lines, trying to do procedures under pressure. I can usually do IVs when I have time to look for options, but when it's under pressure I feel like I miss easy ones =( So now I call someone who's better, with no shame, LOL. I have floated to ICU during the surge to work under supervision of ICU nurses, and I know I don't want to do it. If you like adrenaline, are organized and can stay calm under pressure, I say go for it! But if someone goes to ICU/ER because they want to impress people and not because you actually want to do that type of work, you will be miserable. 

[frenchtoastwaffles, BSN, RN]

8 minutes ago, JKL33 said:

In part because the ED is no posh place where there are tons of resources either. It's chaotic and can be at least as demoralizing as any other area of nursing has the potential to be.

As to why the subject matter in M/S might not pique the interest of a new nurse--that's much more curious to me. There is plenty going on there, it heavily involves real, actual, hands-on traditional bedside nursing care. Opportunities for teaching, for rapport-building, for honing communication skills...in addition to the other nuts and bolts of it.

So taking these two things together it really does seem that a certain contingent of people just want to be where things are wildly reputed to be either adrenaline-filled or over-the-top exciting or big-shot in some way. Because anyone with a realistic view of things knows they aren't really all that. And anyone with a realistic view of things understands that there is plenty going on in med surg and lots of other areas.

The problem with floor nursing is that while ideally you have the opportunity to build rapport and teach, you oftentimes do not have time to do so in a meaningful or effective way. Yes, when things are moving smoothly these are the most rewarding experiences you can have on a floor. But when you only have an assignment for a day or two and those patients are all flying off to tests all day, one of your patients/families is continually demoralizing and scrutinizing or straight out not listening to you (despite your MS honed communication skills), you’re discharging the two patients you were able to build a rapport with but teaching got cut short because you have two admissions on the way. 

No, the ED isn’t glam. That’s something I’ve never tried and not sure I will, but I’m sure it’s more than a challenge some days and other days may drag. The ICU isn’t either, and both can be wildly overwhelming and intimidating. But we all went to school and connected with nurses in clinical who demonstrated how happy or unhappy they were and why. No one held back about why they love this or hate that. Many of us jumped on allnurses and read what people had to say.
 

Being entirely realistic, it’s not that med surg can’t be interesting or doesn’t have a lot to offer, but new nurses aren’t interested in feeling used and abused or burning out in the first two years into their career. 

[9kidsmomRN]

On 12/3/2020 at 7:45 AM, OUxPhys said:

bunch of medical shows now and Im sure the ICU and ER are glamorized from that.

Glamorized, yes, but so not real that it makes me want to puke. I can hardly watch any of them, and the few episodes that I have watched I criticize so much that my family can’t watch them anymore either. 
That said, new grads in my area seem to want ICU, nicu or L&D. Up until COVID wages at my hospital had been equal across the board. They said no need for ICU differentials because even though the ICU requires advanced skills we were “only taking care of 2 patients while the general floor nurses care for 4-8 patients (depending on the shift), so they deserve the same pay.” 

[JKL33]

18 hours ago, sarolarn said:

Being entirely realistic, it’s not that med surg can’t be interesting or doesn’t have a lot to offer, but new nurses aren’t interested in feeling used and abused or burning out in the first two years into their career. 

I know. My whole point is that the ED isn't where one might want to go to make sure they don't get used and abused or to avoid endless rough days where there's nothing but running around with little opportunity to make connections with patients while under a great deal of pressure.

I'm not trying to be argumentative, but overall this is a silly train of thought: "Well of course people prefer the ED more than m/s! On med surg you just run all day and have little time to use many nursing skills...." ? I mean, that is practically the very description of the ED itself!

 

[subee, MSN, CRNA]

On 12/4/2020 at 12:34 PM, Squeamish BBA LPN said:

1. Unless it has changed since I was actively working in acute care. ICU et ER specialties are [still] paid the most. 

2. ICU et ER specialties have been the most glamorized specialties in Hollywood et MSM. 

It just makes me smile when people who have NO IDEA what goes on in any specialty, decide right out the gate what their destinies are.  It's just part of the Aren't They Cute When They're Young syndrome.  I can't hold it against them because I did the same.  I was so sure that I wanted to be in psych but ended up in anesthesia after 10 years of a variety of jobs.

[TheSquire, DNP, APRN, NP]

Loads of people here forgetting that nursing students for over a decade have had access to social media, including this very forum.  They read and have an idea of what they're getting into, the monthly "How do I prep for x unit" posts notwithstanding.

[subee, MSN, CRNA]

9 hours ago, TheSquire said:

Loads of people here forgetting that nursing students for over a decade have had access to social media, including this very forum.  They read and have an idea of what they're getting into, the monthly "How do I prep for x unit" posts notwithstanding.

Oh yeah.  Social media.  That's a great to to experience a specialty.

[ruby_jane, BSN, RN]

On 12/3/2020 at 8:48 AM, NurseBlaq said:

The comments in this thread have taken me out! ?

^^^ same, under my desk choke-laughing ^^^

OP - most of us in nursing school didn't know enough to know anything. By that, I mean we had these ideas of what we thought life would be like. And life isn't like that.  What I tell new grads is: Your goal is to get a job that will safely train you to practice as a nurse - whatever that is, and whatever it looks like..

[Silver_Rik, ASN, RN]

OR was one of my top 2-3 choices from before I started nursing school.  The biggest influence was probably that my mentor through school is a Periop nurse though she never pushed me toward OR.  

In school I worked as a CNA in psych and LTC, and I could always see myself as a psych nurse, but told everyone I wanted to start somewhere I could develop my medical nursing skills.  I think I didn’t really expect to be hired into the OR straight out of school.

I figure “everyone” wants ICU as a stepping stone to CRNA school, though most of them end up doing something else.

And I liked doing my practicum on med surg