Emergency or Critical Care..Its up in the Air!!??!!

[jellybeanmead]

hi good people. i am graduating from nursing school in one week. i had an interview for a critical care internship and an ed internship. they said they have all the needed people for the critical care one and offered me the ed intern. however, i am not sure if i really want ed. i think i like icu more because i like patho. and i would have more time to assess my patient. i haven't really had a lot of experience in ed, but, i have not found the area for which i have a burning desire for. i was thinking maybe i should give it a try, but i am not sure. i have heard so many stories about the ed. your experience and input would greatly help me. i am so confused. please give me some pointers. :uhoh21:

[WVUturtle514]

My advice would be . . . . NEITHER! Do yourself and your patients a favor and do a year of med-surg, then go into ICU.

As a new-grad I wanted to go straigh to ICU. I NEVER wanted to do med-surg, and went straight into a CCU stepdown. I soon realized I bit off more than I could chew and was miserable. It was also a terrible teaching environment with inconsistent, undedicated preceptors, and an abusive manager. After about 10 weeks I'd had enough.

I did a year of med-surg, got bored, went into an extremely busy ER in New York City where I've been for about 9 months, and I'm doing great.

Patience . . . .

I think this is all situation dependent though. It sounds like you had a not-so-good experience in the ICU. OTOH, my experience was a complete 180 of yours. I started as a new grad in the ICU and it was great. I had wonderful preceptors, a very supportive manager and a wonderful teaching environment. I do think that there are ICU's that are not good for a new grad to start in, simply for the reasons you stated above, but it is not like this everywhere. I think that if ICU is something that the original poster wants to do, then she should go for it. No need to spend time on a med-surg unit if you have no desire to be a med-surg nurse, just like there was no reason for me to work L&D for a while.....I had no desire to be an L&D nurse. Like I said, experience will only help you, never hurt you. If you feel that you need experience in med-surg before going to an ICU or ER, then by all means do that......but it's not necessary for everyone.

[aquaphoneRN]

I think this is all situation dependent though. It sounds like you had a not-so-good experience in the ICU. OTOH, my experience was a complete 180 of yours. I started as a new grad in the ICU and it was great. I had wonderful preceptors, a very supportive manager and a wonderful teaching environment. I do think that there are ICU's that are not good for a new grad to start in, simply for the reasons you stated above, but it is not like this everywhere. I think that if ICU is something that the original poster wants to do, then she should go for it. No need to spend time on a med-surg unit if you have no desire to be a med-surg nurse, just like there was no reason for me to work L&D for a while.....I had no desire to be an L&D nurse. Like I said, experience will only help you, never hurt you. If you feel that you need experience in med-surg before going to an ICU or ER, then by all means do that......but it's not necessary for everyone.

I agree with you, there are new grads who successfully go into critical care and do quite well. I think the main factor is the quality of the teaching they receive on the job. Excellent, experienced preceptors, adaquate staffing and supportive managers are necessities.

I did have a terrible expereince as a new grad in CCU step-down, and a better preceptor and manager would have made a huge difference. That being said, the ER where I work now had a pretty lousy teaching program, but because of my med-surg experience I was able to adjust without too much difficulty. Had I entered this ER as a new grad, I never would have made it.

When I interviewed at the CCU stepdown, and my current ER, they promised me they would train me properly, and they did not fulfill their end of the bargan, which sadly, happens often, at least in NYC.

Again, my advice is to get a year of med-surg, which will NEVER hurt you, and will build you confidence and skill in many, many ways which I will not go into. Good, luck, whatever you decide.