Emergency or the NICU?

[Lemonkiss143]

i[color=#333333] graduated a few months ago and was lucky enough to land a job in an emergency department as an rn. i hate med/surg nursing and for a long time i questioned whether i went into the right profession. i feel nurses are overworked, the labour is physically demanding, and in real life', very few people appreciate nurses.i sort of enjoy the er but i find that as a new grad with no previous experience, i'm overwhelmed and i don't like the 20 family members that hover around you, or the large patient loads. i'm not being given enough time to train and i don't want to risk my license or anyone's life. also, the hospital i work in is really grimy and managed horribly. in school, i spent a few days in the nicu and loved it, now the question is... should i try for the nicu (i think i may have a better chance now of getting a position with er experience than i did as a new grad) or should i stick it out in the er and really push myself, and build my confidence(perhaps in another hospital)? i want to make sure that the nicu gives me the chance to make a difference and that i get to really critically think, not just play maid. i love having my voice heard in the er. i don't know if my dislike for the er stems from the nature of the job or is it just that the hospital i'm at is poorly managed. all the nurses hate it there.

[color=#333333]likes - patients i can lift, autonomy, critical thinking (that's one thing i love about the er), actually being asked what i think by doctors and working as a team!!

[color=#333333]dislikes - screaming family members, heavy patients, taking care of icu patients along with 3-4 er patients (yea... i know.. so unsafe.. i don't know anything ), bed baths, psyche issues, playing maid, geriatrics.

[color=#333333]if there is any other area that any one can think of i'm open to suggestions. i'm young.. and i think its sad that in the few months that i have been working, i've been abused by staff and patients, almost thrown out my back thanks to a hefty patient and demanding family (i'm 5 feet tall and weigh 96 lbs), almost been punched by a drunkard, and been told 10 billion times that i'll be sued.

[color=#333333]sometimes i wonder... does any nurse wake up and think.. "i love my job..!" before she starts her day or are we all dying for our shifts to be over... i just want to truly love my job and give my best to my patients, not be so miserable and burnt out... i went into nursing thinking i'd be making a difference that i'd be able to run codes and help save lives, that i would be respected, that i would love and care for my patients..and i just feel so... overwhelmed and so discouraged.

i also want to teach and do research one day.. but where do i start...???

[missnurse01, MSN, RN]

holy moly Lemonkiss...go shadow in nicu, and see what a shift is like.

Continue your education since it seems that your interest is not in bedside nursing-you said you like teaching, research, being the brain in the pt's care to a very large degree, and do not like many of the things that we do at the bedside (bathing, 12 hours of emotional or abusive pts, playing maid, etc).

You have to think 'why did I go into nursing?' Maybe your focus is more in an NP role, or CNS. Go shadow them. They will probably be happy to tell you a day in the life. Also even about the PA route-sometimes they have more hands-on stuff they do if you like the technical side; where I am they are the first people we call for issues (I do open heart recovery). Different areas of the country use their mid-level providers differently.

Have no fear, many of the feelings you describe are exactly what many nurses feel-overworked, underappreciated, harped on by management, not respected for our voice in pt's care, etc. This is why there are so many other areas you can go work. This is why nurses are burned out. Yes your work environment makes a huge difference in your happiness, even with the same type of pts!

So, shadow...

Think of different roles...

Think of changing hospitals, although the work is usually the same, so it will be politics and coworkers that are different...

And good luck!

[Snowbird17]

I have learned few people love their jobs...My goal is to like my job more days than not. To have a job that supports my lifestyle, because I want to work to live, not live to work. I think that is reasonable. Nursing offers these things in short work weeks, hourly pay, and checking the job at the door. Try to get your personal satisfaction from your personal life, not your job.

If you think ER family members hoover, wait until you see the parents in a NICU.... Neither are for the thinned skin. Nursing is not for the thinned skin. Search around until you find a place you don't dread going to, rarely will you wake up excited about going to work (you know the old saying, "that's why it's called work").

I am not cynical. I am just a realist. It took several years in nursing because I adopted this outlook, and it really improved my life-work balance. It makes me a better nurse when I don't personalize the dysfunctions of patient care and there are many.

Honestly, most of your dislikes will occur in any in-patient nursing area. So really evaluate what you want from a role. Be brutally honest with yourself, sometimes it is hard to admit certain weakness even to one's self. This I can tell you- ANYWHERE you go in nursing, ANYWHERE, you will be a maid on one level or another. Get used to it. As healthcare is becoming more consumer driven, it will only get worse.

All that being said, I have heard that most NICU nurse like their jobs. A lot stay in the NICU for many years, that says something.

Give it time and you will find your place. Good luck!

[Altra, BSN, RN]

The ER and the NICU are totally different animals.

Some of the things you say stand out to me: we give very few bed baths in the ER ... but you would do them daily in any ICU. Families who are annoying in the ER for a few hours are annoying in an ICU for days/weeks on end. I can pretty much promise you that you will not love road trips to CT or MRI with an ICU patient who is vented, on a pressor and with a brain drain.

However, you may find that you enjoy the thoroughness of focusing on 1-2 patients ... vs. the constant shuffle of ER flow.

Good luck to you, whatever you decide to pursue. And p.s. ... put me down as a nurse who loves her job. We do exist. :)

[Bortaz, MSN, RN]

I love my job in the Nicu. I do not love people who think my Nicu is an escape from the hard work or bad conditions of other units. Until you've had that baby...the baby you've cared for for 4 months, daily...die horribly...until then, you may think the Nicu is an escape. Not afterward, though. Not when you're shrouding that baby while trying to ignore your broken heart.

[Altra, BSN, RN]

LOL ... I read NICU as neuro ICU. I missed the "patients I can lift" part of the OP. However, the fact remains -- the ER and and ICU setting are vastly different worlds. Consider this carefully.

[Lunah, MSN, RN]

As this is an ER forum, you're probably going to get a lot of ER-slanted responses. :) Personally, I am not a baby-person. Never had one, never gonna. They're cute, but not for me. I see enough peds in the ER, and crying babies make my uterus shrivel, hahahaha. ER all the way!

[Lemonkiss143]

I DEFINITELY don't see the Neonatal Intensive Care as an 'escape'. Speaking to NICU nurses, I KNOW how challenging it can be. Everything about nursing is challenging. I just want to be passionate about where I work and my patients.

I just need advice.. I feel like I'm having a complete breakdown because I can't find my 'calling'. A part of me likes Emerg, I just am too too overwhelmed. If I had more time, I MIGHT feel more comfortable but I don't see myself loving it the way I always thought, NONE of my coworkers love it either.

As for the NICU, I've enjoyed the 2 shifts I've spent shadowing a nurse there, I know its incredibly challenging and emotionally trying but I think I might be better with that. Nothing about me really says "ER nurse". I just don't want to close future doors for myself and because the NICU is so specialized, I'm scared that might happen. I just want to enjoy what I do.