I'm about to start on a med-surg unit, my first job as an RN. I'm planning to stay there for about two years, and then move onto something else. What, I'm not sure.
I find that I really enjoy it when something unexpected happens. One of my most exciting and memorable clinical rotations was on a Neuro ICU floor with a patient who developed increased ICP and had to have an emergency craniotomy. I can enjoy routine stuff too, like getting all the meds passed and all the charting done in a timely fashion, but when something starts to go wrong is when I really feel alive...doing multiple assessments, paging the resident, trying to figure out what might be going on, etc.
On the other hand, I presently work as a PCT on a rehab floor, and it's pretty boring; the vast majority of the patients are stable. It's only very rarely that something unexpected happens.
So what type of unit would most likely have these sorts of complications arise? I'm pretty sure it doesn't happen that often in med-surg.
Specializes in Med surg, cardiac, case management.
Lots of close monitoring and equipmement/technology. I love it, I love to put my hands on things and be busy
I feel the same way. :wink2:
I agree with most of the people here, either ER or ICU.
I've heard that in ER it's most like triage, you fix the obvious problem and send them elsewhere. I think I'm looking for something more subtle, that requires careful, gradual assessment. So maybe ICU would be better for me. Also, I've heard ERs can be chaotic and I tend to be more organized and controlling.
So I'm leaning towards ICU, I'm not sure which type. I'm sure all are high acuity, but I wonder if there aren't some with more unstable patients than others.
I like BMT because we have a mix of very unstable patients on mutliple drips to walky-talky self sufficient patients. We get a huge spectrum of age and acuity, yet at the same time, the basics apply to all of the patients there.
You see a lot of sepsis, and often with fast onset. They often require pressor support.
Lots of bleeding issues related to low platelets and DIC.
Mental status changes related to steroids/brain mets.
Constant transfusions.
Cardiac issues as everyone who comes brings their past medical history with them and we just load them up with chemo making it 10x worse.
I also see some crazy rare stuff.
Working at a teaching hospital, I get to play with a lot of protocol drugs too. It's cool giving a drug not knowing what it will do to your patient, and knowing you may be participating in a trial for the "next big thing." There's nothing quite like the feeling of giving a someone a drug just labeled as "B34412318." Kinda goes against everything you learn in nursing school about being familiar with the meds you're giving.
A lot of our complications stem from GVH too. These people can just plain go into multisystem organ failure rapidly depending on where it's effecting and how badly.
But the truth of the matter is, you're going to have emergent issues and unstable patients anywhere you go.
Good luck, and I'm sure you'll find a position you love.
Joe NightingMale, MSN, RN
1,735 Posts
I feel the same way. :wink2:
I agree with most of the people here, either ER or ICU.
I've heard that in ER it's most like triage, you fix the obvious problem and send them elsewhere. I think I'm looking for something more subtle, that requires careful, gradual assessment. So maybe ICU would be better for me. Also, I've heard ERs can be chaotic and I tend to be more organized and controlling.
So I'm leaning towards ICU, I'm not sure which type. I'm sure all are high acuity, but I wonder if there aren't some with more unstable patients than others.