Figuring Out my Niche

[nurse7502]

Hi everyone, I wanted to ask about how everyone has found their niche in nursing. I'm still a new grad a I haven't really found where I want to be yet.

I used to work as a CNA in inpatient psychiatry, which I liked, but I couldn't see myself as a psychiatric nurse. I graduated nursing school in June this year. I currently don't like the job I have, which is my first RN job. I work in a sub-acute rehab. It's hard balancing 12-16 patients at once with their IVs, meds, TPNs, wounds, and tube feeds, plus often doing an admission on top of that. I love doing the actual care, but it's difficult with so many patients. I also don't like working 5 days a week on evening shift. My shift technically is 3-11, but me and my co-workers stay often several hours later to finish up charting and admissions. We're not allowed to pass on any work to night shift unfortunately. I also don't feel a lot of support from the other staff I work with. And there's definitely no support from management. There's been a lot of turnover at my work since I started working there in July. I would definitely prefer a 12 hour shift schedule, day shift preferably.

I'm also a licensed EMT. But, I'm still relatively new to that as well. I just got my license a couple months ago and recently started riding-along with the more experienced EMTs at my volunteer fire department. They love having an RN ride with them because I bring a diverse array of skills to the team! They let me participate in the assessments and take the vital signs. I LOVE working at the fire department and wish I could be with my EMS crew more often. I have no problem moving quickly with decisions/clinical judgment with this type of patient care only because it is a limited scope of practice and there are super specific protocols and flowcharts that dictate care. Nursing isn't as clear cut unfortunately.

I know only I can truly know where I belong as a nurse, but I ask for your help. Given the fact that I like EMT work, you probably would think I would like ER nursing. I'd like to think I would like it as well, but I'm worried it would not be a good fit at this time given the fact this I have limited nursing experience. In addition, I am not by any means a nurse that moves at lightning speed like an ER nurse does. As I'm still new, I move at a much slower speed.

I plan on going back for my NP in less than a year or maybe a couple years. The NP program I'm applying to doesn't require any acute care experience, but I'm guessing everyone will say it's better to have acute care experience before you go for your NP.

I'm waiting to hear back from an interview I had for a neuroscience floor in a hospital. The same hospital wants me to interview for other positions there including their Ambulatory Surgery Center. I'm also going to be interviewing for an Emergency Department at another hospital... but not sure if that's for me. Lastly, I'm waiting to hear back from an urgent care center.

My conclusion is that I should try to find a job on the Med/Surg floor. I should probably brace myself for an even higher stress level on that type of floor. But what do you guys think?

[Coffee Nurse, BSN, RN]

I think your rehab job sounds pretty lousy - honestly, whyever would you not be allowed to hand off tasks to the oncoming shift? - and that you should definitely be looking for a new position. I also think you should consider why you want to become an NP and if you really think it would be a good fit for you. It seems many new nurses treat it as a given that they'll go on to it, but if you like your EMT job specifically because it has protocols in place to direct care, why would you want to take on a role that involves more independent decision making?