"IMC Patients"?

Ruby Vee, BSN · Apr 16, 2018

Hello!
I began my first job as an RN on a BUSSSSYYYY surg specialties floor last August. We have about 60% surgical patients and 40% med patients, we pretty much take everyone leaving the ICU, and from PACU. Sometimes we send patients to orthopedics, oncology, and the medical floor. Usually 15% or so of our patients are on that we call Intermediate Monitoring Care. Basically instead of monitoring and charting a full spreadsheet every 4 hours, it's every 2 with IMC patients. IMC patients usually have like an insulin infusion going, or are carotid endarectomy patients day 0, active bleeders, dependent bipap patients or amio/dilt drip patients for example. They always have full monitors running, at least q2 vitals, I+OS, and assessments.
Anyways, I enjoy my job a lot, my unit is great and my coworkers are all great but I just don't think Med/Surg is for me. So my question relates to resumes and talking in an interview. Would you say my having IMC patients counts as critical care experience? If the ED were my goal, how relevant is this experience?

IMC isn't really critical care experience. It IS IMC experience, and it's relevant to the ED. I hope you're planning on staying at least a year before moving on, though.

Ruby Vee, BSN · Apr 17, 2018

Ruby,
Is there an unspoken rule against hiring nurses still on their 1st year? Some coworkers have given me this impression. I know that 1 year of exp is your ticket to ride for most nursing jobs, I just don't see much benefit to staying any longer than needed in a place I'm not happy.

No, there's no unspoken rule. I think the rule is pretty well communicated. It's communicated on this forum, by your coworkers, by HR, by the hiring manager -- when someone is hired, the expectation is that they will stay long enough to add some value to the unit. A nurse in the first year is just learning to be a nurse; you still require mentoring and back-up and you're not yet in a position to mentor someone. You've been a nurse for about eight months, and I presume that you were on orientation for several weeks or even several months. You haven't learned enough to function competently and independently in your role. Confidence takes about a year, competence takes about two years.

The first year of nursing is miserable for most folks, and very few are happy in their first job before that one year mark. Stay where you are for at least a year, then see what you actually like and don't like about your job.

You may find someone that will hire you without that full year of experience, but switching jobs before you become competent will slow down your process of becoming competent. Nurses who switch jobs several times in a few years don't gain a few years of experience; they gain months of experience several times.

Being happy isn't in getting what you want; being happy is in wanting what you get.

ruby_jane, BSN, RN · Apr 17, 2018

So wise I wish I'd never have asked. Thanks, sort of.

She is among the wisest of us all.

It is *possible* that you could get another job on another floor for a few more months to get that magic year of experience. My story: I just knew three months in to my first job that I was never, ever meant to be a hospital nurse and left (with six months in) for an ambulatory care job. Never looked back, never regretted it. Flash forward to now....there's a neat case management opportunity with the homeless clinic that is owned by the public hospital, and I know the doc! Woohoo!

Guess what? To be an outpatient case manager I still need a year as a floor nurse. I can't get past the recruiter.

So - Ruby Vee is dropping wisdom. And she's right. Four months seems like an eternity when you are a new nurse, especially when you are unsure whether you like what you're doing. Good luck.