Desicions, desicions...

[ERNurse752, RN]

OK, I currently have all these ideas bouncing around in my brain, so I'm going to put them down on "paper."

As a student, I worked on CICU for 3 1/2 years at my current hospital, and I also did a 12 week rotation on ICU at a Level I Trauma Center one summmer. I decided that I didn't really like CICU - too focused on cardiac, a little on the boring side etc. I liked my rotation at the trauma center however. It was a summer thing though, and so I left after it was over, deciding not to apply for a job there b/c they had a required number of hours you had to work during school, and my CICU job was basically work whenever I felt like it. When I graduated I went to the ER of the hospital I'd been at for a few years. I thought I wanted the action, adrenaline, and variety of the ER, and liked the idea of not having to deal with the longer-term issues of the ICU.

Now I've noticed that I feel like I'm missing out on big chunk of knowledge and skills that you don't get a lot of in the ER, like the whole pathophysiology of illnesses/injuries, and skills like mgmt of vents, swans, ICP's, chest tubes etc. We do get those things, but not enough to become proficient at those ICU skills in the ER.

I'm thinking about leaving and applying for a job in the ICU of the trauma center to get the experience I feel I'm missing out on. I haven't been happy since I've been in the ER...but I don't know if I'm really not happy, or if I'm just stressed out b/c I'm still new and going through that adjustment phase everyone goes through where they really don't like their jobs for awhile (I graduated in May).

But I have noticed that the best nurses in my ER are the ones who have ICU experience. Also, when I was at the trauma center, I had SO much respect for those nurses...they just knew so much it was amazing. They had a very strong desire to keep learning new things, which I don't see much of where I am currently. I'm just getting very frustrated...I dread going in to work every night (like tonight), and I'm not sure why...like I said, either it's ER really isn't for me, or I'm stressed b/c I'm new. Leaving the hospital and the ER is maybe just an escape for that...b/c who knows? I may be just as unhappy doing ICU...I left it before. Sigh...

I'm committed to my current hospital for 1 year (til June) b/c I took a sign-on bonus. It wasn't a lump sum though, it's monthly...I think I'm going to check and see what would happen if I left before a year, whether I'd have to pay back what I've gotten so far, or if I just would not receive the rest (obviously.)

Anyone have any comments/ideas/advice? Venting is good...

[oramar]

Oh to be young and strong and have all the options a new nurse has these days. It is true that these are difficult times to be a new nurse but the upside is that the opportunties are endless. OK, here is what I would do and remember your fate is in your hands alone. My first choice would be to complete my one year committment. You only have six months to go and by that time you maybe more comfortable where you are or have a better idea of what you want to do. If I absolutely felt I could not complete the committment because I was so desperately unhappy that I felt my mental or physical health would be damaged, I would check into seeing what it would cost me to get out of the contract. You made a typical newbie mistake not asking questions about what it takes to get out of the contract before you were hired but I am sure you won't do it again. Many times we have heard experienced people on these boards say that they are concerned that new grads are going into the ER and critical care with out enough experience. Now you are finding out why they make that statement. I have a friend named Betty who has 2 years med/surg experience, 2 years telemetry experience and 6 month ICU experience. She recently went into work in the ER where she was heard to say that she wished she had stayed in ICU a year before she transfered. Is it any wonder that you are feeling some stress if a person with much more experience is feeling stress in the same situation? In closing I have to say that most new nurses have some doubts about what they are doing several months into their first position so you are pretty typical. Oh, one more thing, that trauma unit you were talking about sounds really great.

[hoolahan, ASN, RN]

Follow your dream.

I know I would never want to work in the ER. It just isn't my cup of tea. Even wuth all my critical care experience, the er scared me. You never knew what was coming in the doors. It might be OB/GYN :eek: or psych:eek: :eek: or peds:o , or someone with hamburger tongs stuck up his butt (Yes true story.)

I watched ER and yearned for the excitement, and scheduled an interview, then my dtr broke her arm the eve before, we went to the ER, and the things I saw, well, let's say I cancelled the interview.

So, I am very biased. I have nothing but repsect for ER nurses, I don't know how they do it. I wouldn't sell yourself short on your skills, b/c in my humble opinion, er nurses are the only ones who truly use all the knowledge we learn in nursing school, med-surg, psych, OB, and peds, critical care, you do it all, and have to be prepared for whatever walks or rides up to, that door. KUDOS to you ER nurses, thank God you're there when we need you!

[Jenny P]

It may be that you are just going through the angst of the first year as a new nurse: it feels like you aren't good enough at whatever you do; the grass is always greener on the other side of the fence; the old "should I?/could I?/would I?"syndrome.

If you are in a toxic environment with people hazing you, I'd say leave now and find something else and somewhere else to work and grow. However, that is not what you have said here. Stay for that first year and learn as much as you can while you are there.

Join your local ER or critical care nursing association. Get involved; nothing can kick start your interest and career as much as being involved in a professional organization and networking with some sharp nurses who can mentor you in your future career.

[thisnurse]

funny because i am a med/surg nurse wondering if i should transfer to er or ICU to get THAT kind of experience.

i agree with hoolihan. the er nurses are the best!

[traumaRUs, MSN, APRN]

I'm an er nurse in level 1 trauma center and the reason I love the er is that you DON"T know what's coming through the door next -I love that sense of excitement and adrenaline rush!!

However, the level of comfort I have (after six years) isn't something you have after six months. Maybe giving yourself more time. What about talking privately with a nurse you admire and find out what she could advise you to make your comfort level higher.

I was an ICU nurse for one year before coming to ER and also had a couple of years of med-surg. I also was an LPN before I became an RN.

[RNKitty]

This may be off the thread a bit, but I bow before the experienced nurses of ER and ICU. I am in L&D, and very good at what I do, but don't send me a sick patient! I worked at a hospital for four months (before I resigned due to unsafe working conditions) where they would routinely float me to the ICU or ER if L&D was slow. Can you IMAGINE? If the nurses with actual experience are stressed in that environment, what is the management thinking (or are they) when they send me to those areas? Give me the preeclamptic on Mag, full internals, crash C/S for abruption, or a meconium baby to resus, but DON'T send me to the ER or ICU to deal with MI, broken bones, Swan lines, balloon pumps, etc. That's what I call YOU for!

Take the advice to stick out the commitment. Your word is your bond ! Then ask the nurses you most respect how/where they got their best experience. With experience comes comfort. Good luck!

[WriteStuff]

As a new grad I give you a lot of credit for asking yourself all those important questions NOW......before you've spent a decade or more doing what you wonder is the best thing for you.

I have no personal experience with the sign-on bonus thing but from what you've shared, in my mind (drawing from many years of experience here), I would complete the contract and during the six months you have left concentrate on doing a personal inventory - all the pros and cons and all that stuff - of your career wants, needs, goals, etc.

Six months is not really a long time at all and will pass very quickly. If you can somehow embrace the remaining months as a "challenge" maybe it will relieve some of the frustration you feel right now.

Whatever you decide......welcome to the bump and grind of the world of Nursing.

[nicola]

Is it me, or is there something about that 6 month point? I'd always wanted to do home care and was blessed to land a position right out of school doing home care case management. I bit off a big chunk! The first couple of months were bliss, followed by increasing doubt until I got to about the 8th month. When I made a year working as an RN, I celebrated!!!

I really think that you'd be best served to finish out the year there and then think about moving on. It takes at least a year to really understand a job and it looks bad on a resume if you don't stay the full year.

But the world is wide open and I'm sure that you'll find the perfect fit for you! Good luck!