Should I move on, or stay put?

[egRN11]

I'm kind of at a crossroad in my career lately. I was first an LPN for 2 years, now I've been an RN for 2 years. I started off working in Medsurg, but then I had to move for my husbands job, and began a career in Ortho. I've been working in Ortho for about a year and a half now. My problem is, I can't decide what to do next. I've progressed quickly in Ortho. I feel confident and comfortable in my job, and I'm already working as charge nurse.

I'm sure most nurses have encountered this issue. After all, I became a nurse because of all the different career opportunities. I'm very happy with my job, but at times I find myself feeling bored. I've established a level of comfort to the point where I don't feel as though I'm being challenged anymore. I enjoy learning new things, and I feel like my job isn't giving me as many opportunities to learn. I will be finished with my BSN in October 2018. So, I'm at least going to stay in this position until then. But after I graduate, from what I see, I have two options. To either move on or stay put.

If I stay put, my goal would be to eventually work my way into a leadership position. Hopefully, I could become an assistant manager someday. This comes with several advantages: more money, more regular hours, and being in my comfort zone. But this also comes with the disadvantages of missing out on gaining more skills, and getting stuck in a specialty nursing field.

If I move on, I would like to pursue a more challenging job. I've always dreamed of becoming an ICU nurse. The skills you gain from working in the ICU are immense. But I question if this is possible. Will they look at my resume and see ortho and a little bit of medsurg and deem me unqualified? I've attained my ACLS and I do study the CCRN book just to keep myself informed.

My questions to my fellow nurses are as follows: Do I move on or do I stay put? If I choose to move on and pursue a career in ICU, what else could I do to prepare myself? I would love everyone's input.

[OldDude]

See where your BSN takes you in your current job. Along the way poke around the ICU, gather intel, chat up the nurses, and see how that develops.

[RNNPICU, BSN, RN]

I could see two different career paths.

You could, after your BSN pursue the leadership path. You would gain an immense amount of skills in learning new forms of time management, priority setting, goals development, managing people, families. You would not be losing any skills rather puting your skills, especially as Charge RN to a higher use.

I could see it helping you advance as a RN. It could open more a different doors. True, you will not have the direct patient contact as a staff RN, but that does not mean you will miss or lose skills.

You could also stay as a staff RN but in a different role. You would also learn different skills and care for a different population ICU vs Ortho, skills you learn would be more tasks and different assessments. The populations are more critically ill. With time you could also become Charge and look to leadership. Working in the ICU is challenging because the population is critically ill and things can change quite quickly. It is very straining and draining at times, especially because most patients are intubated and unable to speak. The harder part is somethimes dealing with the families especially if a patient is not doing well and is dying. Burnout is high in the ICU.

I think you will need to think, do you want a lateral move, look at the ICU. You would be taking a step back in a sense as going from Charge RN to Staff RN, but you would learn about a different population.

If you take the leadership position, it is a increase in responsibility, and instead of a lateral move it is a step up, in a sense. You would learn a ton of skills as well.

Think about what are your career aspirations. Nursing is needed in both leadership and direct patient care.

One thing to keep in mind, both ICU and Ortho are specialities. Any area of nursing can be considered a speciality, MEd-Surge, LTC, SNF, ICU, Peds, Ortho, AMbulatory, ER, etc.

There is not a wrong choice

[Ruby Vee, BSN]

A resume reflecting steady employment as a nurse is not detrimental when applying for an ICU job. Your resume reflects one job change in two years because your husband's job required a move -- that's a reason for leaving that every employer will understand. The skills you've learned in ortho are a good, solid basis for the skills you would learn in ICU. There is no reason to worry that saying in Ortho will make you unhireable for an ICU postion when you're ready to make the move.

That said, how stable is your husband's employment where he is right now? Is he going to be transferred again in a year or two? If that is likely to be the case, you may want to stay put and extend your skill set by joining hospital-wide committees, becoming active in the union, doing volunteer work, developing yourself as a preceptor or teacher, etc. It's a good way to grow in your career and to learn a bit about what management entails.

Here's another consideration -- are you going to want to start a family after you finish your BSN? Are you going to be pregnant, take a long maternity leave and/or return to work part time? Perhaps you'd be better off staying where you're comfortable. I've seen a number of nurses transfer to ICU while pregnant or get pregnant immediately upon transfer, go on maternity leave either during or right after orientation and then come back and have to start orientation over pretty much from the beginning. Most of them don't stay -- either because they're too busy at home for the "homework" they need to be doing or because at this point, they're around a year into their employment and are still not functioning where they should be. It's a whole lot easier to return to work at a job that you know well than it is to return to a job you've barely gotten started in.