Hi, all---I read a number of threads addressing my question that I want to ask here, but I thought just asking in the general forum would still yield a good result. I've been a working RN or three years now. My first year was in physical rehab and frm then up to now has been in med-surg/neuro-tele, both nights. Both the jobs were super exiting to me when I started, but I'm starting to become bored with my current job. I was really bummed, then my BSN buddy (i'm an ASNer) told me that according to nursing research, and from talking to other nurses, this is where most folks start to get bored. I felt a little better knowing that. Professionally, only time-management is a challenge, and that's not really all that hard. I take care of very few patients I really have to think about. And the stuff that tedious, like pain-med seekers or high-anxiety patients that monopolize nurses' time, but don't try not to, are starting to get to me. I don't really feel bad about this attitude anymore; it naturally happens to a lot of nurses, but I've realized always being around that kind of thing doesn't go toward me engaging my empathy, hahaha.
I've been talking to all the old nurses I can about specializing. Here is a list and my thoughts.
ICU--I think I would like the fast-paced stuff. Being super detail-oriented has been problem for me, but I can adjust. Learning in-depth pathology and therapies sounds interesting It was my favorite clinical in school.
ED--Again, the fast-paced stuff has that allure to me. I want to get beer at working codes too. I work about 2-5 a year and never get enough practice to feel confident. I think there's also less documentation than med-surg too. Sometimes when go down to the ED, nothing is going on. That seems boring to me. I know that's not case with all EDs.
OB/L&D--no thanks.
Cath Lab--maybe doing the procedures would be fun, but watching waveforms on a monitor all day is a one-way ticket to Boresville for me.
Peds--I love kids. They're so fun and silly. I have a real soft spot for them and want to help them. Lots of coworkers have told me I'd be good at it. I'm good at interacting with kids. Something I've recently thought about was that peds don't necessarily intrigue me physiologically. I'm ok with the fact they're different from adults. I just wonder if me wanting to move to that specialty based largely on just thinking it would be fun is misplaced enthusiasm.
And finally, med-surg--what I like about it is that I stay moving all the time, I've learned a lot from it, but am getting bored. I like some of my coworkers very much that are med-surg nurses at heart.
This is getting very long, so I'll sin off for now. I'm not really looking for answers, just ideas from other folks who've been in my shoes before. Any input is very appreciated.
If your hospital has a float pool you sound perfect for it. Constant changes, challenges, you never know what unit you'll be working on. Great exposure to different areas and hopefully you'll find one that is a better fit.
ED--Again, the fast-paced stuff has that allure to me. I want to get beer at working codes too. I work about 2-5 a year and never get enough practice to feel confident. I think there's also less documentation than med-surg too. Sometimes when go down to the ED, nothing is going on. That seems boring to me. I know that's not case with all EDs.
The ED is inconsistently consistent- i.e., you get the same diagnoses over and over but the picture changes with each patient. Does that make sense?
Some days you'll have down time, most days you're moving your whole shift. It depends on how big the ED is and what trauma level it is.
Careful about saying less documentation- yes, you're doing focused assessments, but let's not forget about moving through numerous patients throughout the day. There's a decent amount of charting in the ED.
To be blunt, I think you need more exposure to the areas that you're considering because from your post, you don't seem to know a lot about them. Try shadowing in different departments. It seems that you have these pictures in your head of what they are but haven't really experienced them.
ED--Again, the fast-paced stuff has that allure to me. I want to get beer at working codes too. I work about 2-5 a year and never get enough practice to feel confident. I think there's also less documentation than med-surg too. Sometimes when go down to the ED, nothing is going on. That seems boring to me. I know that's not case with all EDs.
I need to add my input on this part of your statement. There is not always more documentation than med surg, but in my ER there is still hourly rounding and expected patient updates like approximately what time the IN infusion stopped. There's tedious stuff you still have to document too... the psych patient who needs restraints, the patient refusing care. Heck, my ER just started mandating that we document whether an aspirin was chewed or swallowed.
We also don't get traumas all the time; some days its 5 or 6, other times we go days without any. We get a lot of abdominal pains, chest pains that are really indigestion or pulled muscles, headaches, pain seekers or unnecessary nursing home send outs. I really wish I had been more realistic about the types of things I would see before I decided to work in the ER.
Looking for any help or ideas of past FNP students in how you obtained clinical preceptors. I am at a loss as I can't seem to receive any phone calls back. Any help would be greatly appreciated! Thanks!
The great thing about being a nurse is you have all these different options to choose from. If you decide to change positions and dont like it you can always change again. I would recommend ED or ICU because once you have done that you will have the critical care skills wherever you go! In any ED you will be begging for the days where you are bored and cherish any downtime you get :)
Just so you know - ICU is not necessarily fast-paced. There are plenty of boring days with ventilated patients where all you do is turn, oral care, clean ups, minimal pressor titration etc.
So very true! I think learning something new is always exciting in the beginning. It gets old after you've seen/done it 1,000 times. I could (and have) run codes in my sleep. You get so used to the routine you're just on autopilot so to speak. Believe it or not even the ER gets old after you've learned to triage and you realize that 98% of the patients who come to the ER are not emergencies! They are people who either don't have health insurance (or the money to pay for an office visit), people who are too stupid to realize that vomiting twice in a 6 hour period will not kill you, incompetent parents who are sick of listening to their toddler cry so they assume the child must be sick, drug seekers, and people who want a doctor's note to get off work for the day. And when you actually do have an ESI 1 or ESI 2 patient, the people who come to the ER with this other nonsense only get in the way and then complain because somebody who is having a STEMI was brought in ahead of them. And good luck explaining that the ER isn't "first come, first serve". They aren't intelligent enough to comprehend what you are trying to tell them.
I need to add my input on this part of your statement. There is not always more documentation than med surg, but in my ER there is still hourly rounding and expected patient updates like approximately what time the IN infusion stopped. There's tedious stuff you still have to document too... the psych patient who needs restraints, the patient refusing care. Heck, my ER just started mandating that we document whether an aspirin was chewed or swallowed.
We also don't get traumas all the time; some days its 5 or 6, other times we go days without any. We get a lot of abdominal pains, chest pains that are really indigestion or pulled muscles, headaches, pain seekers or unnecessary nursing home send outs. I really wish I had been more realistic about the types of things I would see before I decided to work in the ER.
Amen to this! When a patient who was actually sick came in I would hug them! Unfortunately common sense isn't all that common anymore. I don't know what grated on my nerves the most...women checking in for a pregnancy test, pregnant women coming in c/o abdominal pain just so the doctor would do an ultrasound and tell them the sex of the baby, parents bringing children in with a temperature of 103 who didn't give an antipyretic because they wanted the doctor to "see how high the temperature is", or because they can't afford it (as a pack of cigarettes and an iPhone falls out of their purse, and they are driving an Escalade), drug seekers, and the list goes on and on and on....
I would try a different department. I think you'd prob like ER over ICU. I actually put in full assessments on all my patients except for level 4 & 5s. Many don't, but I feel like you should when so many get admitted. I did ICU and floated to most inpatient units for a bit and I'd say I chart at least similar amounts in the ER because I have more patients usually. A sick patient can require a lot of notes and documentation because you need to assess, chart intervention and then state the reassessment to deem effectiveness. You do that a ton in ER. I did a level 1 trauma for a couple years and my burnout was related to staffing issues and downright dangerous work conditions. I miss the action, but I recommend it to anyone who is seeking excitement and some good skills.
I recommend either trying to float as others suggested or try a different unit.
Peds it's own animal, I used to want to do it, but then going over to the peds ER and helping document during a code...yeah I prefer my mostly adult patients. If you really love kids seeing sick ones can be heart breaking. I admire any nurse who can do that daily.
brownbook
3,413 Posts
If your hospital has a float pool you sound perfect for it. Constant changes, challenges, you never know what unit you'll be working on. Great exposure to different areas and hopefully you'll find one that is a better fit.