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Having second thoughts. Dilemma! Advice appreciated.


Hello All,

I have a good problem, but a problem nonetheless. I am graduating this month and was offered a great opportunity in CICU at a large teaching hospital. In my job hunt at the beginning of this year/semester, many of my peers were starting to put applications in in January and I didn't want to be left out. So I put in applications everywhere. I had always kind of thought I would want to work in an ED, more specifically a level I trauma center. However, as graduation neared, I felt less and less sure about going straight into and environment like this. I work in a small but very busy hospital as an ED tech and was thinking of just starting there out of school, as it would be a good learning environment to start out in as it wouldn't be as sophisticated, large, and I already know/get along with almost everyone. But I started to realize that it may be hard to transition roles to RN from PCT and I don't know if I would want to work with some of the personalities that are there now. So, since the ED didn't seem to be the best idea at the time, I applied for a few ICU jobs in a large teaching hospital simply off of two recommendations from clinical instructors (who I really respect) because they said that I would be a good fit.

I accepted the CICU offer mainly due to the learning experience it affords (nurses are encouraged to sit in on medical school lectures), the manager seemed like a straight-shooter, and the fact that I really like the hospital. Not to mention I was offered my preferred shift, will make $3 more per hour as opposed to the ED I work at now, and the good benefits. However, it is a 45 min drive as opposed to the 15 min drive to the ED.

The dilemma I am struggling with is that in school we had NO clinical in ICU, just observation only. We did have a good mix of other clinical experiences, though. I am worried that I don't know what I am getting myself into. I know the ED and I like almost everything about it except, as a new grad, I'm just worried that I wouldn't be ready for those chaotic days when it seems like 1,000 patients just walked in at once and you have to think on your feet. I don't have much experience in the ICU and honestly, the thought of managing a patient for length hospital stay (hygiene, bed baths, rectal tubes, bed changes....) is just little unappealing to me. It's not that I consider myself too good for this, I know it's necessary. It's just in the ED, you do the necessities and in the ICU, you harp over details.

I am open to advice, or new ways I can look at this. I would just appreciate some guidance!

Also, I want to be an NP and plan on going back to school either by the end of this year or the beginning of next year to start my BSN.

Thank you so much!