How long to know if job will work out?

FurBabyMom, MSN, RN · Aug 16, 2012

That's gotta be your call.

I worked neuro med surg for about a year and am going to the OR. Some of our patients had had incredibly complicated procedures but others were general medical surgical or rehab patients. Some patients were just short of impossible at night and made it hard to place them at SNF or LTV but we couldn't discharge them onto the street.

Having a lot of patients with the same several diagnoses can become "routine" but I never used that word. Patients leaving AMA, patients with rhythm changes on tele, patients with pauses or runs of v tach on tele, patients with blood sugars sky high or super low, starting heparin drips, blood products, cardizem and nitro drips, chest pain patients, patients with neuro changes, patients who ought to go to ICU but there's no ICU beds open, I even had to assist with CVC placement at night, taking patients with changes down to CT, codes, rapid responses, putting dementia patients to bed (washcloths as a pile of clothes to fold are your friends :) ) - so many many things happened at night.

Regardless of your decision - you need to be able to identify the skills you've learned and perfected. Talk to your manager. Are there opportunities for growth for you? ACLS? PALS? Do you want to learn to charge? Is there another unit with more variety or sick patients?

amzyRN · Aug 16, 2012

That's gotta be your call.
I worked neuro med surg for about a year and am going to the OR. Some of our patients had had incredibly complicated procedures but others were general medical surgical or rehab patients. Some patients were just short of impossible at night and made it hard to place them at SNF or LTV but we couldn't discharge them onto the street.
Having a lot of patients with the same several diagnoses can become "routine" but I never used that word. Patients leaving AMA, patients with rhythm changes on tele, patients with pauses or runs of v tach on tele, patients with blood sugars sky high or super low, starting heparin drips, blood products, cardizem and nitro drips, chest pain patients, patients with neuro changes, patients who ought to go to ICU but there's no ICU beds open, I even had to assist with CVC placement at night, taking patients with changes down to CT, codes, rapid responses, putting dementia patients to bed (washcloths as a pile of clothes to fold are your friends :) ) - so many many things happened at night.
Regardless of your decision - you need to be able to identify the skills you've learned and perfected. Talk to your manager. Are there opportunities for growth for you? ACLS? PALS? Do you want to learn to charge? Is there another unit with more variety or sick patients?

I'm going to be doing the extra certs. I know that I need to be able to manage my time and I have too much time in this facility. If only all facilities were staffed this well! But when I transition, I'm going to have to be able to handle a larger more hectic facility and more diverse patient load. Ideally, I'd like a surgical or tele floor to get me ready for the next step. I don't know what that is yet, but if my experience isn't challenging enough, I'm afraid I won't be able to hack it at a different facility. Once I'm an "experienced" nurse, I will be expected to perform at a higher standard as a new grad but might be losing skills here.

FurBabyMom, MSN, RN · Aug 16, 2012

I'm going to be doing the extra certs. I know that I need to be able to manage my time and I have too much time in this facility. If only all facilities were staffed this well! But when I transition, I'm going to have to be able to handle a larger more hectic facility and more diverse patient load. Ideally, I'd like a surgical or tele floor to get me ready for the next step. I don't know what that is yet, but if my experience isn't challenging enough, I'm afraid I won't be able to hack it at a different facility. Once I'm an "experienced" nurse, I will be expected to perform at a higher standard as a new grad but might be losing skills here.

There were days (nights actually) I thought I'd go crazy working on a med surg tele unit. But I learned a lot. I'm sure you've learned a lot where you're at now. I'm glad your facility is staffed well, I can't imagine having too much time. Enjoy that! I frequently had a ratio of 1:4-6 super sick but not quite sick enough for ICU and then covered an LPNs 5 patients so it was 10 patients to know about.

With any job there is a lot to learn. We had a nurse go to my now old unit from a procedure area. She hadn't done in depth assessments and PO med admin and other skills in years. But she worked hard and hung in.

I'm not sure what skills you haven't gotten to use - are there other units you could float to to get to use those skills? Definitely focus on what you are good at and have experience with as selling yourself is a big part of switching jobs.