Insight & advice on Critical care(ICU) VS. general Med-Surg floor?

Nurses General Nursing

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New here and just seeking some advice... I'm a third-year nursing student who's in the process of getting an externship at a hospital. Currently I have a choice between either University of Pennsylvania Hospital or their sister hospital, Presbyterian Medical Center. UPENN hosp currently has no critical care externship positions, but PMC does.

My question is if anyone has any insight to shed on critical care and med-surg(specifically, surgical telemetry for example) particularly when it comes to an externship. I'm currently in my med-surg clinical rotation, and really haven't found it to be anything great/appealing. As for my future I think I'd eventually like to do OR or ER, but one goal I've considered pursuing would be to eventually become a CRNA.

ANY advice anyone could spare would be appreciated. Thanks!

OP means "original poster" :)

Still wondering why people think med-surg isn't a specialty...?

True, never thought about it like that but I'd absolutely cry if I got floated there...would not be competent AT ALL. There are so many things that get done on a M/S floor that I have no idea about. Couple that with a higher patient/nurse ratio...whew!

To that I want to ask, does the externship matter so much when considering this? Since externships are generally only 8-10 week programs, I'm just wondering peoples' opinions on if it really matters what you do since it seems like it'll mainly be just a "taste" of things to come.

No, I don't think it matters for an externship. I chose my externships based on my interest in what type of nursing I wanted to do. I did 2: one in telemetry, one in PICU. I'm now a PICU nurse, loved that, hated telemetry.

--I'm in my medsurg rotation right now, and to be honest I really don't like it... To some extent from what I've seen, it almost reminds me of being a waiter, but providing a totally different service, lol.

That's exactly the metaphor I use when justifying why I'm a PICU nurse. I can't give good service to more than 4 tables, definitely can't be a good nurse (me, personally) with too many patients.

Specializes in Nurse Anesthesia, ICU, ED.

--The biggest reason I'm taking an externship is for the experience, since honestly we don't get nearly as much of it as I expected in clinicals. And I know that working full-time for 8 weeks will be just perfect for getting experience. Not to mention I can't think of a better-paying/more rewarding summer job! Heh.

I guess the main thing I'm curious about at this point is on the choices for an externship in general(since I can do or transfer to whatever I want after graduating.) Do you guys think it's a big deal to choose one path over the other just for the sake of an 8-week externship? Again, thanks to all that have already replied.

To the first part, make sure you know what it is you are allowed to "do" during your externship. In my experience, most students are limited to CNA II level tasks and responsibilities, and even that can vary depending on the facility. During my externship, we did not give meds, altough we were encouraged to be knowledgable about them, and we do not do some of the more anxiety producing skills such as foley cath insertion, IV's, etc. However, you can focus on other skills like communication, time-managment, and resource managment

As for the second point, we need to consider the possibility that your externship can be extended, often to employment. With that, I would think very hard about your choices.

Specializes in Adolescent Psych, PICU.

I'm doing my externship in either the ER or the ICU. Around here they hire new grads on both areas so that isn't a problem.

I work as a tech on a med/surg floor (I get floated all over though) and I absolutly hate it most days. It truly is a specialty, and a speciality I wouldn't be good at. I think your heart has to be in it. Floor nursing is not for me.

I think you should go with what interests you!!

Specializes in retail NP.

go straight to the icu.

as a new grad, i would do nothing but that.

seriously. i mean it.

for all the reasons stated above, and for all the reasons i could add but won't.

:behindpc:

Specializes in ICU.

I simply don't understand this at all. Why american hospitals would even consider taking new grads straight into the ICU is beyond me. Huge huge safety issues. I would refuse to work or stay in a hospital that has this policy of hiring new grads into ICU.

Specializes in retail NP.

whatevs.

Specializes in retail NP.
I simply don't understand this at all. Why american hospitals would even consider taking new grads straight into the ICU is beyond me. Huge huge safety issues. I would refuse to work or stay in a hospital that has this policy of hiring new grads into ICU.

that's ridiculous. seriously. ridiculous. for all the reasons stated above and all the reason that i could add but won't.

new grad programs in the icu are extensive and the preceptorship is invaluable. it's different south of the border, my friend.

sorry you aren't open to progress.

:idea:

Specializes in ICU.
whatevs.

Ok then. Its even more frightening to me that you as a new grad do not understand why this would be a safety risk. Perhaps you will "get it" once you start actually working.

And for the record, I'm a relatively new nurse. I know what i'm talking about.

Specializes in retail NP.

i am working. in the PICU actually, i am a new grad in a 14 week preceptorship and i'm enjoying every moment of it. that's how we're doing it here.

and yes, i "actually get it."

:smokin:

Specializes in ICU.
that's ridiculous. seriously. ridiculous. for all the reasons stated above and all the reason that i could add but won't.

new grad programs in the icu are extensive and the preceptorship is invaluable. it's different south of the border, my friend.

sorry you aren't open to progress.

:idea:

Open to progress, LOL, I'm not open to putting my patients at risk by assigning a seriously ill patient to someone who is inexperienced and incapable of assessing appropriately. Thats the facts. I'm sorry your country is so short on nurses that they are forced to accept new grads into the ICU.

If you were my student, I'd slap you upside the head for attitude. You're going to have one hell of a rude awaking one you start working.

Specializes in retail NP.

i know "what i'm talking about" as a new grad picu nurse as well. hugh_laurie_house.0.jpg

Specializes in retail NP.
Open to progress, LOL, I'm not open to putting my patients at risk by assigning a seriously ill patient to someone who is inexperienced and incapable of assessing appropriately. Thats the facts. I'm sorry your country is so short on nurses that they are forced to accept new grads into the ICU.

If you were my student, I'd slap you upside the head for attitude. You're going to have one hell of a rude awaking one you start working.

these colors don't run.

ummm...i'm not a student. and ummm...i don't deserve a slap. i feel that you are taking yourself way too seriously. lighten up, canadian friend! it's valentine's day! :smilecoffeecup:

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