Is 2 years in ICU enough to teach med surge? I want to work in pediatrics.

classicdame, MSN, EdD · Dec 21, 2009

sounds like you have some real issues with what you want to be when you grow up. Pedi nurse? Educator? CRNA?

I think you ought to concentrate on one goal right now, and get it right. Then worry about the rest.

llg, PhD, RN · Dec 21, 2009

I agree with classicdame. Don't make the mistake in investing in additional education that may not be steering you in the right direction. Decide on a career direction ... THEN invest in the education to, not the other way around.

Personally, I think that if you want to teach adult med/surg, you should get some adult med/surg experience first. The skills required for ICU and med/surg are different. You will need to learn to deal with the med/surg population and also need to learn the organizational skills necessary to care for 5-8 patients at a time. You don't learn those skills in an ICU.

If you want to be a peds nurse ... get a job in peds before you go back to school to see if peds lives up to your expectations. A lot of people have that "peds dream," but find that they don't like it once they try it.

Graduate school is not generic. It should be steering you towards one specialty or another. Figure out your specialty BEFORE you invest your educational money, time, and effort.

caitiecait · Dec 22, 2009

OK...Let me break this down to you guys. My dream is to teach. I have always wanted to teach since I was a kid and still do. That is my goal; is to go to graduate school and major in nurse education and teach nursing students period. But during grad school I will be working as a nurse. And during that time I would like to work in PICU. I have decided to start grad school in the Fall versus Feb. I have worked in a MEDICAL SURGICAL ICU for a year and a half and my goal is to work a solid 2 years, earn my CCRN and then work in Pediatric ICU. When I was in nursing school I loved my pediatric rotation and picu rotation. I love crititcal care, and so PICU makes sence to me. What I asked this blog is do you think having 2 years experience in ICU and 2 years experience in PICU will that give me enough experience to teach med surge, physical assessment, pharmacology, and or pediatrics? I would love to teach all those courses during my teaching career. By the time I graduate I will have 4 years experience as a nurse.And I dont see it a problem to work in Adult ICU and PICU. Sorry but I am not a medical surgical floor nurse. But I get the medical surgical background on my ICU. We deal with every disease process, and surgical pts. Just because we only have 2-3 pts does not mean I dont know how to manage my time and pts.I deal with very sick pts, titrate gtts, focus HEAD TO TOE assessments every 4 hours, families, end of life issues, ventilators, different surgical procedures, drains, hemodynamic monitoring,transfers, admissions, code nurse incase one of the floor pts codes, RRT incase a floor pt becomes really sick and may need ICU, all the while taking care of my 2 sick pts. charge nurse etc. etc. And nowhere in this blog did it mention CRNA. Only time I thought about CRNA was in nursing school. So if you could answer what I asked that would be nice. Thank you :yeah:

MedSurgeMess · Dec 23, 2009

What I asked this blog is do you think having 2 years experience in ICU and 2 years experience in PICU will that give me enough experience to teach med surge, physical assessment, pharmacology, and or pediatrics?

You may have med/surg ICU background, but it is totally different than a dedicated med/surg background. Again, you have to be able to balance 6-10 patients, and have that experience to transfer to the student learning experience. I'm not saying it's not do-able, but it will be challenging without any direct med/surg experience. I've worked both med/surg and ICU (med/surg) and they are very, very different environments. Try getting some med/surg experience if at all possible.

caitiecait · Dec 25, 2009

I am just going to be honest to you all, and you will hate me for saying this, but I dont care... If I were to work med surge, I would probablly leave nursing all together. It is soooo very dangerous to take care of 8-10 pts. I don't know how many RRT and code runs I have been to on the floor b/c a pt had a complete change in status or died b/c the nurse was soo busy taking care of her other 7-9 pts. Its not the nurses fault its the fact that on the floor you are forced to take care of too many pts, to the point that it is unsafe. I will not sudject myself to that TORTURE!!!! I believe in mandated nurse to patient ratios, and being a NURSE ADVOCATE. Happy nurse= happy patients. And I would not be a happy nurse working in med surge. When I get my advanced degrees I will fight for this. Our children's hospital in the area makes it a point that on the floor the ratio is 4 to 1. That is the way it should be to deliver safe care. I am already apart of a safety committee at my hospital and I am bringing this to their attention. And when it comes to teaching I feel competent to teach med surge, disease processes, nursing implications, etc. etc. We are in a nurse faculty shortage. I know I will be a great teacher, and a great advocate to our nurses and future nurses, because that is what this profession deserves.

JaneyW · Dec 25, 2009

Finish your two years, go ahead with the MSN and switch over to NICU or PICU if you want. Your peds experience may be what gets you the job over the med/surg experience. It is often difficult to get faculty in the specialty areas. I am a new faculty with only OB experience other than a year of student teaching nursing fundamentals (med-surg). I now teach fundamentals and OB at nursing school. I LOVE it. I am not qualified to teach advanced med-surg by any stretch of the imagination, but the first 9 weeks of nursing school are perfect for me and I really enjoy teaching that. Then I get to go to 9 weeks of OB with more advanced students and am in my comfort area and am able to pass meds, start IVs and do sterile procedures (Foleys) with my students there. Best of both worlds for me and I hope my students benefit from my happiness. All schools do things differently and different states have different rules. Go ask questions of the faculty of nursing schools in your area. I'm sure they will be glad to speak with you and the networking is great for later. Go for it with the teaching if that is where your passion is. I LOVE teaching and am quite happy to have gone down this road.

caitiecait · Dec 26, 2009

Finish your two years, go ahead with the MSN and switch over to NICU or PICU if you want. Your peds experience may be what gets you the job over the med/surg experience. It is often difficult to get faculty in the specialty areas. I am a new faculty with only OB experience other than a year of student teaching nursing fundamentals (med-surg). I now teach fundamentals and OB at nursing school. I LOVE it. I am not qualified to teach advanced med-surg by any stretch of the imagination, but the first 9 weeks of nursing school are perfect for me and I really enjoy teaching that. Then I get to go to 9 weeks of OB with more advanced students and am in my comfort area and am able to pass meds, start IVs and do sterile procedures (Foleys) with my students there. Best of both worlds for me and I hope my students benefit from my happiness. All schools do things differently and different states have different rules. Go ask questions of the faculty of nursing schools in your area. I'm sure they will be glad to speak with you and the networking is great for later. Go for it with the teaching if that is where your passion is. I LOVE teaching and am quite happy to have gone down this road.

Thank you for your response. I feel like 2 reasons why I went into nursing was for 1: if you are unhappy in one area you can always switch, and 2: I have always wanted to be an elementary teacher, but in nursing I get to be a nurse and TEACH:loveya: The ICU that I am at now is great, and I will probablly never leave it completely. I will probablly work PRN to keep up my Adult ICU skills and work full time at PICU. I am very excited!!

Moogie · Dec 29, 2009

Caitiecait, I think I get what you're saying. You have almost two years in ICU but have always been interested in peds. You want to teach and have a variety of interests and you're concerned that if you take some time to explore your interest in peds, it might hurt your chances to teach when you do finish your master's.

From my experiences, I'd say that the variety can only help you. What you're going to get in a master's program with a NE focus is a lot of theory---much more depth than what you got in a baccalaureate program---and a much better appreciation of nursing research. Some MS programs are very clinically specific but others are a little different. I started one master's program---did not finish because I moved and there was no option to finish the program via distance ed---and I am starting over at a different school next month. Both programs---my first one and this one---have core classes in nursing theory, research, health care policy and finance, pathophysiology; the first school required a course on roles for advanced nursing practice, pharmacology and health promotion but the school I am now attending requires "roles" only for NP, CNS and CRNA students; health promotion is an elective but a physical assessment course is required. Both schools have focus courses on nursing education such as teaching strategies, curriculum development and evaluation, a teaching practicum. The first school had an introductory course on nursing education and two teaching practicums, one in a school of nursing and the other in an institution working on staff development. I've always been more interested in teaching in an academic setting rather than in doing staff development, so I think the second school is a better fit for me in that respect.

My expectation upon finishing the master's program are that I would be able to teach general nursing courses in either a classroom or clinical setting in a practical nursing school or associate's degree program. Some baccalaureate programs do hire master's prepared faculty as well; indeed, some schools hire BSNs as clinical instructors. I was a CI for a while in a baccalaureate program when I was working on my master's at the first school.

I am planning on going into a PhD program as soon as I finish my master's (although I have applied for the BSN to PhD option at the school I'm attending.) I see more specialization at the doctoral level than I do at the master's at this particular school. My main research interest is gerontology, which I think is broad enough to permit me to explore several options---but it does mean closing a door to other nursing interests. I loved the little amount of time I spent in OB and would have loved to have made OB my career---but I know I will never have the expertise to teach or research OB so that door is, unfortunately, closed.

Honestly, I don't think you will be hurting your future teaching career if you spend some time working in peds. I presume that you're young and you have the time to try pediatrics. I would think that you would be a more well-rounded nurse, educator and person if you pursue this interest---even while you're going for your master's, especially if your program is more general, like my first and current programs are.

BTW, you may also wish to consider working as adjunct faculty (most likely as a clinical instructor) while you're going back to school. It can be trial by fire but it does give you a good chance to see the real world of teaching.

Good luck to you! :up:

caitiecait · Dec 29, 2009

Thank you Moogie for understanding where I am coming from! I think I will try for NICU bc that is what I have always wanted to do. I think having a mix between adults and kids will help me teach. What school do you go to for your MSN? I am looking at Old Dominion University and Liberty University. Both are online and ODU is a great school but Liberty U has advanced pathophysiology advanced pharm and advanced physical assessment all of which will help with teaching like what you were saying. LU does not require a GRE. ODU does not offer the advanced patho, pharm, and assessment just education courses research and nursing theory. ODU does require a GRE. On paper a MSN from ODU may look better but I like that LU offers those advanced nursing courses. What is your opinion? Both schools require a practicum in the classroom. ODU's program has 2 practicums. One for the classroom and 1 for clinicals, which I think would be helpful. LU I dont think offers a clinical practicum just a classroom practicum. So any thoughts to these programs along with where you go to school at would be great :)

Moogie · Dec 29, 2009

Just sent you a PM answering some of your questions.

You know, graduate programs do differ significantly. I honestly thought most had fairly similar curricula until I tried transferring graduate credits. The school at which I started had a combined, 4-credit theory and research class but most programs separate theory and research into two 2-credit classes. The school to which I am going has 3-credit courses for both theory and research. I looked at a program that would have permitted me to transfer in the combined course but I was concerned that, since theory and research are the foundational courses for a graduate education in nursing, I might be shortchanging myself by transferring and not taking the courses. At the school to which I am going, the point is moot since the credits aren't equal.

I honestly believe that pathophysiology is essential to a nurse educator to familiarize him/herself with the biological basis for diseases and disorders. Advanced pharmacology is also important but with new drugs coming out all the time, it's better to have a good foundation in the different categories of drugs than to try to memorize everything. (I remember a question on a test in my advanced pharmacology course that listed several symptoms then asked what the nurse would prescribe for the patient. I wanted to write that I would not be prescribing anything because I planned to be a nurse educator, not an NP or CNS with prescribing authority!) My program does not require an advanced pharmacology course but I am okay with that since I had it in my previous program.

Re: the teaching practicums, I do think it would be great to have a practicum of just teaching clinicals. However, most schools that offer only one practicum have you teach in the classroom and in the clinical setting, so you are getting exposed to both. My first program scheduled both its nursing school and staff development practicums the same semester, which we were supposed to finish in about ten weeks. The school I attended at the time was 100 miles from my home and the staff development site was in the same community as the school. The school of nursing was about twenty minutes away, easy enough for lectures, but their clinical site was over 100 miles in a different direction. Logistically, it was a nightmare. So you might want to consider scheduling in your decision: would the teaching practicums be during the same semester or staggered? Same location or would you have to find different sites?

You also mentioned that one school requires the GRE. There are threads here that cover the GRE. Thing is, you do have a lot going on right now, trying to pass your CCRN exam, so maybe consider the school that doesn't require the GRE.

caitiecait · Dec 30, 2009

I do agree that studying for the GRE would be a llitte much at this time. I guess trying to figure out the best grad school for me becomes a bit of a head spinner. The one thing that ODU offeres is that fact that it is 20 minutes from me and if I have any questions they are right there. The only bad apart of ODU is that I may have to work part time the second year, and I do not know if I can afford to work part time. I just want to be sure that the school I go to will prepare me to be a great instructor. I also want to be sure that the school I attend will look good on my resume. Another school I am looking at is Walden University. What I like about Walden's program is the fact that A. No GRE. B. It is very doable, one c an work, have a family, and a life and still do this program, and C. They also require a teaching practicum. The only thing is it is a complete online school that is not backed by a brick and mortar program, but I have heard nothing but good things about the program from everyone I have talked to that have gone through Walden's MSN nurse educator program.

As far as Liberty's program goes, I really like the advanced courses. I know pharmacology is always changing but I think it is always good to know the ins and outs of your drugs. But one thing you mentioned that I think this program does, is those advanced courses are not just for the nurse educator they are also based for the CNS program, and I wonder if it will be more of teaching you how to diagnose and prescribe meds all of which a nurse educator can not do. I also wonder if those courses are a waste of time because no other MSN nurse educator program requires those classes. AHH my head is spinning now!!