Medsurg vs. ICU or ER

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Specializes in ICU.

I work on an oncology/medsurg unit. It's my first RN position, having just graduated in June. The majority of the time it's very busy. Hardly anyone punches out on time. I like the floor (co-workers, management and patients...usually ;)) but I also find myself wondering if there is something else I might like better.

Another RN who usually works ICU and ER has filled in on our floor a couple times. He's incredulous at our workload. I told him this is the only nursing I know. His basic recommendation was, "Dude, try ER or ICU. You might be pleasantly surprised."

I'm not looking for the greener grass necessarily but I'd like something that doesn't involve constant running. What do y'all think?

Cheers,

Dave

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Specializes in critical care.

Don't go to icu then-you'll be running for sure

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Specializes in ICU.
Don't go to icu then-you'll be running for sure

Yes, but maybe I won't have to run as far;). Just kidding.

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Specializes in Trauma ICU,ER,ACLS/BLS instructor.

Your where u need to be right now. You like your job and it seems your co workers. A nurse ,as the er nurse, who comes and makes a statement like that is someone who has never worked a med surg unit. Might have,but poor memory of it. Med surg will teach u so much and give you a base that most who specialise (ICU,ER,etc) do not get. You will hear many ,many pro and cons on this. It has been debated until the alphabet has retired,and it will continue to be debated.

Nurses in the ICU's and ER run also. Pt ratio is less, in most cases ,but aquity is also usually much higher. ER is fast paced. Time spent by pt's waiting and in the ER,is usually tracked by the powers that be. Turn over is huge. Nurses need,IMO, a good base to be able to safely treat these pts. ICU,well u might have 1 pt or 3.But u might never leave a pts side in 12 hrs.You travel from the unit to xray,CT,MRI,interventional,or even the OR. The pts and their specialty beds are heavy.Sometimes u bring multiple pumps,a vent,aline,swan along with u. One needs to now what to do if something happens . Its heavy,back breaking work at times. Heart wrentching and mind boggling.

So in my long vent here ,I guess what I really wanna say, is that grass really isn't any greener on the other side,and the experience u get will bring u far in advancing ur career. Good luck and enjoy ur day!

Christine

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Specializes in Tele, ED/Pediatrics, CCU/MICU.

Depends on what kind of new nurse you are. I am a novice in the ED and I do PLENTY of running. If you are self motivated learner and you are flexible, the ED might work for you. If you picture yourself in critical care situations and feel uneasy, perhaps it's not the time.

I've always had an inclination toward emergency.... it's just my thing. I'm starting in a small community hospital, learning the basics, and then I'll work my way up from there.

You have to find your happy medium.... for me, I knew I would be unhappy in med surg, and times have changed. Novices are being trained in specialties. You may be at a disadvantage if you aren't the kind of learner that can extrapolate what they learn to different areas of care... at work, I always make a point to think "What will this patient need when they get to the floor?"

ED holds ARE medsurg pts, and the state of health care right now is such that many, many patients waiting for tele or medsurg beds sit in ED's for 24 hours or more.... I get plenty of practice with daily meds, maintenance fluids, PT consults, and more.

You have to think about what your future goals are, how motivated you are, and how willing you are to continually expose yourself to new environments..

I plan on trying every care area I can... that's the beauty of nursing :)

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I am coming from a slightly different perspective. I started as a new grad in the ED and just recently took a med-surg job. So far, I am finding that it is still busy, but it is a different kind of busy. Few things are as critical on a daily basis like they were in the ED. I am finding it a little difficult to switch from the priorities of an ED patient to the priorities of a med-surg patient. The difference that I find the most annoying is that the physicians are difficult to communicate with on the med-surg floor (i.e.- you waste valuable time paging and waiting for them to call back for the simpliest of tasks- taking out a foley or IV, etc.). Also, the lack of communication on the medical plan drives me crazy. In the ED, the physician is right there and recognizes the need for the nurse to know the plan of care. You also have a lot more autonomy as an ED nurse.

It depends on the ED or floor that you work on, but I had more patients when I worked in the ED. In fact, it was too many patients, which is one of the reasons that I decided to leave. However, at this point I am not liking the med-surg floor all that much and I really miss the comaradarie of the ED. But the reason why I took the med-surg position is that I wanted a job with less stress, less patients, and a good foundation for the rest of my career. I would advise you to stay put for a year and then you can move into any area you want.

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Specializes in ER OB NICU.

Many hospitals used to require new grads to work MS for the first two years, just to give them a working knowledge of meds, treatments, planning your day and time, procedures, and the wide variety of patients to whom you work with. It is the basic basis for the nurse so to speak. For some reason, other than in L&D, Where it was one on one, I have always been a charge nurse , from my first position on up to House Supervisor. WHY who knows, When I went for my first interview, and was called back, they told me that was the job they found me suited for. Makes for rapid advancement for sure. BUT I charged Med surg and I worked my buns off.BUT I learned a lot,and am glad for the 2 years I spent there. In additon, I prned in ER, L&D, Icu NSY. so got lots of experience in those first two years. Experience is the basis for the split second decisions that are often so vital to extending some one's life. AND the moment you make one of the decisions based on you instincts, and realize that you were right, it a great breakthrough. GOOD luck, hang in there.

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Specializes in ICU.

Thanks for the replies. I do like where I'm at. A good number of my classmates went straight into ICU, NICU, CCU. But, I felt compelled to get some basics down in medsurg first. I'd also like to get chemo certified next year.

I've had a few 'aha' moments leading me to think that ICU might be something I'd like to go for next. I haven't had a patient code yet (knock on wood), but when I've called rapid response for a patient going bad I get a lot of satisfaction out of the focus on making sure the patient in trouble gets taken care of.

As busy as it is, I always feel good about what I've accomplished at the end of the day. Even if the day is an hour and half longer than it was supposed to be.

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If you are a good nurse you will be running your butt off no matter where you work.

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