Most challenging nursing department

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In your opinion and experience, which nursing department has been the most stressful and challenging? Oncology? OR? CCU?

Share your thoughts.

The one you got floated to when you aren't feeling too well, have no prayer of getting out on time, and really REALLY wanted to have a smooth shift.

Yep, that unit's the worst!

I second floating. As the odd duck on the unit you KNOW you are going to get stuck with the worst run and the unfamiliarity is stressful.

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Specializes in ICU.

My most stressful was ICU step-down (some call it Progressive Care). Patients on multiple drips with constant monitoring, too sick for the "floor" but just well enough to be a PIA!

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My most stressful was ICU step-down (some call it Progressive Care). Patients on multiple drips with constant monitoring, too sick for the "floor" but just well enough to be a PIA!

True that. My number goal for the day on their care plan board was to downgrade to med surg hahaha

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Specializes in ICU.

Inpatient rehab, by far! The one I worked in as a CNA was in a hospital, and we had three patient populations: brain injuries, who were just as likely to hit you, grope you, or scream at you (The 27 year old strong guy screaming, "Why you stabbing me?!"that required five people to hold him down to check a blood sugar because he would try to break your nose comes to mind); mostly paralyzed strokes that could require up to three people to transfer them to the bedside commode because this was rehab, we didn't use foley catheters or bedpans even if the person was totally paralyzed on one side; and the spinal cords, who required extensive amounts of braces to get up or down if they weren't paralyzed, and required straight cath-ing every 4-6 hours to avoid autonomic dysreflexia if they were... phew. The nurses took 6 patients, and all of them might be 3 person assists and there just wasn't enough help in the world. Working ICU is much easier!

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For me personally, CVICU, ER, and a poorly ran LTC facility. I've done all three of these and feel these were the most challenging for different reasons.

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I did my thesis on this concept and believe that it depends on the individual's personality traits, character and preferences. Anything is hard if you do not relate to it or do not like it.

^^^THIS^^^ I acutally did Private duty nursing once and that stressed me out more than CVICU. Did not fit my personality at all.

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Specializes in ICU.

Dialysis. There are plenty of units I have worked that I didn't enjoy (most med-surg wards, paeds, L&D) but dialysis is where I actually felt STRESSED out, like I couldn't work hard enough or fast enough and I think dialysis patients show the least appreciation for how hard you are working for them and the least tolerance for having to wait for anything. I actually love dialysis nursing but working in an environment where you are expected to miraculously treat more patients than there are physical chairs is ridiculous.

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Specializes in Critical Care, Education.

Sorry - researcher here. I am stumped due to the lack of clear definition of "challenging" in this thread. Don't mean to be pedantic, but . .

If the operational definition of "challenging" includes lack of job satisfaction, IMO it is absolutely Med-Surg Tele. Those units have the highest voluntary turnover in every organization I have ever worked with.

OTOH, If "challenging" is equated with the need for ongoing development and learning along with feelings of accomplishment for successfully dealing with 'stretch goals' - it would connote a positive dimension. For me, this is Critical Care - one of the reasons I love it so much is the continuous mental effort/learning required.

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Every department has it's challenges. Are you talking about the actual different fields or the floors. They have m/s nurses taking 7 patients at the hospitals where I live. They have icu nurses take three at times. Each department has it's challenges and it depends on how the hospital manages the care of their pt. Each field come with their own challenges basic nursing care is the same. Each field will have a specialty though. ED pts are treated differently than icu or or pts. Each one has a specialty and a different focus. Once you learn the specialty then you are fine.

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Specializes in neuro-surg, psych, CM/URP, CM/URP Mgr..
I did my thesis on this concept and believe that it depends on the individual's personality traits, character and preferences. Anything is hard if you do not relate to it or do not like it.

classicdame, that sounds really interesting! Personality type, life experiences, and coping skills could help or hinder for sure. Very interesting.

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Specializes in Med Surg, Perinatal, Endoscopy, IVF Lab.

I second the poster that said PICU. That is the LAST place I would work. There, you not only have critical care, but you have such a wide age range from 0-18. In one bed you have a 1 month'er and in the next, an 18 year old (essentially an adult). Plus you have the range of everything from respiratory distress to suicide watch. It's insane. I watch it from the Peds floor next door and think "I would NEVER want to do that" :no: Kudos to PICU nurses. No doubt.

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Some of my fellow per diem staff have worked in Long Term Acute care, and that sounds challenging.

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