Need advice from seasoned RN's

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Okie Dokie...

I just finished up my summer Extern and have been offered to stay on through this fall semester to my Intern in the spring until gradation etc., etc.

The problem for me is that the head of the Education Department wants to know (by Monday) what floor/unit I see myself working on post graduation, so that they can put me there to work. While I agree that is a wonderful idea, I have no clue what my "niche" is.

I am 28, single and have no kids, so my future goals (within the next 2-3 years) include travel nursing. Thus far I really (really) like ER and L&D. And I kind of liked PCCU, it wasn't my favorite, but I could work there and be happy.

What I need to know is where to plant myself for the next 9 months (till I earn my RN) to gain good experience in general, and to plan for traveling. I will be grateful to anyone who can offer some advice and shed some light on this for me.

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Specializes in Psychiatry.

I'm not a seasoned nurse, but if you really liked the ED, go for that. There seems to always be a need for ED RN's and it's not so specialized as L&D.

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Specializes in ER.

I am a seasoned nurse. Seasoned ED nurse, my advice is, start in your basic medical surgical floor and learn the things that you did not learn in school, which are many. ED nursing is very specialized, don't let the above poster fool you. I have precepted many nurses and those who have spent even as little as 6 months on med surge overall have done much better than those who have come straight into ED nursing. In the ED you need to have organizational skills as well as outsanding customer service skills, and if you lack the basic nursing skills and have not developed your critical thinking skills you may feel overwhelmed in the ED. The ED always needs nurses and that is because of the shortage many new nurses go into ED and find it to be too much when in reality if they had taken just a little time to develop basic nursing skills they may have turned out to be the best ED nurse. Travel companies usually will not even consider hiring you until you have at least 2 years of experience, because your abilities are what keeps them in business. Hope this helps and good luck! Hope to hear you are working in ED in several years if that is your desire.

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Specializes in Maternal - Child Health.

I'm going to offer a different point of view.

Life is short. Nursing is a very tough job, especially if you are not fascinated by your patient population. Critical thinking and organizational skills can be learned on any unit and in any setting. Med-surg does not have a lock on this training.

Go where your interests lie.

When I graduated 20+ years ago, were had it drilled into our heads that we needed a year or two of med-surg before trying a specialty. I already knew that I didn't like med-surg and was not about to spend another year or two doing something I disliked. Maternal child health was my passion, and I found (rather easily) a NICU job in a tertiary care center. I had an excellent orientation, learned more in a few months that I had learned in 4 years of nursing school, and loved my job. After 2 years, my hubby was transferred, and we moved to a much smaller city, where the only NICU required experience of its new hires. If I had listened to my well-meaning, but ill-informed, instructors, I would have never gotten into the NICU.

Med-surg is a specialty in its own right, and should be staffed by nurses who are interested in that patient population. If you like med-surg, go for it. If not, don't.

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Specializes in Pediatric Psychiatry, Home Health VNA.
I am a seasoned nurse. Seasoned ED nurse, my advice is, start in your basic medical surgical floor and learn the things that you did not learn in school, which are many. ED nursing is very specialized, don't let the above poster fool you. I have precepted many nurses and those who have spent even as little as 6 months on med surge overall have done much better than those who have come straight into ED nursing. In the ED you need to have organizational skills as well as outsanding customer service skills, and if you lack the basic nursing skills and have not developed your critical thinking skills you may feel overwhelmed in the ED. The ED always needs nurses and that is because of the shortage many new nurses go into ED and find it to be too much when in reality if they had taken just a little time to develop basic nursing skills they may have turned out to be the best ED nurse. Travel companies usually will not even consider hiring you until you have at least 2 years of experience, because your abilities are what keeps them in business. Hope this helps and good luck! Hope to hear you are working in ED in several years if that is your desire.

I must respectfully disagree with this post. Travel companies are desperate for help and most are happy to take nurses after one year of experience. I have many friends who went into travel nursing after a year. I think the ED is a GREAT place to start out if your hospital has a support system in place for new grad critical care entry. There are new grad RNs that thrive and flourish in the ED and new grads who drown on a med-surg floor. It's all relative to WHO is accepting the position and your personality fit. I will say this about direct-entry ED. You have to be motivated. If travel nursing is your goal you need to get all of your certifications out of the way in the next year. I would see if you can take an ACLS course this year if it's offered through the hospital. You'll need your standard critical care courses, tele courses, ACLS/PALS, and there's a slight chance you may be ready to take the CEN by the time you're ready to travel if you wait two years, but probably not. The more certifications the better your pay scale will be. The ED will ALWAYS need competent nurses, whether they are brand new grads or seasoned veterans. It's not just a med-surg world anymore! Good luck OP, let us know what you decide. :D

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just finished my 1st year of nursing (went into the SICU right out of school). My best advice is make sure you get a good orientation! You'll probably do just fine wherever you want to go; yes, its very stressful, but you can get through it as long as you have support!

as for finding your 'niche', have you looked at the ICU? it's impossible to be bored there, there's always crazy things to see and you get smarter by osmosis!!! (all those old smart RNs). If you like machines, are a control freak, don't mind working in constantly depressing situations, don't get grossed out by huge wounds, and want the education to keep rolling in...it's your niche! Plus, after 2 years in an ICU, you can go anywhere. and i mean anywhere--cruise ships only hire ICU trained RNs, great bunch of knowledge to have anywhere in the hospital or out of it.

good luck!

:p

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Thank you all for your input! :-) It has helped me feel better about coming to a decision.

Gratefully,

A

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Specializes in Pediatric Psychiatry, Home Health VNA.

What did you decide?

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Specializes in Psychiatry.
ED nursing is very specialized, don't let the above poster fool you.

I was referring to the fact that you'll get more variety in your learning in the ED (MVA, MI, trauma, amputations, accidents, etc etc etc)...not just pregnant women with or without complications in L&D.

Sorry! I wasn't trying to "fool" anyone.

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