NEED ADVICE!!

[tachycouture]

Hi everyone,

I recently graduated from a LPN-RN transition program after 3 years as an LPN. I worked in my small, rural hospitals' ICU as an LPN doing direct patient care under the supervision of an RN. I know this sounds crazy that I had the opportunity/responsibility to care for these patients as an LPN, but the learning experience was worth it. Upon graduation, I was offered a weekend option day shift job on the med-surg floor. I love the patients i take care of and my coworkers, but I really dont feel like it is what I was meant to do. I applied at a Level 2 trauma center for a position in their ICU and just recieved an offer letter from them. This unit is very intense, they recover all of their own surgeries, have CRRT, IABP, swan's, recover open hearts, all the things that make people shiver with excitement!! Of course im scared to death right now as I should be, but when I brought up the subject of leaving with my nurse manager she set me up an interview with the ED manager at our hospital. I had the opportunity to stay in the CCU i worked at, but in any other hospital would consider it a stepdown unit and I dont feel like I could learn and be the best in that unit. Also, I dont feel that i spend enough time with the patients on the floor, and most of the time find myself obsessing over small details instead of doing my umpteen dozen dressing changes or helping to bathe my 8 patients. I dont know if ER would be the perfect fit for me or not. The level 2 trauma center job is an hour and a half away so I would have to move eventually, which freaks me out in itself. So I guess the question is? Med-surg? ICU out of town? or ER where I am at?

Thanks for reading this I know its all over the place,

Tachycouture

[HouTx, BSN, MSN, EdD]

Wow! Lucky you - so many options to choose from. Obviously, you have proven yourself to be a valued employee - Well done!

One phrase sticks out in your message " I don't feel that i spend enough time with the patients on the floor, and most of the time find myself obsessing over small details". As an ICU nurse, I can assure you that working in the type of high-tech trauma center environment you described will not provide you with an opportunity for more patient interaction. When you're dealing with high tech interventions, your attention is even more focused on the tech & even more details/data, and the patient is usually sedated or minimally aware. That's not necessarily negative. . . some of us LOVE the machines (like me). But if patient interaction is what really makes your job worthwhile, it's something to think about.

Where do you want your career to go? Do you want to be involved in 'cutting edge' clinical technology? If so, that trauma center job is probably the right move. If it doesn't work out the way you want, I would bet that your current employer would welcome you back with open arms.