Need help choosing 1st job....

estherojin · Jun 20, 2008

reading what you wrote about your personality and what you enjoyed in your clinicals, it seems like you are already leaning on an ICU.

txnurse32 · Jun 20, 2008

I feel the same way you do about med surg. I dont hate the task but I hate the crazy run med surg can be. I think in icu at least it is a controlled chaos and I think you would have more backup help if you needed it. I would go for ICU.

ONCRN84 · Jun 20, 2008

In med surg, it's not like they just throw you into a full patient load with no training. You get an orientation period where you will have a preceptor and you will start with just getting organized and used to all you have to do. If you want an area to learn a lot about a lot of different things and build your confidence, med-surg is actually good for that. You'll feel pretty good when you're on your own and get through a full shift with 7 or 8 patients (on nights), get everything done, and still have time to look through the chart and find out more about your patients.

Make sure when you're interviewing, no matter what department it is with, that you check out the orientation process. Ask questions! How long? What does it entail? Any special classes they send you to? Evaluations of performance during orientation?

Good luck to you! I started in medical/oncology and it's been 18 months. My orientation went well and I had the necessary support when I was on my own to help build my confidence and my abilities.

Batman24 · Jun 20, 2008

I'm a new nurse in M/S. I would ideally like to work in the OR but they suggest wetting your feet in M/S. It is very hectic and you need to stay on top of everything which is hard when there isn't enough staff. They just hired someone new so that should help some after they get trained. I do think it's great in that you really get to use your entire skill set.

CHATSDALE · Jun 20, 2008

look over your clincals and decide which one you like/felt comfortable doing...we spend a lot of time at work, it is better when you are happy at work

walkingonsunshine · Jun 20, 2008

Yes, you are right that I leaned towards ICU. It is what I thought I wanted. But, I talked to a couple people who did ICU. One gal told me how she felt she barely scraped by her first year there. And, she is very, very smart. But, I think this lady is like me; a perfectionist. So, she would probably struggle no matter where she goes, as we have too high of expectations for ourselves. I wish I could turn off that switch, but it is really hard to do that.

I also loved all the mother baby stuff, but it is more difficult to find a job there it seems. And I am not sure that fits in as well with my long range plan to get my nurse practitioner degree down the line or my dream of working for the VA.

I find myself in new territory because I have usually been in the top "performance" (for lack of a better word) tier in my other work experiences. In nursing, I have to ask for so much help. For some reason my confidence is not as high as it should be now. I am too keenly aware of how a mistake could ruin not only my own career but someone's entire life. This itself is overwhelming.

Are there any nursing jobs that are more repetitive where I could quickly learn the ropes? Is anyone up from GI lab or dialysis who can tell me how they feel there?

Thanks to all who have responded so far. Your responses have all been very helpful to me.

GrumpyRN63, ADN, RN · Jun 20, 2008

From what I've seen, GI lab or Hospice requires previous experience, ICU, any or NICU or Neuro would be a good choice, as their acuity is so high, you usually have 1 or 2 pts and a very extensive orientation program for new grads, I believe dialysis and definitely cardiac cath wants ICU experience also, ED is great if your an adrenaline junkie, same w/ L and D, also would take about a year to know what your'e doing. In any event, depending on what type of HH you are interested in, that would probably determine where you want to start. HH Hospice would like to see you have ED,ICU or oncology experience, reg HH would take a year of Med/Surg, so those are some factors to consider--Good Luck,Grumpy

whodatnurse · Jun 20, 2008

I just wanted to say that I think it's important to not allow your (natural) desire to want to be 'there' - at a point where you feel you've mastered your job - to be what drives your choice. You know that whatever area you end up working in that, given the pride you take in the things you do, you'll be motivated to give it your very best.

In other words...don't make your decision based on how quickly you can get over the learning curve. No matter what area of nursing, every single one of those working in it did not show up on day 1 and know everything there was to know about it by day 10.

Base your choice on what you think will make you happiest (because that's usually the 'right' job we all should be working in).

And keep in mind that there is value in the 'process'. Most of life is 'process', not arrival.

al7139, ASN, RN · Jun 20, 2008

I graduated and went to a cardiac/tele/medical unit. It was an ideal place for me to start. I got to learn alot, and do all kinds of things. I was like you at first, and wanted to go into ER or ICU, but now, I don't regret my decision at all, and am very happy. I was a nursing assistant while I was in school, and all the nurses told me to do med surg first. I used to think "yeah, whatever" and was convinced I would ignore their advice. But I rapidly changed my mind after two clinicals on the unit I work on now. The learning environment was great, and the orientation is excellent. I had 12 weeks (two in classes, and 10 on the floor with a preceptor). Cardiac care is really interesting, and a good jumping off point for the other areas you mentioned. We have 6 patients usually (sometimes 7) and it was overwhelming at first, but you get a rhythm, and your own way of organizing after a while and it gets easier, until you leave work one day and realize you actually know what you are doing.

Plus, realize that if you go into a highly specialized area like dialysis or surgery it's difficult to get out of it and into another area, since it is so very different.

This way, you get a well rounded foundation that will take you anywhere, and it's easier to go to an acute care setting like ER or ICU with the experience, than it is to start out there.

You still get to see and care for very sick patients, and there are still codes, and critical patients, but it is an easier environment (I think) to learn about that stuff.

In my opinion, there is alot to be said for going into a med surg setting first.

Amy

al7139, ASN, RN · Jun 20, 2008

Hi again,

I will add that most nurses are perfectionists. It is a good thing in this field, but don't delude yourself into thinking that you will never make a mistake (in fact, accept that you will). Most (all?) new grads make mistakes at some point, and so do experienced nurses. It is inevitable, you must however handle it correctly when you do. I am my own worst critic and punisher. When I have made errors (and yes, they have inevitably been when I am feeling rushed, or have alot going on at once), the most important thing is that I admitted my error, let the proper people know (team leader, and MD), and did what I had to do to fix it. NEVER EVER try to cover it up!!!! (I know nurses who have, and many are no longer nurses). Get clarification if you are unsure, even if it means calling the MD at 0300. I'd rather they be mad that I woke them up than be mad that I did something without clearly knowing what I was doing and why.

Don't look for the job where you learn "quickly". After all, you didn't leanr stuff quickly in school, and you need to realize that your first few years is basically an extension of school. Learning quickly is in my humble opinion a recipe for potential disaster. Take the time to learn it right and hone your basic skills while learning new ones. It wil pay off in the end. You will soon realize how little you really know when you start working...I swear I felt like I had never gone to school my first few months! But you soon get it, and realize that your basics are there, you just have to learn how to apply them in the real world.

You are in a job where you will be learning for the rest of your career. You will never reach a point where you know everything (if you do, you need to quit!).

So relax, sit back and enjoy the ride, and remain teachable.

Amy

HM2VikingRN, RN · Jun 20, 2008

If you want to work for the VA do so. MPLS VA has a very good new grad program. I would venture to guess that the larger VA hospitals do.

I am starting in three weeks at the VAMC and am very excited as my first job.

Google your nearest VA hospital and look for a nursing careers section.