New Grad deciding between two positions.

[missjessicag, BSN]

Hello, I will be graduating this December with my BSN in nursing. I am currently completing my preceptorship on a cardiac ICU. Care consist of recovering open hearts, thoracotomies, TAVR's, CABG, etc. I have been offered a position in the medical/surgical ICU and have been offered a position in a heart/vascular ICU in a level 1 trauma hospital. I am not familiar with medical/surgical ICU, so any insight would be appreciated. I should note that I do plan to return to school in a few years for ACNP, so I definitely want to feel prepared and get good experience. Both offers are part of nurse residencies that offer great training for the first year. The medical surgical ICU is within the same network I currently work in and love the environment, but it is not a level one hospital if that makes a difference. Thanks in advance!

[seaofclouds21, BSN, RN]

The combination med/surg ICU is most likely going to give you a wider range of experience than the heart/vascular ICU. That means you would see surgical and medical issues, rather than limiting yourself to just the heart/vascular issues. Does the hospital that offered you the med/surg ICU have other ICU's as well?

Since you specifically want to further your career as a ACNP, it may be more beneficial to go with the med/surg ICU for the wider range of experience.

[missjessicag, BSN]

Thank you for your response. The hospital that has the MSICU also has other ICU's, including the one I am currently precepting on at this time. I am also working as an aide within this network right now and having really enjoyed working within this network.

[ivyleaf]

If you have a specific interest in cardiac, and/or working in a more cardiac-focused setting as an NP, take that into account.

[ladyandthetiger]

Cardiac ICU all the way. I work in a lvl 1 ICU which does Med/surg and Cardiac and the Cardiac work loads are almost always better.

They can be complex enough to be interesting upto and including the occasional reopen in the ICU.

Med/surg is often the home of frequent faecal incontinence, full contact precautions, ICU psychosis, please just let me dies, and lots of other nursing nasties.

Don't get me wrong, all my patients get the same skilled and compassionate care regardless of how frequently they are incontinent in the bed or how often I have to don full PPE to stop their drip beeping again but I'll take a fresh CABG or valve replacement any day given the choice.

[MurseJJ]

CTICU/HVICU sounds interesting (but I've always had an interest in cardiac and neuro and not really general medical or surgical units, including ICUs). A consideration could be what you plan to do as an ACNP, as many positions in specialties ask for RN experience in that specialty for new grads (so if you want to be a heart failure or electrophysiology NP, new grad positions may ask for 1-2 years RN experience in cardiac nursing).

Of course, you can always move to another ICU in the future, so you aren't really "stuck" in whatever you choose, especially if your interests evolve. So for now, I'd go with the unit that has a more interesting patient population for your personal interests. Good luck!

[purplegal]

You should be eternally grateful you got those offers. Sure wish I had this problem, would love to be an ICU nurse.