New Grad RN: Neuro ICU vs BMT residency

[pebblebeach, BSN, RN]

Hello everyone!

I am a newly minted BSN interviewing for my first job as an RN. I had two interviews this week for a 1-year graduate nurse residency program. (The residency program provides extra education, about 5 months of orientation, and several hands-on in-services and training sessions, etc. - still salaried/full-time, just newbie status)

I had one interview on a Bone Marrow/Stem Cell Transplant unit. Patient population mostly leukemias, multiple myeloma, aplastic anemia, etc. I am interested in oncology from both a personal perspective (cancer in family) and nursing-learning perspective - I think the research happening with stem cell transplant biology is super exciting and this facility is doing some really cutting edge procedures with their patients. 36 beds, pt ratio is typically 4:1. Incredibly impressed with the unit (they just poured tons of money into it, and it shows) especially the focus on family integration and comfort for longer LOS.

Another interview with Neuro ICU. Equally impressed with facility and family focus. Equally excited by research and technology available to this unit. Patient ratio is 2:1, sometimes even 1:1. 40 beds.

Got offers for both units. Same facility, same pay and benefits. I did not have access to the ICU in nursing school, only 1 day of shadowing at clinical. I did, however, float often to an oncology floor as a CNA and loved it. The BMT unit said I will likely be working nights, the Neuro unit said I will likely be working days. However, I am willing to work both.

Also, I was super impressed at the longevity of the nurses on the BMT unit. Most I talked to had been there over 10 years. Got the impression at Neuro ICU, most nurses were young, and are using the job as a springboard for another opportunity later (CRNA school, etc.)

On BMT I also enjoyed that the staff celebrated "birthdays" (first day of transplant) by putting balloons on the patient's door - they emphasized that they are like a family on the unit. I liked that.

I am super excited about both of these and know neither choice will be a mistake, but I was hoping some nurses with experience in either specialty can offer some perspective to a new grad nurse deciding between the two. There are these nursing grads who are very "I'm going to be critical care/peds/etc. nurse ALWAYS and I LOVE IT" and I'm like, you haven't even started yet?! I know what interests me, I know I have curiosity for both areas, and I know I am willing to work hard and learn as much as possible. I guess - I don't feel I have earned the experience to say I will ONLY work in a certain area, because who knows what I will thrive in?

My long-term plans are possibly NP, but no interest as of now in CRNA or anything further. My strengths (from my mere CNA and nursing school experience) are therapeutic communication and I tend to be extremely thorough, my weaknesses are perhaps needing to prioritize which tasks I am thorough with - there isn't time to be thorough with everything (or anything, some days), I also have been working on handling criticism since I left the womb (getting better every day!) :)

Any tips would be appreciated, and I'm so honored and pumped to join this wonderful community of nurses!

[Southpawdown]

If you re-read everything you wrote you already know the answer of which to choose - it's evident your interest lies more with the BMT offer. Go get it!

[ivyleaf]

2nd southpaw ; )

[pebblebeach, BSN, RN]

Yes :) It was super helpful for me to type it all out on here, and I did end up going with the BMT offer. Thank you!

[Kareegasee]

I hope you enjoy it, though I personally would have gone with the neuro ICU position, especially if your plans are to pursue an NP education. I've worked both types of positions, and I have learned that the ICU is hands down the best environment for learning, developing autonomy in managing patients, and gaining the ability to see the "big picture." Keep your options open.. you may find you wish to pursue a different area after a year or two.

[pebblebeach, BSN, RN]

I hope you enjoy it, though I personally would have gone with the neuro ICU position, especially if your plans are to pursue an NP education. I've worked both types of positions, and I have learned that the ICU is hands down the best environment for learning, developing autonomy in managing patients, and gaining the ability to see the "big picture." Keep your options open.. you may find you wish to pursue a different area after a year or two.

Thanks, Kareegansee! I will definitely keep my options open, and plan to keep in touch with the Neuro ICU director (we're only a couple floors apart at the facility). I see you're in the SICU, is that where you started out as a nurse?

[Kareegasee]

I always knew critical care was where I wanted to be, but I wasn't able to get a position until a year into my career. I started in med-surg and took it as an opportunity to learn as much as I could!