New grad--should I specialize in ICU or L&D??

Published

Specializes in MICU.

Hi All,

I'm currently a nursing student graduating in May 2013 and am looking at my job prospects. I work in a MICU now as a student nurse and probably have a good chance of getting hired as an RN after graduation. However, I'm doing my L&D clinical now and have made some connections that I believe lead me to have a pretty good chance of getting hired there also. I've always been set on doing ICU, but the L&D experience sounds great too. I would be required to work as a tech for a few months to be trained to scrub into surgeries, which I don't mind and actually think is really exciting. Just wondering if anyone has any advice about which is best to start in? I'm soooo torn. I'm afraid of getting stuck in L&D, but I also am afraid to pass up the opportunity to learn to scrub and get hired on such a unit as a new grad. Ultimately, my goal is to work in global health for an organization like MSF (Doctors Without Borders). Any advice would be appreciated!!

Up Vote Up Vote ×
Specializes in Utilization management, psychiatric-mental health.

I don't have too much experience in nursing since I am in a nursing specialty as well but I really do feel ICU may be a bit much for a new grad starting (from what I heard). Then again, I read that some ppl got into it as a new grad and they were fine. ICU needs more critical skills, its fast paced and you usually have one or two patients, max. L&D is on a slower end and you can definitely do that as a New grad. I feel med- Surg should be every new grad initial exposure because you learn a lot and see so many diff kind of cases. This is how I feel now, i don't have med Surg exp(it was hard for me to find a job first so I took the first offer). But at the end, the decision is yours. As long as you have a good preceptor and you are not left to thr wolves, :-), I think each specialty are excellent and you have to know what you would like to do five to ten years from now. I think I would choose ICU but like I said, you have to decide. good luck, :-)

Up Vote Up Vote ×
Specializes in Maternity.

I guess it depends on our own strengths and weaknesses that will determine what is easier vs harder but I completely disagree with above. L&D is extremely faced-paced and requires quick critical thinking during a rapidly progressing process for a woman. Although child birth is considered "natural" and you are dealing with (usually) other wise healthy patients, it requires intensive/continuous monitoring. As the RN in L&D I'm not dealing with trachs and the amount of monitors that are seen in ICU, but I am required to have SHARP assessment skills to r/o anything that could possibly be going wrong. In a single second THINGS CAN GO BAD. Not always easy for a new gard although it can be done! I'm sure ICU would be tough, but again it's with your own level of comfort. Both would present you with great opportunity. To continue with your long-term goal, you might want to consider a specialty that is more broad based. But honestly, take whatever you can get in this economy!

Up Vote Up Vote ×
Specializes in Utilization management, psychiatric-mental health.

Hi BellasMommyOBRN,

I wasn't trying to offend anyone in L&D, actually. But just from both of experiences as a student nurse and as a mom giving birth (and I was hoping to actually work in L&D, maybe in the future), I do agree that nurses have to deal continuous monitoring of the mother and her baby but I don't seem them doing too much but popping in to check on the patient but otherwise, they can look at the monitoring screens at the nursing station. I see most of them sitting down but I know if the mother is ready to have her baby, they will be there. But I really feel it's not that fast paced until it gets to the final stage of childbirth and yes, you are right, if anything goes bad, it can go bad really fast. But this is just from my observation and experience. You are probably different and better nurse than most. My patient experience in L&D was not all that great with the nurses but I had my husband and doula and they were amazing. I saw my nurse the first time I was admitted and didnt see her until I gave birth and I was definitely disappointed that she didn't really check on me. Maybe she felt because I had my husband and doula in the room, who knows? But for some ladies who don't have that, they get pretty lonely going through those contractions by themselves, I'm just saying (even they receive epidural). And I gave birth without it(my choice) so my nurse had a bit of an attitude with me and mentioned well, "you may change your mind so let me know, okay". And she left. So I had my opinions about L&D nurses and mentioned to myself that if I ever worked in L&D, I would be so much better than them. But I am not trying to offend you or anything.

Up Vote Up Vote ×
Specializes in Intensive Care Unit.

Any job as a new grad will be worth your time. Just get in SOMEWHERE then go from there. Hard to be so picky in the new grad market

Up Vote Up Vote ×
Hi BellasMommyOBRN,

I wasn't trying to offend anyone in L&D, actually. But just from both of experiences as a student nurse and as a mom giving birth (and I was hoping to actually work in L&D, maybe in the future), I do agree that nurses have to deal continuous monitoring of the mother and her baby but I don't seem them doing too much but popping in to check on the patient but otherwise, they can look at the monitoring screens at the nursing station. I see most of them sitting down but I know if the mother is ready to have her baby, they will be there. But I really feel it's not that fast paced until it gets to the final stage of childbirth and yes, you are right, if anything goes bad, it can go bad really fast. But this is just from my observation and experience. You are probably different and better nurse than most. My patient experience in L&D was not all that great with the nurses but I had my husband and doula and they were amazing. I saw my nurse the first time I was admitted and didnt see her until I gave birth and I was definitely disappointed that she didn't really check on me. Maybe she felt because I had my husband and doula in the room, who knows? But for some ladies who don't have that, they get pretty lonely going through those contractions by themselves, I'm just saying (even they receive epidural). And I gave birth without it(my choice) so my nurse had a bit of an attitude with me and mentioned well, "you may change your mind so let me know, okay". And she left. So I had my opinions about L&D nurses and mentioned to myself that if I ever worked in L&D, I would be so much better than them. But I am not trying to offend you or anything.

I don't find your comment offensive but I would cheerfully strangle the nurse who gave you that impression. On my floor our labour patients are 1:1 the majority of the time. Last night my VBAC got frequent position changes, care, empathy and education from me and had a beautiful delivery. I was in the room the majority of the time doing her care. It's been that way at all three of my jobs (even the one with central monitoring).

Yesterday we had a placenta accreta that turned into a massive bleed, a hysterectomy and the woman had over 60 units of blood products and a 7 hour surgery that involved vascular surgeons, multiple OBs and anesthetists, art lines, you name it. ICU didn't get her until we were done with her.

As a new grad I'm sorry you were given a wrong impression of LD nurses by your birthing experience. All I can say is give it a chance. I've never been bored (and I'm a person who likes change!).

I've also heard great things about ICU--in the end, it's up to you!

Up Vote Up Vote ×
Specializes in MICU.

Thank you all for your advice! I'm not so much concerned about being overwhelmed as I am about doing what is best long-term for my career. I feel like ICU in a lot of ways is med surg, only with much sicker patients and better nurse to patient ratios. At least that has been my experience with working in a MICU. And I know L&D definitely can get very intense and almost be ICU-like, especially where I am looking to apply--it is a top teaching hospital that gets all the most high-risk cases. I definitely don't want to be bored so I'm glad to hear you have never been bored on L & D! That's encouraging for me. My biggest concern with going into L&D would be becoming so specialized that I can't move to any other nursing field if I want to explore something new. Any thoughts on that?

I will feel lucky with any job offer, but I like having my ducks in a row in my head so I know what my next move will be. Based on my school program, grades, experience, and willingness to relocate, as well as the jobs other people at my school have gotten right off the bat, it seems my prospects may hopefully not be so bad once I finish school.

Up Vote Up Vote ×
Specializes in Telemetry, OB, NICU.

Go for ICU then. Yes, L&D is highly specialized. ICU is more diverse, but with critical patients. You would learn more broad knowledge in the ICU.

Or think about which one would help you get into where you want eventually.

I really think med-surg gives new grads a good base. I did 1.5 year of telemetry, and I am starting in OB next week. I am glad to have the experience I have now.

Up Vote Up Vote ×
Specializes in MICU.

Thank you so much, Seas! That really helps! Good luck with your new job in OB! =)

Up Vote Up Vote ×
Specializes in Maternity.
Hi BellasMommyOBRN,

I wasn't trying to offend anyone in L&D, actually. But just from both of experiences as a student nurse and as a mom giving birth (and I was hoping to actually work in L&D, maybe in the future), I do agree that nurses have to deal continuous monitoring of the mother and her baby but I don't seem them doing too much but popping in to check on the patient but otherwise, they can look at the monitoring screens at the nursing station. I see most of them sitting down but I know if the mother is ready to have her baby, they will be there. But I really feel it's not that fast paced until it gets to the final stage of childbirth and yes, you are right, if anything goes bad, it can go bad really fast. But this is just from my observation and experience. You are probably different and better nurse than most. My patient experience in L&D was not all that great with the nurses but I had my husband and doula and they were amazing. I saw my nurse the first time I was admitted and didnt see her until I gave birth and I was definitely disappointed that she didn't really check on me. Maybe she felt because I had my husband and doula in the room, who knows? But for some ladies who don't have that, they get pretty lonely going through those contractions by themselves, I'm just saying (even they receive epidural). And I gave birth without it(my choice) so my nurse had a bit of an attitude with me and mentioned well, "you may change your mind so let me know, okay". And she left. So I had my opinions about L&D nurses and mentioned to myself that if I ever worked in L&D, I would be so much better than them. But I am not trying to offend you or anything.

No offense taken, seriously! I wasn't trying to be rude in my reply.....sorry if you took it that way! I realize that what I may consider "difficult" is very subjective and is subject to change with each person! Just sharing my two cents and experience :)

Up Vote Up Vote ×

I must say Isis nearly spit out my tea at the "l&d is slower paced" comment. LMAO. Slow as in NASCAR is slow maybe! LOL!

Up Vote Up Vote ×
I must say I nearly spit out my tea at the "l&d is slower paced" comment. LMAO. Slow as in NASCAR is slow maybe! LOL!

Darn phone LOL

Up Vote Up Vote ×
+ Join the Discussion