Love NICU, hate med-surg?

llg, PhD, RN · Jul 9, 2003

Oooo.... forgot to say earlier,

I have coordinated RN orientation in a couple different NICU's for about 15 years of my career. Those orientees coming from an adult med/surg background have very little advantage (if any) over new grads. They are usually a bit more mature and able to organize/prioritize their care a little better, but that's balanced out by the fact that they often feel "worse" than new grads emotionally because they have come from a place where they have grown comfortable (med/surg) and find themselves in a place where very little translates. They have to go back to being beginners again, and many people hate that.

Good luck,

llg

shirleyTX · Jul 9, 2003

Karen and to all the other nurses that posted messages, I start the BSN program next month and was just curious why med/sug is so bad. I have no idea yet, and would like to know what to look foward to if you don't mind venting alittle bit longer.

roxannekkb · Jul 9, 2003

Well, not everyone finds med/surg terrible. But for me, I just had no desire to take care of adult patients. To put it bluntly--um, baby pee, poop, and puke is a lot easier to deal with. A lot less quantity as well!!!

Adult patients often have multiple health problems, are on multiple medications, and have concerns and issues that need to be addressed. Adults can be difficult patients, they can scream and curse at you, they can refuse to take meds, be abusive or even combative.

Babies are at the start of life, and while families dynamics do come into play, the situation is still very different. A newborn does not have a medical history--the medical history is beginning now. They are tiny, helpless, and require a very different sort of care than one an adult. It is the type of care that I much prefer.

Med/surg involves a lot of juggling, a lot of patients to keep up with. And in today's climate, patients are sicker and more numerous. There's a lot of paperwork, a lot of running, and a lot of patients to keep track of. Who gets which med now? Who needs to be cathed? Who needs their cath pulled? And so on. You need great organizational skills, and you're going to be on your feet a lot.

I like the idea of being in an ICU with only a limited number of patients. Working on a floor, and having to juggle 6, 8 or even more patients is not my thing. In the NICU, all of your patients are in one room, easily reached, no one really out of your site.

Anyway, those are just my thoughts. I worked in many different NICUs since I did agency, per diem and travel nursing. I worked in all types, under all conditions. And never, ever, did I want to go to med/surg.

It's really a matter of choice more than anything. It used to be pushed on nurses that they needed a year of med/surg no matter what. But now nurses are going directly into specialty areas.

:) :)

shirleyTX · Jul 9, 2003

Thanx for the heads up.

tinyhands4Him · Jul 9, 2003

I thank God every day that He made each of us different with very different talents, personalities, and likes/dislikes......someone has to take care of everyone.....babies, kids, adults, elderly, and even kids with developmental problems....I have always known that I wanted to do something in peds and my clinical experiences in nursing school confirmed that. I felt just as I think everyone taking a NICU job felt....med/surg isn't for me....I hated every minute, but like they told us in nursing school....you don't have to like everything, you just have to do it....and I made it through looking foward to graduation and being allowed to do what I know God has prepared me to do.

I start as a new grad in the NICU at Tulane in New Orleans on the 21st of July. I know this is the place for me, especially after reading all that ya'll have posted...Thanks to everyone....ya'll have been a great source of encouragement b/c lately I have been feeling really nervous. Good luck to everyone else that is starting out.

peaceful2100, BSN, RN · Jul 10, 2003

ShirleyTX With Med-Surg it is just not for me that is why I can't wait until I can get out. Also there are too many patients to be responsible for in Med-Surg. I am on my fourth week of orientation have not taken boards yet and already taken care of 6 patients and doing EVERYTHING like assessments, medications including IV push and IV piggybacks, ALL the paper work, double checking day shift work and making sure they got all the orders off the chart, giving pain meds to patients literally every 2-4 hours depending on the medication. I work on a post-op surgical care floor so these patients are in pain and will call out exactly at the time they are to have their pain medication. It seems like no one calls out for a while and then all of a sudden someone calls out and everyone at the same time decide to call out at once making things crazy. I have forgot some things because of having so many patients as a new grad. I was told that once I take boards next month I could have 10 patients or MORE with a LPN that is crazy. I could have 7-9 patients with a Patient care Tech and Techs can't do much besides vitals at night.

I believe what makes med-surg least desirable at LEAST among my class mates is the fact that they expect new grads to come rushing into it so quickly with so many patients. They expect a charge nurse to do both charge nurse duties and precepting duties. They start looking at nurses with less than 2 years experience to take on responsibility of charge nurse.

It is crazy. It is my license on the line (Once I get it) and I REFUSE to work in unsafe conditions.

CVnurse08 · Jul 10, 2003

Hi,

Don't mean to "hijack" the thread but wanted to present a scenario ( not neccessarily going to be the case w/ me ) : What if you didn't mind med/surg for a year and wanted to go for the learning experience but your heart was in NICU. Would that hurt your chances of getting into the NICU after a year in any way ??

Just thought I would present that scenario and see what ya'll think.

peaceful2100, BSN, RN · Jul 10, 2003

Wannabebabynurse See that is what I am fearing. I have heard rumors that at the hospital I currently work at now the nurse manager prefer new grads or nurses who have been working in NICU and really don't like hiring those who have been in med-surg for a while. Hopefully those are just rumors and I am not going to believe them. I will just have to see. In fact I am going to make the transfer and apply for the NICU position in December and that will only be 6 months as a new grad for me so I will still kind of be new. If I get into NICU I will be sort of new. I did work there in the NICU as a Tech last summer for a very short time just to get a taste of what it would the envirnoment is like.

llg, PhD, RN · Jul 10, 2003

Wanabebabynurse: My suggestion is to talk with the mangager of the NICU you are interested in. If she has a strong preference one way or the other, she will probably be quite happy to steer you in the direction she would prefer that you go.

Most NICU's I have worked in don't have a strong preference one way or the other.

llg