Non "floor nursing"

Published

Hello

I graduate in 2 semesters and I plan on eventually working in the ER.

I was told by a previous instructor that I should work in med surge for 1-2 years for experience. I really don't like floor nursing...could anyone recommend an area that would give me nursing experience prior to working in an ER.

Specializes in Med-Tele, Internal Med PCU.
I'm right there with you KFF! I work on a med/surg floor and graduate in 1 year. I am transferring to the ED in our hospital because that is my calling. They are more than willing to work with me when I am done. They also told me to try to start in med/surg, but that is not for me by any means. ED and ICU.....I hate getting more blankets and jello! Go with what you want, what's calling you!

There is a key difference in your situation and many students. You are working in the field, gaining exposure, and building on school. I on the other hand have no medical background other than school and clinicals; so to continue to gain competancy in the basics is of great importance, allowing for confidence and proficiency building.

I'm somewhat biased, coming from a Navy career I strongly feel that there is a lot to be gained from doing the "dirty work" and gradually taking on more challenges as you are able. I too wish to work in an ER/ICU but know there are several areas that will need attention after graduation: pt/ family communication, patient/family education, community resources, actually practicing nursing, hospital politics. That's not to mention the personal stuff that will change like schedules, continuing education, balancing family-work-education.

Up Vote Up Vote ×
There is a key difference in your situation and many students. You are working in the field, gaining exposure, and building on school. I on the other hand have no medical background other than school and clinicals; so to continue to gain competancy in the basics is of great importance, allowing for confidence and proficiency building.

I'm somewhat biased, coming from a Navy career I strongly feel that there is a lot to be gained from doing the "dirty work" and gradually taking on more challenges as you are able. I too wish to work in an ER/ICU but know there are several areas that will need attention after graduation: pt/ family communication, patient/family education, community resources, actually practicing nursing, hospital politics. That's not to mention the personal stuff that will change like schedules, continuing education, balancing family-work-education.

There is absolutely NO reason that you cannot learn communication skills, nursing skills, continuing education, and balancing work and family life in an ICU or ED setting. To think that one has to begin learning in a med-surge setting is a complete falsehood. Coming from an airline background, I can say this: There are pilots that come from civilian training, and they start their learning in small and slow aircraft. Then you have military pilot training that begins their flight training in high performance aircraft. Neither one makes a better pilot. They are just taught differently from the beginning. As long as you are trained properly, the outcome is exactly the same. The same holds true for hospital work. You can start in med-surge, or the ICU. But, as long as the training is good, there is no reason that you cannot start your career in an ICU. They will train you to proficiency! That is their job. There is a natural law of learning known as the Law of Primacy, which states that the first thing you learn is the one you will remember most. So, if you train in med-surge first, then those skills and tasks you do there will have to be "un-learned", and then "re-learned" doing it the way the ICU does. This un-learning and re-learning process takes more time, and is unproductive. If someone knows they want to go into the ICU (like me) then they absolutely SHOULD start there from the beginning. It doesn't make sense to do it any other way.

Up Vote Up Vote ×
Specializes in Emergency.

I start my second semester ADN med-surg clinicals in two weeks so I interested to find out what that expericence will be like, but right now I have a job in a ER as a tech and it's a good fit. I am getting a good feel for the pace, paperwork and RN duties without the full load on my back. I will be in this postion for 18 months when I graduate and they are grooming me to step right in when I get out to hit the ground running. This postion is a way for the hospital to invest time and training on the right person, and I think it will benifit both myself and this small hosptial. I feel I have a step up on some of my classmates with the additional training and free rope I am getting compared to other CNA postions. With my limited experience my two cents is to work were you want to when you get done. My situation is unique to ER and I thought I would pass it along.

Up Vote Up Vote ×
Specializes in ICU.

I'll add a little something to the discussion (even though I'm a chick ;) ).

My nursing career started off as a tech for 1.5 years (while in school) on med-surg floors. I learned absolutely nothing about nursing except how to draw blood (on a few occasions), collecting stool or urine samples, transferring patients from bed to bed, and obtaining basic vital signs. There is absolutely no way that my experience as a tech helped me once I passed the boards and became an RN.

My first job as an RN was in a Neuro ICU. I barely lasted 9 months there partially because of the bizarre nature of a small group of nurses working there (coined the "Nursing Mafia" by some agency nurses whom I recently met) who fight to keep a stranglehold on the unit and the overwhelmingly high turnover rate. The typical length of employment there is one year. That must cost the hospital a fortune in hiring and training!

After quitting, I was so terrified of ICU nurses that I went to work on the floor at another hospital. My assessment skills consisted of knowing neuro exams. Nothing else aside from what I picked up in school and self-taught. This floor (primarily Neuro, but with a huge mix of med-surg patients) showed me how to be a real nurse, how to interact with other nurses, MDs, mid-level providers, PT/OT/ST, etc... I learned the basics of following orders, reading charts, finding pt. histories, and understanding lab values specific to my patient population.

Had my orientation at the ICU been this thorough maybe it would have been a good learning opportunity. But it wasn't.

After over 1.5 years doing floor work our Neuro ICU opened and I transferred there. I've been working there 6 months and have never been happier. It's exactly what I've been looking for as a nurse.

Here's the biggest part of having experience on the floor... I was humbled. I know what it's like to have 8 patients, how very little time we have to collect the sort of information that we have in the ICU, how to stay on top of meds and ways to observe for early recognition of acute deterioration. Those nurses who have never worked anywhere but the ICU can sometimes develop an ego about their status. We're there for the patients, not for ourselves. Inflated beliefs about ourselves as nurses only gets in the way of our work. I see it daily and don't like it.

This is only one perspective. I would have been very happy to start and end my career as a nurse in the ICU, but that wasn't how things turned out. My experience gave me a lot more than expected.

The OP seemed to lean towards the ED which is completely different from ICU. With a good training program and willingness to learn without passing judgment on floor nurses, I believe anybody can make it in their specialty without having to work med-surg.

Up Vote Up Vote ×
Specializes in ICU.

Wow. That was a long post. Sorry. :doh:

Up Vote Up Vote ×
+ Join the Discussion