Basically, I'm approaching a year in my first job as an RN, and thinking of next steps. I'm on a neuro stepdown unit, and would like to transfer to an ICU in the near future. In nursing school I loved cardiac, worked for a couple years as a tech on a telemetry unit, and did all of my adult clinicals on cardiac units, including a CTICU. When I applied for jobs, the cardiac units at my hospital didn't have openings at the time, nor did the two ICUs that hired new grads. I got a job in a SICU at another hospital, but for various reasons turned it down, and took a neuro stepdown job at my hospital.
Almost a year later, I definitely enjoy neuro, and am doing stroke-related research right now. My unit is great, but I love "technology" and "devices", so I'm still interested in the ICUs, though I'm trying to figure out which one. I still do think about CTICU, as it seems to have the most technologies and devices out of all the ICUs (the CTICU at my hospital does heart/lung transplants, ECMO, VADs, artificial hearts, IABP, etc). ECMO also sounds very interesting to me, and all of the ICUs have ECMO, except Neuro ICU (though its mostly found in CTICU and MICU).
Interestingly, the Neuro ICU recently started taking VAD patients that stroke, so the RNs there have relatively recently been trained on them. The neuro ICU also does multimodality brain monitoring, though when I asked one of the nurses about it recently, she said they don't do it as much these days, and its become more for research purposes.
Another thing I think about is marketability and further opportunities. I may be wrong, but I feel that cardiac experience would go further as far as opportunities outside of the ICU (cath lab, EP lab, etc) or hospital, and that cardiac is more...."accessible" than neuro for RNs and APNs, as far as being able to carve out roles. In the future I think I'd like to do ACNP, though I don't plan on applying for a couple years (I plan on staying at the bedside and doing the clinical ladder, committees, etc), so that may change. Also, it seems that there are more opportunities for APNs in cardiac nursing than neuro, at least in my area.
TLDR: I'm a neuro stepdown RN, almost one year down, originally wanted CTICU, doing neuro, like neuro, still think about cardiac, not sure what to do.
I definitely need to shadow in both to see what they're like, but thought I'd ask here as well. Thanks!