selecting a capstone- need advice/words of wisdom

[RookieRoo]

Hi there,

So the time has come to choose my preferred placement for my summer capstone this year. I was hoping I would be clearer by now on my preferences, but the truth is I am torn between two very different areas: ER and LD. I just don't know how to pick between them!

Here's some background:

ER- I've had three different rotations there so far (and one more coming up). I also have background EMT experience that puts me in the "emergency care experience" category, and going into nursing school I had a feeling ER would be IT for me. And it has been- I have loved every single second of my time I've spent in ER. I very much like the adrenaline, fast pace and environment of the ER; I also like the constantly rotating patients and the lack of ADLs and such activities. I have had great experiences here and would do every clinical here if I could.

LD- I've had a paltry two hours experience there, and that is all I will get. At my school, we do three OB clinical days, two of which are spent on mother-baby and one of which is a day split between NICU and LD. I really loved LD while I was there and did not want to leave to go to NICU (NICU is not for me). I got the opportunity to witness/assist a birth but the nurses weren't great and weren't very willing to talk to/engage with students (except one) so other than what I gleaned from observations I'm not entirely sure I got a full accurate picture/feel for the job. I did love every second spent with laboring patients though; enjoyed looking at FHR and mother's strips, talking with/encouraging laboring moms, learning how to do checks, etc. The birth was amazing also- nothing better than watching a human be born into this world! Birth and labor are something I've had a passion for for awhile, outside of and before nursing school- similar to my passion for emergency care. I could see myself one day going back to school to become a CNM if this is the route I take. OB has by far been my favorite class and I also love our instructor, who would be my clinical instructor and possible preceptor if I were to choose OB. I did have a conversation with my instructor about the possibility of getting more LD time before choosing a capstone or shadowing her in her job as a LD nurse (she had offered previously to those who didn't get to witness a birth as I did) but no further opportunities are available. I get what I got and now I have to pick.

Now, one last thing. A lot of people have said the capstone isn't the end all be all... and they may be right and it may not be, but the two hospitals at which I would do either my ER or LD capstone are both very well known for hiring their capstone students directly into ER/LD. In fact, the LD capstone hospital (different from where I did my clinical rotation) won't even take students who aren't seriously and explicitly interested in working there afterwards. So, picking one of these is kind of like picking a career, in that by doing so I am giving myself a big chance to be hired on in one of these positions (provided I perform adequatly in the capstone of course; I'm not trying to imply that anything is guaranteed job-wise!).

I just can't pick. And I feel like we haven't been given any guidance. We were literally emailed the forms and told to send them back with our choices. There has been no discussion of capstone placement possibilities, importance of, or even how they pick who goes where. Nothing has been said outside the email, so that is frustrating too and I am desperately seeking words of advice! Does anyone have any advice for me?

Thanks in advance.

[NICU Guy, BSN, RN]

If were set on applying for only ER nursing position, then apply for the ER capstone. The capstone will help you in getting a job in the specialty of the capstone, but the main purpose of the capstone is to give you experience in a specialty that you are interested in to decide if that specialty is something you want to pursue. My advice is to go for the L&D capstone. With the EMS experience and ER clinicals, you have a good idea of what an ER nurse's role is in the ER and the types of patients they care for. Since you had very little time in the L&D department, going for the L&D capstone will give you a very good idea of the role of the L&D nurse. It is better to do the L&D capstone and realize that it is not the specialty for you than to get a job as a nurse in L&D and and hate it causing you to hve to stick with it for 6 months to a yr to transfer.

[jj224]

Ditto^. You have some experience in ED so you have an idea of what emergency nursing is like. I'd go for L&D so you can see if you love it or to find out if ED is better suited for you.

[nurseprnRN, BSN, RN]

And you can always apply to the ED and say, "I did it that way because I wanted to learn more about L&D and let someone else have the slot of ED since I had so many opportunities already. But what I learned that ED is where I want to be .. and I will know more about L&D if someone comes into the ED in labor." :)

[RookieRoo]

You guys are all awesome. That helps so much. Very valid points, all of you!