which specialty area = satisfaction

IHeartPeds87 · Oct 29, 2009

from my general understanding of having been on these boards for awhile, it seems as though nurses working in critical care are more satisfied (totally a generality but something i've noticed). It's not to say that they are any less busy, but because they tend to have less patients they generally feel as though they are able to give their all to the patients they do have. They have less patients because their patients are needier. I guess it's sort of like this: would you rather have two-three patients and do everything for them or have 7-9 patients and do a little bit for each? it sort of depends on your personality.

I wouldn't say that any one specialty is more satisfying then the other though. All areas of nursing are facing hardship right now...the type of hardships may vary by situation and specialty!

tencat · Oct 29, 2009

Hmmm.....good question. I think a lot of burnout has to do with feeling powerless to change anything or have any kind of positive impact on a situation. I know when I worked Med/surge I felt like a glorified maid who handed out pills. I had little opportunity to use my critical thinking skills or my clinical judgement. That made me hate my job. Another aspect of burnout is a heavy load of patients. My current job is not good about caseloads....it's all about getting as many paying patients as possible....but I am able to function as a clinician and not as a highly trained maid, and so I love my job. But my fellow nurses are really burned out on high caseloads and being on-call.....I think everyone is different. So to answer your question, I think it might be harder to find job satisfaction in a hospital because of the way the environment is structured. I couldn't go back to hospital nursing unless I absolutely had no other options.

krstxn · Oct 29, 2009

from my general understanding of having been on these boards for awhile, it seems as though nurses working in critical care are more satisfied (totally a generality but something i've noticed). It's not to say that they are any less busy, but because they tend to have less patients they generally feel as though they are able to give their all to the patients they do have. They have less patients because their patients are needier. I guess it's sort of like this: would you rather have two-three patients and do everything for them or have 7-9 patients and do a little bit for each? it sort of depends on your personality.
I wouldn't say that any one specialty is more satisfying then the other though. All areas of nursing are facing hardship right now...the type of hardships may vary by situation and specialty!

I totally agree that it depends on your personality. In school I spent an entire semester in the MICU/SICU and I absolutely loved it! and most of my classmates hated it- so it is def an individual thing. I hated med/surg.. for the reason you mentioned above- I was very busy, nonstop busy, in the ICU , but I knew my 1-2 patients' history and felt I could devote more time to each. In med/surg I felt like it was all about tasks and that I was running around like a chicken with my head cut-off!

Flare, ASN, BSN · Oct 29, 2009

Job satisfaction is what you make of it. There are places that are simply miserable to work at where they don't have any qualms of making you risk you license and don't back you up and there are places where you may not be working with the population that you dreamed of, but you are happy and well cared for.

Many people do a little time on a m/s floor to refine their skills - others go right into a specialty and refine their skills as they work. Neither is incorrect, it's what works for them.

If you think you'd like to work in ICU, then strive for a job there - if you find out that it's not for you, then start looking for a transfer or a new job -but use the time whereever you land to learn as much as possible.

ajaxgirl · Oct 29, 2009

I am a new graduate and I have been reading through posts and I see alot of stressed out/ burned out nurses and it seems to be a recurring theme for those who post in the med/sug and LTAC forum. I am shocked by the pt loads, tasks and enviroment these nurses have to work in- I am so thankful that this forum was created so that they have a place to vent because I dont think family and friends who dont work in the healthcare field really understand what we go through. It is so upsetting to see how upset they are and that they are "stuck" there do to the current economy. I hope things turn around soon so that they can get out and find something less gruelling.:heartbeat:redbeathe:redpinkhe
I dont know how to ask this question without upsetting anyone-or sounding selfish so I apologize in advance. I dont want to be one of the burned out/stressed out nurses coming home in tears every night and I was wondering if there is a specialty in the hospital that would give a nurse a bit more job satisfaction, rather than having to put up and shut up? I know any specialty is going to be tough, and I am willing to work hard, I was just wondering if there is a specialty area that I could work that wouldnt make me feel like I want to quit everyday- and I am not looking for easy. I hope this makes sense because it can be interpretted different ways.
I know alot of nurse like NICU, Postpartum and L&D and state they wouldnt work anywhere else and the enviroment (generally speaking) isn't so much like the "front lines"... just wondering if there are some other areas that are like this as well??

Many people in the OR love it and would never work elsewhere.

kateyes7 · Oct 29, 2009

If you are still in school and can choose your own clinical rotations for your last semester, do ICU. Most of the nurses in my classes were scared of it but this will give you a better chance of getting an ICU position right out of school. This is your best bet! Good luck!

PostOpPrincess, BSN, RN · Oct 29, 2009

People don't like change. They would rather complain.

Don't be one of those people.

Embrace change and challenge and you will like nursing for a long time.

HealthShepherd · Oct 29, 2009

Whenever I read stories on AllNurses about rotten patient behaviour, I'm thankful to be a NICU nurse. Babies can be high-maintenance, but at least they're never ********.

MB37 · Oct 29, 2009

Some of my friends who are new nurses are thoroughly enjoying adult med-surg, even if for some it was just about their last choice (and given the job market, they wound up taking the only position they were offered). It's personal - I'm in a very high acuity ICU, and I like it, but there's a steep learning curve and I come home many mornings feeling like an idiot, and thankful I didn't kill anyone. Even if critical care is your eventual destination, you may be more comfortable learning basic nursing skills on a medsurg floor. Or you may not, and getting the 4-6 month new nurse ICU preceptorship may better prepare you for the job. Maybe L&D is more your scene, or mom/baby, if you don't like sad stories (not that they'll never happen there). Maybe it's NICU, where your patients won't annoy you - but their parents might drive you insane. In the OR, your patients are asleep - for some people, that's perfect, and for others they aren't using all the skills they went to school for. In psych you might not use all those skills either, but you'll learn a whole new set.

What did you enjoy about clinicals? What wasn't so great? Do you know any nurses at hospitals in your area? Even for medsurg, the pt load varies greatly from hospital to hospital. One place in my area has a 4:1 ratio, max, while others go to 8+. The acuity may be different, and the 4:1 place may have no techs, but you can see how one might be more stressful than the other. The great thing about nursing is that even if you don't love the first area you wind up in, you can move. Get that all important first year of experience, and you can try a new specialty every time you get bored or burnt out. I had a preceptor on my unit who has worked ICU, med-surg, psych, home care, and LTC. She's also certified in various holistic/alternative therapies. She's had a long career, and tried many aspects of nursing, and right now she's in ICU mode. You don't have to pick what's perfect for you right out of school - but try to find something that interests you, and no matter what learn everything you can from the experience. Good luck!

PostOpPrincess, BSN, RN · Oct 29, 2009

Whenever I read stories on AllNurses about rotten patient behaviour, I'm thankful to be a NICU nurse. Babies can be high-maintenance, but at least they're never ********.

Babies aren't the problem.

It's some of those crazy parents and families.

They used to drive me bonkers. :eek:

Medic/Nurse, BSN, RN · Oct 29, 2009

You ask a very interesting question. Unfortunately, there is no ONE right answer.

I agree with the others that note reasons for burnout (powerlessness, frustration, disenfranchised, overextended and just plain old stuck and tired) and it is hard to reset that "switch" without some major changes - so, I guess the keys to your question are more questions -

1. How do I find the area of nursing that will be most rewarding to me?

2. How do I stay satisfied as a nurse?

I know that these are difficult questions - and the answers will differ for everyone. I do believe that there are some things that you can do that will give you a bit of a better chance of finding a more satisfying situation.

First, know yourself. How do you function best - controlled chaos or relative calm? How well do you multi-task? How detail oriented are you? What group of patients do you find most rewarding? least rewarding? How emotionally ready are you for certain areas (some are just more demanding than others)? How much time and effort do you want to commit outside of work hours (on call, continued education, etc)? Any unique personal issues that may inspire or prohibit you in your quest for harmony in practice?

I believe that nursing has something for everyone - provided that they want to be a nurse.

The BEST thing about nursing has to be the almost endless number of practice areas.

I think personal inventory is the most important first step - what do you enjoy? what can you tolerate? what are your deal killers? and if time is an issue - how flexible will your financial situation allow you to be? Did you enjoy any certain area? Any chance of job shadowing in an area you want to consider?

Some think you have to do a year of m/s before you should consider a "speciality". I think that is flawed. I do think certain skills (that can be adapted to other speciality areas) can be honed on m/s (primarily - organization and advocacy) simply due to the patient load and variety of doctors/patients/support staff/demands/families that m/s nursing is all about. But, I think those same skills can be acquired in other areas as well - but maybe not as fast. I think that m/s nursing is it's own speciality.

IMHO - I think there may be some advantages to entering speciality practice as a new grad provided that you can find a position with a first rate orientation/internship program. Sadly, there are more new nurses than there are ideal situations, so some will get a bit stuck as they start to practice. If you find yourself in a "stuck" spot at first, remember that all experience is useful - it can even tell you what you just DO NOT want as well - and with that info you will have a better idea of what it is you will want as your career evolves - and it will evolve!

So, I guess I am not really answering your question - because there is not any one right answer. What works for me might not work for you - everyone is different. I think the key is to ask yourself the tough questions - decide on an ideal and then have your back-up options. Again, consider job shadowing or remember that everyone starts somewhere and be open to possibilities. Many folks have been surprised to find that they ended up being very happy in areas that they could never have imagined when they first stared practicing - grow with the changes. :)

As for staying satisfied - good employers are the starting point, realistic patient loads, supportive peers and managers and financial security are all important to me.

You also have to keep motivating yourself - I have had several episodes of "burn out" and my cure always involved setting a new goal - certification, speciality classes or conference attendance. In the process of working through the "burn-out" I'd often take a break, study for a class and obtain a certification or attend a national conference that made me set new goals or renew my enthusiasm.

Self care is vital in this profession - caring for others is demanding.

Good luck. The sky is the limit!