Three interviews on very different units - need advice

Is the Otho/trauma/stroke icu or floor? There’s going to be a difference.

I work in a Neuro/Trauma icu. We have lifts to help turn and get patients into chairs. But I know it’s not the ambulating that the floors do. Stroke patients usually have deficits. So it can be physically taxing to move them. We have a lot of logrolls as well and you can’t use lifts on them.

I’ve been on my unit for 6 years now. I love it. I love the brain and how unpredictable it is. I like treating big strokes. I also like a fresh trauma and all that goes with it. I’m also a little older. Early 40s. I just make sure I use safe lifting.

But, I’m always on the go. I rarely have a down day. Neuro patients though can sometimes drive you crazy. It’s a whole different thing having patients that have damaged brains.

55 minutes ago, LovingLife123 said:

Is the Otho/trauma/stroke icu or floor? There’s going to be a difference.

I work in a Neuro/Trauma icu. We have lifts to help turn and get patients into chairs. But I know it’s not the ambulating that the floors do. Stroke patients usually have deficits. So it can be physically taxing to move them. We have a lot of logrolls as well and you can’t use lifts on them.

I’ve been on my unit for 6 years now. I love it. I love the brain and how unpredictable it is. I like treating big strokes. I also like a fresh trauma and all that goes with it. I’m also a little older. Early 40s. I just make sure I use safe lifting.

But, I’m always on the go. I rarely have a down day. Neuro patients though can sometimes drive you crazy. It’s a whole different thing having patients that have damaged brains.

As far as I know the Ortho/Trauma/Stroke floor is not an ICU. It's a specialized unit, but not an ICU. So you are saying that would have more lifting etc. than the ICU correct?

Both rehab and ortho can be physically demanding. Can you ask to job shadow?

On 8/23/2019 at 3:22 PM, Golden_RN said:

Both rehab and ortho can be physically demanding. Can you ask to job shadow?

I did job shadow on Friday on the Ortho/Trauma/Stroke unit and the Rehab unit. I knew right away that the rehab unit was not going to be for me. I didn't like the structure of the unit at all. The ortho/trauma unit was really, really busy but overall looked like something that I could possibly like. I am going to job shadow in the behavioral health unit on Monday and see what that's about. That unit makes the most sense because of my background, but I am just not sure.

On 8/22/2019 at 9:45 PM, Nurse Magnolia said:

As far as I know the Ortho/Trauma/Stroke floor is not an ICU. It's a specialized unit, but not an ICU. So you are saying that would have more lifting etc. than the ICU correct?

Yes, because now those patients are starting to rehab on the floor and most of them have some type of deficit. Most of my patients can’t get out of bed. They are vented. So I use lifts to turn them for the most part. We have a few here and there that we can get up. But it’s not anywhere near what the floor has.

If you have a stroke patient that their left side is weak or flaccid it can be difficult to ambulate them.

But, I do love my trauma Neuro patient population. It’s so awesome to see a horrible accident victim who was on the brink of death walk again or interact with their family again. It’s cool to see TPA work it’s magic.

I think you should seriously consider the ortho/trauma/stroke unit. It sounds like it's a specialized med-surg unit, so you're going to get the best all-around experience there.

Rehab is great, and I do like floating there from time to time for a change of pace, but you definitely won't see the variety you'll get in the ortho/trauma/stroke unit. Similarly, the Behavior Health will be fairly light on the medical side, even if they have six medical beds. One learns to manage medical patients through the experience of having a lot of them and being surrounded by veteran nurses who can be resources. You will see far fewer things on the rehab or behavioral health units, and will be less confident of your ability to manage emergent medical situations because you won't have that med-surg background.

If you go the rehab or behavior health route, and decide you want to do something else, you'll have a much harder time getting back into the main hospital than if you do a med-surg unit to start. If you take the ortho/trauma/stroke job, and decide after a few years that the physical demands are too much, you'll have that med-surg experience under your belt that will allow you to move to another unit, including inpatient rehab or behavioral health, if you so choose.

45 minutes ago, turtlesRcool said:

I think you should seriously consider the ortho/trauma/stroke unit. It sounds like it's a specialized med-surg unit, so you're going to get the best all-around experience there.

Rehab is great, and I do like floating there from time to time for a change of pace, but you definitely won't see the variety you'll get in the ortho/trauma/stroke unit. Similarly, the Behavior Health will be fairly light on the medical side, even if they have six medical beds. One learns to manage medical patients through the experience of having a lot of them and being surrounded by veteran nurses who can be resources. You will see far fewer things on the rehab or behavioral health units, and will be less confident of your ability to manage emergent medical situations because you won't have that med-surg background.

If you go the rehab or behavior health route, and decide you want to do something else, you'll have a much harder time getting back into the main hospital than if you do a med-surg unit to start. If you take the ortho/trauma/stroke job, and decide after a few years that the physical demands are too much, you'll have that med-surg experience under your belt that will allow you to move to another unit, including inpatient rehab or behavioral health, if you so choose.

I think this is really good advice and I've been thinking along the same lines. Even with my behavioral health background, going into behavioral health at this point in my career seems like a dead end. I'm worried I'd be making the decision right now that behavioral health will be my career from now forward and I'm not ready to say that. I think I will learn a ton on the Ortho/Trauma/Stroke unit and can take those skills with me into other positions down the road if I decide that it's too hard on my body. I have a strong interest in wound care as well and I think I'd be able to transition to wound care after a couple years on this unit as well. It was a super busy, fast paced unit and I actually like that. The ratio is 6:1, but it's pretty much like that everywhere. I'm going to have to come up with a very good "Brain" or handoff sheet!

Thanks for the advice - it cemented in my mind what I want to do. The only way I'll take behavioral health is if they offer me no nights - which they aren't going to do lol

Behavioral health inpatient is not a dead end.

Don't do it if you don't want to, but it is not a dead end.

As an inpatient psych nurse I gave meds, did a lot of education, used restraints when necessary, ran a group, and on the child and adolescent psych unit I communicated with parents daily.

It opened up some doors for me to a community position that is mon to fri 8 to 4 no weekends, nights or holidays and I always get my lunch.

But psych is really only for nurses who enjoy the population. If you burned out of psych in your previous job, then just don't.

Give the unit a look see before you commit.

9 hours ago, no.intervention.required said:

I work on cardiac/ stroke unit, and our hospital has an ortho only unit, so the combination of ortho and stroke is odd to me.

It may depend on how many units your hospital has. Stroke/Neuro patients can have a lot of physical deficits, and combining that with ortho can have staff better trained to dealing with patients and new ADL problems. Can also have the PT/OT nearby because of their higher patient load. Also may depend on where neurosurgery goes, since both ortho and nsgy would be dealing with post-surgical wound care, etc.