Torn between two specialities for preceptorship.

[taylor925]

Hi Everyone,

I apologize in advance for the long post and I appreciate you taking the time to read through it. I am posting here looking for some advice as to what to choose for my senior preceptorship in my BSN program. I have narrowed it down to either pediatrics or labor and delivery/postpartum...two very different specialties. I've always been the type of person that likes to leave as many doors open as possible so that I do not limit myself in the future. With that said, my predicament comes from a fear that if I choose one or the other it will lock me into that specialty and will later severely limit my opportunities when it comes to looking for a job post graduation. I understand that a preceptorship does not define you as a new nurse; but as I have been researching new graduate programs, I have found that many prefer that you have precepted in that field prior to applying. So now here I am completely torn between the two. So far I have completed my OB rotation and I am currently 5 weeks in to my pediatric rotation.

Before I even began nursing school I had an interest in becoming an L&D nurse. I truly view child birth as a miraculous process and I honestly feel honored to have the opportunity to be apart of such a special day for someone. L&d nursing encompasses many of my loves; women's health, being in an emotionally supportive role, and the fact that you also get to care for mom and baby as a dyad. Side note- I also once had an interest in NICU but after my shadow day there I ruled that out as something that I am not interested in diving right into straight out of nursing school. Anyways, the major things holding me back from choosing L&D is the fact that in my OB rotation I was at a very slow hospital and I unfortunately only got to see one birth from start to finish along with never getting to observe a C-section. I was incredibly disappointed because I did not feel that I got a very good sense of what exactly the L&D nurses role/tasks were. I really wish that I could have witnessed more births so that I could have paid more attention to what the nurses were doing rather than the birth process itself. I did gain a ton of postpartum experience and I truly enjoyed every minute of it. I loved all the opportunity for education and getting to care for mom and baby. I'm worried that if I do choose L&D for my preceptorship, it will be incredibly hard to transition to PEDs if I decide that L&D is not for me.

As far as peds is concerned, I have always loved working with kids. I've been a babysitter/nanny/tutor since I was very young and working with kids of all ages truly does have a special place in my heart. From my adult med/surg rotation I know that I would much rather care for kids than adults (aside from women in L&D). I find working with kids very fun and in my 5 weeks on the surgical floor in my peds rotation, I have felt more comfortable that I ever do in my adult med/surg placement. Although, my rotation is somewhat limiting because I am placed on a strictly surgical floor and most of the children are not super ill. Many of them are there for elective surgeries and are otherwise healthy. In the coming weeks I will get to do two observation shifts, one in hem/onc and one on a somewhat more acute surgical floor. If I were to go with peds for my clinical placement I am leaning towards choosing PICU so that I can gain the critical care experience that my regular clinical rotations have not provided me with. Like I mentioned earlier with L&D, I am afraid that if I go with peds it would limit me if I did decide to go with L&D in the future.

So now I turn to my nursing community, what do you advise I should do? I would love to hear your thoughts on the pros and cons of choosing either one.

Thanks in advance!

[Rose_Queen, BSN, MSN, RN]

Well, first of all, are you guaranteed a spot in either of those specialties for your practicum? My school had us list our top 3 choices; only 2 were in L&D and 5 in peds. It has a lot to do with finding the preceptors. Quite frankly, those preceptorships/practicums/capstones don't really make that much difference in new grad programs- it isn't nursing experience; you are still a student.

[KelRN215, BSN, RN]

Neither experience as a senior practicum student will exclude you from working in the other as a nurse. Your senior practicum experience is really only relevant to helping you secure your first job IF that floor has new grad openings and decides to hire you. Once you've worked as a nurse, no one will ask you again where you did your senior practicum.

For what it's worth, I've been a pediatric nurse for my entire career (11 years). 2 people who started as new grads the same year I did also worked extensively in pediatrics- 5ish years in the hospital then each went to community based pediatric positions. Both are now inpatient maternity nurses (after being out of the hospital for 5 years each).

[Rainbow_RN, BSN, RN]

I just chose a specialty for my first job (still med-surg, but orthopedics). I don't regret it at all. Follow your heart. Especially if you are still a student--I will echo what has been said here. It won't make a difference other than networking for you right now. Good for you for planning out your future and being forward-thinking, though. When you choose a career do what makes you the happiest, as long as it's a logical choice in terms of pay/benefits/travel time. I will also mention that practicality includes how many spots there are for new grads. Don't spend your senior year precepting somewhere that won't be able to hire you. If there are spots, look into how many peds has vs. labor and delivery, and let that help guide you. With all this being said, my specialty does not involve working with kids or new moms, so I can't offer any insight into those specific fields.

[llg, PhD, RN]

I disagree with those who say it won't matter. I work in a children's hospital and have worked in the maternal-child field for over 30 years. When we look at hiring new grads, those who have done senior preceptorships in relevant areas definitely have the advantage. In fact, I know of several specialty units that will not hire a new grad unless they have relevant experience (e.g. senior practicum) on a unit that is similar to theirs.

So ... I recommend choosing the field you think you will be seeking employment in -- and as your back-up choices, choose things that are similar to it. (E.g. If you want PICU, then an adult ICU would be considered more similar than a Mother/Baby unit. But a Mother/Baby unit might be considered to be more similar to an L&D unit than an adult ICU - though some might disagree with that.)