I am a soon to be new grad interested in doing travel nursing in 3-5 years. However, I am currently working in critical care (CNA) and plan on doing so as a RN. Do I need to switch every year and do a year of ICU, a year of M/S, a year of L&D etc? Or do I need to stick with one for the full 3-5 years. I abhor M/S and really do not want to do it when I travel anyway, but if I have to float when I travel I don't want to switch from 1-2 pt's a shift to 7 without some experience in time management. I just need to know what experience I can gather to make me well rounded enough to travel without risking my license.
Feb 14, '07
If you plan to work in ICU as a traveler then that is where you should get your professional nursing experience. Most reputable travel companies won't send you on ICU assignments unless you have at least a year of experience working in the unit. They might take you with less than a year of ICU experience if you were working in another critical care area (i.e. Stepdown). It might help to have some Med Surg experience if you are going to work in an SICU or MICU, but I don't believe it is a requirement.
However, you raise a good point about floating while on travel assignments. Invariably, when the unit census drops, travelers are usually the first to get floated out to med surg or tele. And, if you don't have your time management skills down its going to be rough going from an environment where you're used to having only 2 or 3 patients to one where you'll have 6 or more.
Just curious to know what your experience is with Med Surg, though. Have you worked as a CNA on a med surg floor? Otherwise, how do you know you don't like it?
Feb 15, '07
I currently work as a CNA (it is actually a PCA here but essentially the same thing). Unfortunately my experience with Med Surg has been pretty bad. The nurses are usually forced to take care of 7+ patients (on days when we aren't short handed), pt care is nonexistence and RN responsibilities are almost limited to passing out meds because of the overload. My main concern with Med Surg is the acuity tends to be getting worse and worse and the patient ratio remains the same. I am fearful Med Surg may cost me my license because I worry about pushing so many meds while under the strain of overwork and a devastating mistake being made or that I can't answer a phone call about v-fib etc. Also, and I do not know if this is always the case, but where I work the nurses with troubled licenses' or poor work history get pushed on to M/S because it is there only way back in at my hospital. Most importantly RN's are just miserable there. Not just peeved with their jobs but truly miserable and I don't want to have gone through school only to find myself unhappy. I hear from everyone YOU MUST DO A YEAR in M/S but I really don't want to...
Feb 15, '07
OH and yes I worked M/S just transfering over to critical care now...spent 6 months on the floor....
Feb 16, '07
It couldn't be further from the truth that you HAVE to do M/S before going to ICU or anything else for that matter. That used to be the case, but now so many (especially large) hospitals are training new grads in all areas of ICU. If you get into a good preceptorship and critical care program, you shouldn't have any problems.
You really don't even need 3-5 years experience. 1 year is required, 2 is preferred.
Another thing, you can always put into your contract that you are only willing to float to other critical care areas, step-down units or Telemetry unit. That would cut down from taking 8 patients since these areas usually don't have more than 4:1. There are some hospitals that will say you may have to float anywhere. I have passed those assignments up as I am just not comfortable doing that. It may mean that your possibilities for hospitals or parts of the country are more limited, but generally in large hospitals, they will have 3-4 critical care areas and don't really need their ICU nurses to go to the floor.
Feb 16, '07
OkieICU is right. You don't have to do med surg nursing before going into the unit. Most people who insist on this claim that you need to get basic med surg skills down before going into a higher level of nursing practice, but I disagree. First of all, there is really nothing 'basic' about med surg nursing because it is a specialty area in itself. You are going to see the same ostomies, feeding tubes, wound care, pressure ulcers, surgical patients, etc. in the unit as you see in med surg. The main difference is that ICU patients are usually much more unstable and require closer supervision. The ICU protocols are different because the patients often require interventions and use of medications that are not permitted on other floors.
As Okie suggested, its a good idea to apply to a hospital that has a good critical care preceptorship program after you get your nursing license. After you gain a year or so of unit experience you should be just fine as a traveler. There are plenty opportunities out there for nurses, whether they're new or experienced, so there's no reason to do med surg nursing if you don't want to.
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