We're not picking our internship positions yet but....

[hopebewild]

I just wanted some advice on what area I should choose.

So far I have heard my choices are Med-surg, post-partum, ICU, and ER. I am leaning towards ICU and ER but can't decide between the two. I really dont have an idea of what I want to do after nursing school yet. I have been a CNA at hospitals for the past 5 years and have been just about everywhere except labor and delivery, surgery, and I have only floated to an ER once. I ruled out post-partum because even though i have been thinking I might be interested in labor and delivery I heard that you dont learn a lot of hands on skills. I also ruled out med surge because that is the main area i have been for the past 5 years and the floor i would go to is the floor i used to work on. (I loved working there but dont think med-surge is where I want to go. The burn out from nurses on that floor was too high)

So I would love to hear of people's experiences in either the ER or ICU and what choice would be the best.

[hopebewild]

anyone?

[trustbirth]

We dont pick internship positions like you do. The ER might be fun though. The way our school works is that we go to a different unit every semester. Med-surg, ER, psychiatric, OB, Pediatrics...

[hopebewild]

are you talking about clinicals? we do that too with clinicals but im talking about next summer when i get to be with one nurse preceptor 3days a week.

[trustbirth]

We dont do anything with a nurse preceptor. Sorry about that. :)

[hopebewild]

but yeah i think er would be awesome. it's just will it be enough skills so I would feel comfortable going anywhere after i graduate?

and thanks for your reply!

[psychonaut]

I chose NICU (and had to wrangle to get it) because I knew that's where I wanted to go when I graduated.

I did have some envy for my classmates who preceptored in the ER. They got to do many skills repeatedly that may have been neglected in our clinicals, e.g. tons of IVs, foleys, lab draws, etc., as well as lots of good assessment skills.

If you are unsure where you want to end up when you graduate, I'd be tempted to encourage you to think about an ER internship. I think the skills you learn there would translate well into many areas of nursing, even if you don't necessarily want to end up in the ER. ICU would be a close second.

NICU preceptorship prepared me well for my post-grad job (and got me that job, actually), but I am very specialised now and would have to be essentially retrained for just about any other nursing field.

[rwright15]

are you talking about clinicals? we do that too with clinicals but im talking about next summer when i get to be with one nurse preceptor 3days a week.

I did that this past summer as an "Extern I", this next summer I will be an "Extern II". The latter being the graduated one. I did mine in CVICU and really liked it. I got to work with post op hearts and learned so much. I am like you though, I am torn. I would love to go to the ER, I love the adrenaline/busyness and am not fond of downtime, but I don't want to pass up a chance to go to CCU/ICU and work my way up to CVICU. I am afraid once I am trained somewhere, and they say it takes a good year to become really proficient in an area, that I will not be able to switch to the other as easily should I decide that's what I wanted to do. Lemme know what you find out.

[MB37]

ER and ICU will both teach you valuable skills if you want to work in one of those areas after graduation. Med-surg will do more for you as far as reinforcing what you'll need to know for the NCLEX. If you already do well on NCLEX practice questions, then don't worry about that too much - just keep practicing (I did mine in a unit, still passed my first try with 75 questions).

The ER will teach you more hands-on skills. You'll be much better than the rest of us new grads at Foleys, IVs, NGs, and all that other stuff you probably haven't had a ton of chances to attempt in your regular clinicals. You'll also learn time management and prioritization. If you're lucky you'll get exposed to some traumas, and almost for sure get to see (even participate in) a few codes. The ER is really fast-paced (although you will get the occasional slow day) and once each pt gets a room, they might only keep it for an hour or two. You can be assigned to 4 rooms, lets, say, but treat 14 patients on your shift (and that might be a slow day).

The ICUs vary a lot based on what your hospital has. I precepted in a neuro ICU, so I got a really specialized experience. It was great for me, I loved taking care of some of the extremely critical trauma patients we got there. The vast majority of my patients were intubated and sedated and they had all kinds of invasive monitoring. I got less experience (although still a little) with all the cardiac drips than people who went to CCU or CSU. My patients varied a lot in age - we had the young traumas and brain surgeries mixed in with the older strokes and aneurysms. The young ones didn't have as many comorbidities, so again I didn't learn as much about a lot of the chronic conditions as people in other areas did. You'll have 1-3 patients, and you'll often get the same assignment back for the next few days. Most units have chronic patients that the whole staff knows that are either in and our of the unit constantly or spend 3 months there at a time. You have to chart as often as q15 min vitals for some patients, and assess at least q2h.

I think that if you're NOT sure what you'd like to do, and you think you have enough med-surg experience, you should do either ER, CCU, or a less specialized ICU (medical or surgical as opposed to neuro or neonatal). The ER will give you all the hands on stuff, CCU will teach you cardiac monitoring and all your vasoactive drips, and medical or surgical will expose you to more of the chronic conditions you're likely to encounter in any area you wind up in. Sorry for the length, and good luck to you!