What is your day like?

mrmike · Mar 4, 2008

I have respect for floor nursing, as it is quite difficult to manage all the tasks and duties that need to be completed. I have worked on the floor and it is a completely different experience then an ICU. I work in a surgical trauma ICU in a teaching hospital and it is imperitive to analyze and understand every aspect of the patient and their care. It is not just following orders as this would be dangerous! Critical thinking is required at all times, it is tiring but very gratifying to actually participate in the care of the patient. I could never work anywhere is nursing except critical care or ED! Good luck and learn all you can.

sweetsmiles2007 · Mar 5, 2008

I'm sorry to hear your bored w/ nsg. school-- just wait till you get out--you've jinxed yourself already ;P

yes! it gets crazy busy in a cerebral way!! go find an anatomy book and try to figure out the heart. EKG's will boggle your brain, cardiac output, hemodynamics, then, try to figure out a cardiac bypass pump! that should have you reeling ---hehehe

or, if cardiac isn't quite your thing, try to understand the brain--why are people psychotic? how can they fix it? did you know that 10% of people with mental problems have some kind of physical defect (brain tumor, ect)? should 'stupid' be a diagnosis? try reading Sybil. sad, but fascinating story about multiple personality disorder.

the ICU--is a matter of figuring out why someone is going bad, than figuring out the best way to fix it. yes, that's a load of brain work. cause you have to know what your dealing with in the first place, and nsg school doesn't come close to teaching you everything there is to know. Luckily for us, the MD's do lots of the figuring out part, but if we're not on our game, informing them of pertinent info, the pt's never gonna get fixed.

good luck, enjoy getting the basics down!

FuturoEnfermera · Mar 6, 2008

I'm sorry to hear your bored w/ nsg. school-- just wait till you get out--you've jinxed yourself already ;P
yes! it gets crazy busy in a cerebral way!! go find an anatomy book and try to figure out the heart. EKG's will boggle your brain, cardiac output, hemodynamics, then, try to figure out a cardiac bypass pump! that should have you reeling ---hehehe
or, if cardiac isn't quite your thing, try to understand the brain--why are people psychotic? how can they fix it? did you know that 10% of people with mental problems have some kind of physical defect (brain tumor, ect)? should 'stupid' be a diagnosis? try reading Sybil. sad, but fascinating story about multiple personality disorder.
the ICU--is a matter of figuring out why someone is going bad, than figuring out the best way to fix it. yes, that's a load of brain work. cause you have to know what your dealing with in the first place, and nsg school doesn't come close to teaching you everything there is to know. Luckily for us, the MD's do lots of the figuring out part, but if we're not on our game, informing them of pertinent info, the pt's never gonna get fixed.
good luck, enjoy getting the basics down!

Thanks! I'm hoping to be shocked by how complex it will be. That would actually make me feel a ton better. I do enjoy figuring out EKGs so maybe I'll work on that some more.

FuturoEnfermera · Mar 6, 2008

i have respect for floor nursing, as it is quite difficult to manage all the tasks and duties that need to be completed. i have worked on the floor and it is a completely different experience then an icu. i work in a surgical trauma icu in a teaching hospital and it is imperitive to analyze and understand every aspect of the patient and their care. it is not just following orders as this would be dangerous! critical thinking is required at all times, it is tiring but very gratifying to actually participate in the care of the patient. i could never work anywhere is nursing except critical care or ed! good luck and learn all you can.

thanks! have you worked in the ed too? which do you feel is more challenging?

allnurses Guide · Mar 6, 2008

It depends on the type of nursing you like, personally I couldn't work on a ward the shear volume of patients is overwhelming. I liked ICU because I had to be on my toes, you are constantly thinking about potential problems and trying to avoid deterioration of the sick patient.

I have also done a little work in the emergency unit as well, again the volume of patients that are seen is overwhelming, and although now as a NP it is much more enjoyable I feel like I am able to work more logically rather than rushing to get the basics done.

Indy, LPN, LVN · Mar 11, 2008

Rehab may not be acute, but it's got a lot of basic elements in it. I'd suggest that you do some pathophysiology reading in your spare time. If you're bored, try playing "the worst" game. The worst that can happen to this patient is... well usually it's death. Then try thinking how your patient can go from whatever it is, to death, by creative routes. How would you know if this process started, and what subtle signs should you look for?

This is a thing that will help you organize your thoughts and take up some "head space" during your clinicals. We had to incorporate this into some of our care plans as an afterthought and it was really helpful.

pinkiepie_RN · Mar 12, 2008

I'm a second semester BSN student myself and while I'm currently on a Medical Oncology unit, I can totally relate to the level of acuity and skills performed when I was at a sub-acute transitional facility last semester. I've been told it gets more complicated as you get through NS and that you get more responsibilities as time goes by. I'm crossing my fingers for that in the future but I think it's sometimes a break to not worry as much in clinical as I have to do about studying for Med-Surg lecture.

In order to challenge myself, I'm trying to get a NS job on an outpatient surgical unit so I can see new things and get my feet a little more wet. Maybe that could be an option for now, because you and I both have 2 semesters left after this one. HTH!

nursejill155 · Mar 14, 2008

When I was in nursing school, I felt the same way. always picked the most complicated pt and ended up doing hours of research the day before the clinical, and I LOVED it! I started out on a step down, who often had sick patients (at least I thought) but craved more. I then got a job in a busy surgical ICU at a teaching hospital. In the ICU we take everything, we recover CABG and other CT surgery pts, we get crazy bleeding of the bed traumas, vascular etc. anyone who needs the ICU. I will be very honest with you that I cried every night before I left for work, completely scared I was going to kill my pt! It is very stressful and you would be suprised at how little you actually know. You have to develop good critical thinking skills and not be scared to jump in, which can be very difficult to do. When in school you learn about "critical" patients and you think you have an idea, but you don't...that was the first thing I said...."wow they are REALLY sick!!!!" It is possible, don't be discouraged with school, if you want a challenge ICU is the best that it gets. You have to be dedicated to learning and the unit that you work in, there is always something to learn, and this sounds like what you are looking for!!! I hope this helps some. :)

RNFELICITY · May 9, 2008

I think that every unit/floor has its challenges.

Out on the regular non-tele floors, those nurses have to be on their toes to subtle changes in their patients because they do not have monitors telling them every single little thing going on.

I currently work in an ICU and I feel very blessed and lucky that I have experienced many floors nad levels of nursing because each area taught me something and made me a better nurse for my next patient.

gradcare, LPN · May 10, 2008

"I'm feeling very discouraged with nursing after only two weeks of clinical. I'm in my 2nd semester of my BSN program. My clinical instructor thinks that I am way better suited for ICU so I'd love to hear what your day is like (in general) in the ICU. So far I've been on rehab, which I hear is the least acute it gets, and I'm SOOO bored. I NEED to use my brain more or I'm sure to go mad. I precepted last week and had three patients, was able to do all but pass meds myself (acuchecks, i&o cath, showers, vitals, all the charting, changed the beds) and was still craving more action. I'm thinking that's a bad sign as I'm "supposed" to be overwhelmed and nervous my first real week with multiple patients. We go back to only one patient this week. I'm not sure what I'll be doing the whole time if I was bored with three...."

Just remember that the only time you will ever only have an allocation of 3 pts will be in CCU/HDU. Also try other specialties before you comit to ICU. You need not only basic nursing care but also a reasonable broad range of surgical and medical experience unless you end up in a pure surgical unit.

If you can't pick up the number of patients, try looking at their pathophys, rehab plan and see if you can get a feel for why things are the way they are with them. Try writing some careplans, that sort of thing. The whole point of the first couple of pracs is to get the basics sorted and to gradualy step up the time management and clinical skills so by your final year you can really hook in and hit the ground running. So relax, the challenges will come but until then you may need to create your own.

allnurses Guide · May 11, 2008

I worry about students with attitudes like yours, to be honest. It's not a competition to see who can get their work done quickest, or easiest, or prove how smart they are. The biggest problem with nursing students (esp early on, like you are) is that you don't know what you don't know.

Yes, rehab patients often seem stable and boring. However, you'd better know what you're doing when you assess and treat them, because they are often post-surgical, and can turn bad quickly with a PE, or various other complications. In addition, a huge number of elderly patients do poorly because they have insufficient rehab before getting home - it is important stuff to be able to assess them accurately.

If you're bored at clinicals, you're not doing it properly. Rather than worry about which clinical area you'll end up in which will be good for YOU, I would suggest you ask your instructor how you can be better for your patients wherever you are. You can investigate their disease processes, look up the drugs they are on, etc etc. There are a ton of learning opportunities.

I don't mean to be harsh, although I am sure I sound impatient. Being a good nurse means not accepting things at face value, but always anticipating what can go wrong. I totally agree with the person who suggested you do the "what's the worst that can happen?" rule.