What do you like most about your specialty?

oceanblue52 · Nov 19, 2017

Work in outpatient Psych, best part is watching clients get stable after trying and failing a bunch of med combos.

PeakRN · Nov 19, 2017

I work primarily ED. I also do some prehosptial stuff and outpatient pediatric oncology.

Best part: No day is predictable, you never know what is going to come through the doors. We treat everyone from premature neos who were just born to 100+ years old, sore throats to codes, hang nails to massive traumas. Because of this you have to know vast amounts of knowledge. We probably perform more skills than any other unit. If I have a patient I don't like they are generally gone in about three hours. The ED staff work as a team.

Hardest part: ED nursing is not taught in nursing school. You have to know your medicine, while I can often look up things in UpToDate there are many times that I cannot and the patient needs treatment now. You see the worst parts of society, and I mean the WORST. The patients do not stop just because the beds are full. The floors treat the ED like a resource, they only like us when they want help.

I love the ED and couldn't work anywhere else, but it isn't for everyone.

Everline · Nov 19, 2017

I'm a public health nurse. I love the fact that we work to keep people OUT of the hospital. I love educating patients and giving them the tools to make very important decisions in their lives. I like seeing patients more than once, getting to know their struggles and offering resources to help them through. It's really nice to be a part of the every day life of our patients as opposed to seeing them when they are very ill and then not really knowing what ever became of them. I love the autonomy I have as a public health nurse. I have my own office, see patients and use my nursing judgement every day. I have a great schedule with no nights, weekend or holidays. I learn something new every work day.

The hard part is realizing that I cannot help everyone. Some people will repeatedly make the same mistakes or will do things contrary to their best interest. Sometimes these things effect other people, such as their children. It can be very frustrating or heartbreaking at times. It's also difficult to see young people getting themselves into situations that will greatly affect their future. But the bright spot is that often I can do something to help them or point them in the right direction. Seeing teenagers resist the negative peer pressure and pursue their dreams and goals is absolutely fantastic!

azhiker96, BSN, RN · Nov 20, 2017

I love PACU. It has the right balance of autonomy and teamwork for me. I get a pt and a slew of PRN orders which I apply based on my assessment and judgement to stabilize and normalize my pt. If things head south, I can get lots of help pronto. If I need something else I can call the Dr/CRNA and get an order.

It is not for everyone. You must learn when you have to watch every breath and when you can relax a little.

itsybitsy · Nov 20, 2017

I didn't know the ED was the secret smart club...

I dwell in the NICU. You can't expect a normal day, babies health change quickly and you never know when the next 23 weeker is going to drop. We manage everything from ECMO to feeder-growers, post-op heart kids to jaundice, ventilators with nitric to hypoglycemia, codes to normal newborn discharges. Since there is so much variation in the patients you see in the NICU, you have to really know your stuff for the very specific population. We have some of the sickest and most vulnerable patients than any other specialty. Even if I don't like the parents of my patient, they most likely won't be at the bedside all day everyday because their life didn't stop because they had a NICU baby. We all work together if the day is going crazy.

NICU isn't taught in nursing school. You have to know you baby for when subtle changes are occurring so treatment can begin. Most of the time the NNP is near when a baby is going south but if not, we can always manage until an NNP or doctor gets to the bedside. You get some of the worst parents, like the mothers who were addicted to drugs and now their baby suffers while the mother lives out of the NICU... THE WORST. Babies still delivery whether or not we are ready or able, it just means transferring and admitting over and over again. Most other units think NICU nurses are princesses, but they really have no idea what we really do.

AND HOW AWESOME WE ARE. SUPER NURSES FOR SURE.

i.e. Each specialty is special to someone/each nurse and each has unique features. No one specialty does more or less than the other. There are different hardships in every speciality, and not one trumps the other. There are also interesting features of each, and again, not one trumps the other.

PS I felt dirty even writing we have the worst parents, even about drug-dependent mothers. I don't think that. They have their issues and they don't need more from the nurses. I don't know why anyone would say someone is "THE WORST", but I couldn't post this without this postscript explaining my true feelings.

PeakRN · Nov 20, 2017

I don't know why anyone would say someone is "THE WORST", but I couldn't post this without this postscript explaining my true feelings.

Because I have taken care of the newborn who had their head smashed against the wall.

Because I have taken care of toddlers who were sexual abused, left in a bathtub, and brought in by their distraught mother who found them 3 hours later, fast forward 3 days and they are a withdraw of care.

Because I've taken care of the eleven year old who was diagnosed with inoperable metastatic brain tumors.

Because I have taken teens who commit suicide after they were kicked out by their parents when they came out of the closet.

Because I have taken care of septic women who tried a myriad of ways to try to get an abortion because they couldn't access good care.

Because I have taken care of the father in his 40s who codes from a massive MI in front of his school age children.

Because I have taken care of uninsured/underinsured who don't take their meds because they can't afford them, and we can't send them home with meds.

Because I have taken care of the homeless who we do not shelter and loose their fingers in the cold.

I'm sorry but these should not be acceptable. It's not the patient's fault but it's also not okay. Society has failed these patients.

itsybitsy · Nov 21, 2017

Because I have taken care of the newborn who had their head smashed against the wall.
Because I have taken care of toddlers who were sexual abused, left in a bathtub, and brought in by their distraught mother who found them 3 hours later, fast forward 3 days and they are a withdraw of care.

I'll give you these two, but why would you describe the other patients/family as "the worst"? As in the way you wrote it, the actual person/people were horrible as a person. At least that is the way I interpreted it.

Also, other units also take care of all of those patients you listed. And I'm willing to bet for a much longer duration. They are not unique to the ED.

PeakRN · Nov 21, 2017

I'll give you these two, but why would you describe the other patients/family as "the worst"?

I'm sorry but these should not be acceptable. It's not the patient's fault but it's also not okay. Society has failed these patients.

I don't think that what I've said points a finger at the family or the patient directly. And besides, if you don't see a problem with parents who kick their kid out on the street for being gay I don't think I could explain morality to you.

I never said that other units don't see bad situations. I do think that generally speaking the ED sees the greater number of cases and with far less support. The nature of the ED is that we cycle through cases constantly and see very high volumes, even if hourly bed census is the same as other units.

I also never attacked another unit. I don't know why you are so defensive or have a desire to prove me wrong. I didn't answer alexaway's question by saying why the ED is better, why we are the smartest, or why other units are awful.

Were you offended when I said that you need vast amounts of knowledge in the ED? I didn't say that others didn't.

Were you offended when I say that we probably perform more skills than other units? I honestly think that this is true. Performing more skills doesn't make anybody a better nurse, and we do it because we don't have the resources to come help us immediately.

Or maybe you were offended by the idea that as a nurse I don't believe that everyone is inherently good, that I come off as saying that there are bad people. There are. You can disagree with this, but it doesn't change my opinion. Sorry.

AlwaysLearning247, BSN · Dec 4, 2017

I work on an intermediate care floor, which is basically ICU stepdown. I like learning new things everyday. We get a lot of patients on vents, bipap/cpap, drips, etc. Sometimes it can get crazy because the patients are really sick. The ratio is 3:1, sometimes it feels like too much. A lot of these patients would be in the ICU at my last hospital. The hospital I work at now is a level 1 trauma center so the patients tend to be more sick. I love being able to learn so much, it's a great experience!

Purple_roses · Dec 5, 2017

I work cardiac. The best part is feeling like a valuable asset to the team and feeling proud of myself after handling an emergency well. The worst part is that my manager sucks; he rarely acknowledges a job well done and almost always has a negative thing to say. It's a downer and our entire team's morale is actually pretty low because of this. Lots of great nurses are leaving

rkitty198, BSN, RN · Dec 17, 2017

The floors treat the ED like a resource, they only like us when they want help.
.

Like in what way?

I have never asked the ED for anything and I work PCU/MED/SURG/ONC and now do one day a week wound care

I LOVE the varied things I get to do. The multitude of conditions. Some people see an adorable baby in a stroller and say "how adorable is that baby!" As they make kissy faces.

Well personally I see a patient who is 80 and up and say "how adorable are they!"

The older the patient is the better!

i also started doing wound care once a week. It's so fun being a part of a speciality that dr's rely on YOU for your knowledge. It's very rewarding seeing a wound change and heal over time.