What skills/personality types are needed in what specialties?

lpnflorida · Dec 15, 2008

I love Rehabilitation Nursing. I do not mean in the LTC setting ( no offense ) It requires structure in the sense of being organized. We have such diversified patients and diagnosis it keeps it very interesting.

Some of our patients are as sick , some sicker than you will experience in acute care. Due to their multiple co-morbidities.

It is a physically demanding job and also mentally challenging. The best we see miracles happen everyday. Our patient's are with on average 10 days. It is very fulfilling.

nurse_clown · Dec 15, 2008

Ok. That title can be a little confusing, so here is the english translation.
Lately, I'm finding that I am not happy in the Medical/Surgical field of nursing. Nothing wrong with the field, I just think its a poor fit for me. It doesnt suit my personality and strongest assests as a nurse.
So, in other fields (ICU, OR, Oncology, Pediatrics, Home Care nursing, whatever specialty you have been in) what kind of individual would do well?
Me, I am very structure oriented. I work best with routine. I have a great humor and can achieve a good theraputic relationship with my patients. I want to be challenged, but not so much so that I have to rush through my care. My biggest weakness is that I dont patronize well (meaning, administration and I tend to avoid one another).

I'm an oncology and long term care nurse. In oncology, there's always a challenge and also a risk for things to go downhill quickly. The patients while putting on a brave face are generally concerned about their condition - they need a good theraputic relationship with their health care workers. Mind you, there isn't much of a routine. You'll find a lot of routine in long term care. And it is also a challenging field. Long Term Care residents (patients) also require a strong therapeutic relationship with their nurse. The residents trust and rely on their "structured routine" and it can be very challenging to get to know them and what "routine" works for them. Medications and the elderly can be a huge challenge to sort out. It can also be a challenge not to rush because there is a lot of paperwork but the residents are unable to speed around like we can.

Your weakness and my weakness are similar. While I try my best to follow rules and policy, I'm always wondering why. I think money could be better spent on frontline nurses so we can take the time to do a proper assessment and get the whole picture. While I hate documentation, I know it's necessary and it needs to be done properly but it takes a lot of time and patience.

I'm not sure about ICU or OR nursing. I don't even know anyone in that field. I know that in my hospital, the ICU is swamped and the nurses there get frustrated easily. But, I've also heard reports from the patients that were transferred from ICU that the nurses were good to them. When I was a patient myself, I really appreciated the OR nurses but that environment doesn't seem to be "routine" to me.

I hope this helps.

Riseupandnurse · Dec 16, 2008

Have you ever thought about nursing education? You're not often rushed, your opinions are respected, and there is a routine and structure to it. A sense of humor helps and you can enjoy a lengthy relationship with your students who become rather like your patients in some respects.

eriksoln, BSN, RN · Dec 16, 2008

Oh, I have thought about that. I would LOVE to be a theory instructor. That takes a master's degree though, doesnt it. Got to get started on my BSN soon.

NurseKatie08, MSN · Dec 16, 2008

I love Rehabilitation Nursing. I do not mean in the LTC setting ( no offense ) It requires structure in the sense of being organized. We have such diversified patients and diagnosis it keeps it very interesting.
Some of our patients are as sick , some sicker than you will experience in acute care. Due to their multiple co-morbidities.
It is a physically demanding job and also mentally challenging. The best we see miracles happen everyday. Our patient's are with on average 10 days. It is very fulfilling.

Why do you say "no offense" regarding rehab in the LTC setting? Isn't a rehab unit a rehab unit? My unit (TCU within LTC facility) requires structure and organization, and some of my patients are also sick due to multiple co-morbidities--this is why they need rehab.

Have you worked in LTC rehab? If so, I don't feel it's appropriate to comment on what it is or isn't. I am a rehab nurse just the same as my former classmates who work in rehab hospitals.

GadgetRN71, ASN, RN · Dec 16, 2008

OR nurses tend to have assertive personalities..you have to be able to stick up for your patient, and yourself. This can be learned though. I used to be very meek and I'm getting mouthier with each passing year, LOL.

It helps if you can think fast in an emergency and you have a strong stomach, too.:wink2:

lpnflorida · Dec 16, 2008

Why do you say "no offense" regarding rehab in the LTC setting? Isn't a rehab unit a rehab unit? My unit (TCU within LTC facility) requires structure and organization, and some of my patients are also sick due to multiple co-morbidities--this is why they need rehab.
Have you worked in LTC rehab? If so, I don't feel it's appropriate to comment on what it is or isn't. I am a rehab nurse just the same as my former classmates who work in rehab hospitals.

I do not mean to offend. I only ever worked a LTC rehab for 2 days it actually was quite a bit different than what is my experience in the hospital . The biggest difference was the in LTC almost all of the shift involved passing medications. There was much less involvement with the patient than what I experience where I work .That was all I meant by it.

It would be like comparing apples to oranges to me. I found it to be quite different.

Virgo_RN, BSN, RN · Dec 16, 2008

I, too, thrive on structure and routine. A place for everything, and everything in its place. On the other hand, I abhor stagnation, and must always be learning. Of course, I, as my user name implies, am very much a Virgo.

I love cardiac nursing because you can categorize almost everything. You have your chest pain, your heart failure, your arrhythmias, each with their own algorythms, if you will. Each category has its own subcategories, such as chronic renal insufficiency, diabetes, hypertension, and valve disease. If you like concept maps, cardiac is your dream specialty. There is always more to learn.

What I struggle with is the day to day grind of being a staff nurse on the acute care unit. We get tons of medical overflow, surgery patients, neuro patients, suicide attempts, alcohol withdrawals, etc. etc., because all of those patients can have cardiac problems. Finding supplies when you need them, lack of CNA support/cooperation, barebones staffing, high ratio of new grads, all of the things that can make it tough in med/surg are the same things we struggle with in cardiac. On top of it, we have our sheath pulls and our vasoactive drips. We get slammed with back to back admits because all the other floors are full. We are often used as a "dumping ground", so to speak, for patients that have one foot in the ICU. It can be incredibly stressful.

One thing that I am very glad for is that we have very little TPN, very few insulin gtts, and very few PCAs/PCEAs. We have very little wound care. Those things are huge time suckers. If you have a sheath pull, another patient on nitro, dilt, or amio, and a patient on an insulin gtt with TPN and lipids, it can be a nightmare. The one walkie talkie patient you have basically gets their vitals, pills, dinner, and that's about it.

So, I don't know if I can recommend cardiac to someone who needs a lot of structure and routine. But at the same time, the pathophys is fascinating, and the order sets, including what meds you can expect to see, what labs you can expect to monitor, and what procedures your patients are likely to have, are pretty predictable.

eriksoln, BSN, RN · Dec 20, 2008

Ah, I've been considering cardiac nursing too. A step up in acuity from med/surge might do me good.