Whats your specialty?What are the Pros and Cons

Juwon · May 27, 2011

Perhaps I should ask what do you like and dislike about your specialty?

**NickiLaughs, ADN, BSN, RN** · May 27, 2011

I work in Critical Care.

I would say the Pro's are that we typically only have 2 patients, sometimes 1 if they are very sick. (I've seen patients be 2:1 as well and have heard of ratios of 4:1 for VERY sick patients). So because of that, our assessment skills need to be very good and we have a lot of specialized skills for our unit, including care and removal of arterial lines/swan ganz/CVP and arrhythmia knowledge. Not saying these are unique to only ICU, but these are some of the things we deal with.

So because of this you have to really be ready to continually update your knowledge because different hospitals have different equipment and are always looking for ways to improve. You have to be comfortable taking care of sick patients, and I think with most floors, think quickly and be quick on your feet. I enjoy the fast-paced environment.

What I like is when we have that very rare very sick patient with a small chance of survival who gets better and ends up doing to a rehab facility, talk about feeling good inside!

Cons:

Well because our patients are sicker, we also have more deaths on average than most other floors, I believe the average for hospitals hear in California is 13%, and that can range. You tend to have the patients longer because most of them don't recover in a day, so there is definitely some family issues that commonly occur. Good people skills are a need!

I hope that helps a bit! People will have different perspectives to add I'm sure.

TheCommuter, BSN, RN · May 27, 2011

I work in acute rehab.

PROS: There's an interesting variety of cases (CVAs, MIs, knee and hip replacements, CABGs, MVAs, CA, wound infections, amputations, DFS, ORIFs, hemodialysis patients, etc). There are opportunities to learn new skills and build existing ones (IV starts, blood transfusions, PICC lines, mediports, wound care, surgical staple removal, CPM machines, braces, nephrostomy tubes, catheter insertions, blood draws, etc.). On most shifts, the pace is bearable. It is cool to see sickly, bedridden patients walk out of the building a week or two later at the time of discharge.

CONS: The ideal ratio for acute rehab is 6 to 8 patients, but we usually receive 9 to 11 on most shifts, and this can be stressful. Family members become emotionally upset and try to lash out on you when they realize the patient will never return to the prior level of functioning. Since the patients are debilitated, they are heavy and need lots of lifting, and this can be backbreaking work when toileting or showering. Our census partially depends on elective surgeries and can fluctuate wildly.

studentmom77 · May 27, 2011

So excited to see this thread I was thinking about asking the same question, I am a student and although I am very early in my academic/career I really don't know where I want to be in 5-10 years. I would love to hear why you chose your specialties and did you have an Ah Ha moment when you knew it was where you wanted to be?

JustaGypsy · May 27, 2011

I work in Emergency Department.

Cons: You never know what you are going to get. Sometimes you get to see almost immediate results. After someone leaves your care it is rare to know how they turned out. Sometimes people use the ER for nonemergent issues.

Pros: By the time the patient/family gets annoying it's time for them or you to go. You never know what you are going to get. :)

Teleflurry, DNP · May 27, 2011

Critical Care

Pro : autonomy, 1 or 2 patients, the sense of using your brain at maximum capacity to solve issues, there is an unspoken respect given to icu nurses and er nurses which I make sure to return. (peds,onc,ld,rehab,medsurg,medical,tele,nicu,nursery,triage,nursing home, hospice, home health, management, - I LOVE you guys!)

Cons: Not knowing what to do , will lead to disaster...and fast.

eriksoln, BSN, RN · May 27, 2011

5 years as a nurse, most of that in a M/S setting, some in pulmonary. As far as M/S goes:

Pros: You see a lot of different diagnosis, hence can't become comfortable with one thing and just know how to care for that one specific type of patient only. It keeps you on your toes. Its just good, basic, fundamental bedside nursing. You'll grow a lot on a personal level as you get to see the whole spectrum of they life cycle: You sometimes get very young patients (teens having tonsillectomy), middle aged patients and of course the elderly population. It's a good foundation to have with regards to forming your theories/ideals about nursing since you see such a wide range of patients/age groups. Work will never become "stagnant", you will see a completely different mix of people on almost a daily basis (so, if there is a pt. you dread on the unit, you know they will be leaving soon enough). You have a lot of teaching opportunity with the alert and oriented patients. Finally, depending on what your needs are this can be pro or con, but I've never seen a M/S unit that doesn't have the opportunity for OT when you want it.

Cons: People tend to think M/S is dealing only with alert and oriented ambulatory patients. Lots of fall risk patients, but you don't get the reduced pt. ratio to reflect it. The flip side of there being OT if you want it is, with there already being holes in the schedule sometimes its hard to get a requested day off (this seems universal for M/S units).

Elvish, BSN, DNP, RN, NP · May 27, 2011

Mother-baby/nursery/antepartum

Pros: Mostly healthy patients. Lots of opportunity for education, if that's your thing, and most patients are very motivated to learn. Most of our antepartums hang with us for a while and buy their babies time (= a better chance of long-term survival). People are by and large happy about the babies they're having. I like helping people make breastfeeding work, too. That can be really rewarding.

Cons: Fetal demises. My floor, not L&D, delivers the

GHGoonette, BSN, RN · May 27, 2011

PACU, ie post-anaesthesia care unit, also known as recovery room.

Care of patients in the immediate post-anaesthesia stage, encompassing airway management, recovery from the motor and cognitive effects of anaesthesia, haemodynamic stability, pain control, assessing surgical site and restoration of vital signs to within 20-25% of pre-operative levels.

Pros: Best speciality in the house!

Cons: None really, unless there's a staffing problem. Things can get hectic if someone calls in sick.

Caffeine_IV · May 27, 2011

I'm changing specialties now from medical to med-surg ICU but I've worked medical for almost 3 years.

Pros: Lots of variety. You have to be a jack of all trades. Your time management and multitasking abilities will greatly improve (hopefully). You will see and learn a lot and hone your skills from school. If a patient starts going bad, you can send them to tele/PCU/ICU...whichever is appropriate.

Cons: It can be a sort of dumping ground with patients there for weeks waiting for placement. The ratios suck and staffing is usually an issue. It's very busy/chaotic even for the organized people. You are left with the feeling that you didn't get to provide the BEST care because you are sooo busy attending to mulitple needs.

Kyrie · May 27, 2011

I'm a 19 y.o. SN and I was searching for a specialty to build up to when i graduate and get my licence.

I've found out that i LOVE the OR, Next was the ER, and finally the Orthopedics.

I've only done quite a few procedures in the OR as a scrub nurse but it felt really great = ]

I love the clean smell, the clean aura of the staff, the equipments, and the fact that i LOVE to see BLOOD and ORGANS makes the place more addictive...

The pros..?

If you don't like nurse-patient interactions that much then this is the place for you = ]

cons..?

Some surgeries may last more the 4 hours, and rarely more than the 8 hour shift...

so if you don't like standing, having no breaks at times, and taking orders, its not for you..