Which field of nursing is the most technically hard?

elijahvegas, ASN, RN, EMT-P · Jul 19, 2017

Ummmm...where did anyone comment on it?
I feel like someone just needed to beat on their chest and relieve themselves...
It it might not float your fancy that the TNCC classes at my level I trauma hospital are open to anyone...even the Med-Surg nurses...so what exactly was the point of your post?

Tncc is open to any one level 1 through 3 trauma and nontrauma centers..dunno the relevance of that statement.

My initial statement was directed to the op to offer a contrast to what other posters view commenting on the frequency of education required to work. Some places need only acls and an active CPR, others like mine require much more. So it served to show the contrast in fields and their requirements so he has a better idea what things look like across specialties.

As far as tncc, there was a post that mentioned just because it requires more certs doenst make the field any harder, and while thats purely subjective, i merely threw out "dont talk about a field you havent worked in". Having a tncc cert implies youllbe working part of a trauma team which often requires a year or so of solid er experience with critically ill patients as the bulk of your care. Not justsome test to plaster on your resume. I dont recall chiming in on any other specialty or hospital or even mentioning my field was "hard".

If that triggered some kind of hidden inferiority complex in you i apologize. But im not nor was intending to "beat my chest". Just a fact of the er.

This is what ours require to stay at work.

So if thats something the op may find difficult, there he goes. And if not then he can keep exploring options that challenges him the way hed like.

That was the "point"

elijahvegas, ASN, RN, EMT-P · Jul 19, 2017

Double post :|

OlivetheRN, ADN, BSN, RN · Jul 19, 2017

I'm almost 25. I want to try out the hardest type of nursing to challenge myself.

What will be challenging to one person may not be challenging to another based on a variety of factors, i.e. their strengths, their weaknesses, their background (have they worked in the medical field before and if so, as a CNA, an EMT, etc), personality factors (my slightly ADD type personality LOVES the ED and HATED a medsurg environment, so medsurg is "challenging" for me), and also what interests you.

Your initial question does not have a one size fits all answer in my opinion, because there are a lot of areas of nursing that can be as challenging as you make it. In the ER I work in they are always asking for volunteers from various shifts to learn how to use a new piece of equipment such as our CHF vest we have and things like that. Your job and your area of nursing is what you make it beyond the required con ed you HAVE to do for the BON and your job.

cyc0sys · Jul 19, 2017

I don't know what you mean. Just because some certifications aren't required by your facility doesn't mean they aren't necessary to become more competent in your craft. ACLS, Wound Care, and IV infusion would all be of benefit in the LTC but that kind of depends on your facility.

Job difficultly is more a measure of the individual than the specialty. If we're talking Pt to Nurse workload, LTC wins hands down because most states allow 40-50 Pts per Nurse. Some facilities might try to offset these numbers with Aids or Medtechs but they can't perform assessments and LTCs are become more sub-acute than stable.

That being said, I've never heard a nurse say we have an overstaffing problem. The trend is doing more with less. So every area has some type of difficulty, unless your a Medicaid nurse on a state inspection team.

Wuzzie · Jul 19, 2017

I'm almost 25. I want to try out the hardest type of nursing to challenge myself.

The problem is it's impossible to qualify which type of nursing is the hardest. They all have their challenges but those challenges differ from specialty to specialty so you end up comparing apples to oranges. Better to try out the type of nursing that most interests you.

3peas · Jul 19, 2017

I'm almost 25. I want to try out the hardest type of nursing to challenge myself.

What's hard to you might not be hard to someone else. What's hard to me: LTC, burn, oncology-those have emotional attachments to me and that's hard. The burn unit I just can't look at someone in that much pain-those nurses are ROCK STARS!!!! I can work ICU, psych, administration, research and with severely abused children. I just listed areas most people won't touch.

"Try" to do what you want to do and enjoy the journey.

SummitRN, BSN, RN · Jul 19, 2017

The question isn't location dependent "what is the busiest" nor more subjective "what is the hardest." It was "what is the most technical?"

I could say sub-specialties in informatics and research nursing are the most technical with the need to be able to program computer code, run the back-end interfaces for patient monitoring equipment, perform advanced statistical analysis, and deal with IRB rules.

But I assume OP means the most technical bedside role. That would fall to a CVICU/ECMO RN who needs to be proficient in evaluation of more simultaneous continuous wave/numeric readouts, more frequent labs, and more invasive interventions than any specialty, pick a combo of: BIS monitor, hypothermia machine, IABP/Impella/ECMO, dual chamber external pacer, ventilator, CRRT, multiple vasoactives, paralytics, sedation, plus whatever other drips, plus all the other minor technological interventions/tubes/lines/drains.

But one could argue that a critical care flight RN role is the most technical because much of the above is involved, but with the added technical factor of flight operations which includes confined spaces and altitude and the need for emergency response capability as most services do scene responses so add prehospital scene management and field stabilization/intubation.

One could also argue wilderness medicine nursing is the most technical because of the massive amount of technical rescue and wilderness travel/equipment skills necessary, plus the physical fitness/survival capability, plus the need to make diagnosis and decisions without advanced diagnostic/monitoring tools/tests.

canadawali · Jul 19, 2017

I'm thinking either ER or ICU since both fields require continuing education. What, in your experience, is the hardest nursing field?

I am in Pallative and its a emotional drain. I do not recommend it for the light hearted.

Orca, ADN, ASN, RN · Jul 19, 2017

Nursing isn't a damn contest about "who has it harder/works harder/is smarter/etc." Nurses need all the support we can get, including from each other.

Thank you for saying what I was thinking.

pixierose, BSN, RN · Jul 20, 2017

I'm almost 25. I want to try out the hardest type of nursing to challenge myself.

But what's hard for one person might not be hard for you.

I know quite a few nurses who have absolutely amazing technical skills that a lot of pp's have described. But they find that easIER for them because that's what they LOVE.

... but they couldn't do other types of nursing because of the emotional drain.

Example: during my general orientation, the flight nurse was describing amazing stories. He had us transfixed. But then he went on to say how he wondered how some of those patients ended up ... because he absolutely could never be a burn nurse. Or a peds nurse. Too traumatic and emotional for him.

You'll see amazing nurses in oncology and LTC ... and nurses who absolutely should not be in those skill sets because it's an absolutely different set of "hard."

Gosh, my 12-year-old neighbor is undergoing chemo and my mom with stage 4 breast cancer ... I'm already a blubbering mess. Hats off to nurses who can hold it together.

There are different levels of "hard," not just technical.

Long Term Care Columnist / Guide · Jul 20, 2017

I'm almost 25. I want to try out the hardest type of nursing to challenge myself.

The degree of difficulty, like beauty, is in the eye of the beholder. I found med/surg to be harder than mother-baby and even ICU, mostly because of the insane workload and staffing issues, not technical skills (which I was very good at). I was also good at LTC nursing and management, which some consider to be hard because you're using both technical and so-called "soft skills", like dealing diplomatically with demanding families and supervising other employees. Just throwing that out there.

Zyprexa · Jul 20, 2017

Any type of nursing is hard.