Which nursing specialty is most competitive and which one is the least competitive

Nurses General Nursing

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i.e. which one is easiest to get in as a new grad, which one is the hardest to get in and why? Thanks!

Specializes in LPN.

I've worked in LTC/sub-acute for years now and I see many new grad RNs who are here because they can't get a hospital job. I think most people go into nursing with something else in mind besides LTC, but RNs start here while applying for hospital jobs. Some have been told they need a year of experience to be considered for a hospital job.

This is one reason I'm not as motivated as I used to be to go back to school for my RN. I already make more than some of the new grad RN's in LTC, and I would probably still be working here anyway even with a higher degree.

Where do you all think Peds falls? Almost everyone I talk to in my class (all of 7 people, ha ha ha.... I don't have much time for chit chat :D) says "Peds... or L&D". Maybe it's because we have a big children's hospital near our school campus. But generally, where does Peds fit in regards to "competitiveness"/new grad friendly. Personally, at this point, I only want Peds.

Thanks!

df77, you are lucky that you have a big children's hospital near your school. That means that there are more pediatric positions available than a lot of places.

The bread and butter patients of the nursing world are older people, usually with chronic conditions.

There are fewer hospital beds set aside for pediatrics since the inpatient bed demand is lower. Fewer beds mean fewer nurses need to staff them.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I think a lot of people think about specialties and competitiveness in that way about nursing BECAUSE that is true about physician specialties.
It is also true of nursing specialties.

Sorry, but we generally do not see new nurses scrambling and competing fiercely for a new grad internship slot in specialties such as LTC, ortho, med/surg, etc. Many nurses simply do not want to deal with the whiny total knee replacement patient, or the very demented elderly gentleman who constantly pulls at his IV site.

However, many new grads dream about the OR, postpartum, L&D, NICU, ER, and critical care units. These areas carry a certain prestige, whereas other areas fall toward the bottom of an unsaid pecking order.

:

Psych is relatively easy to get into.

Dave

To expand on Meriwhen's comment--

Would have loved to invite you for a guest appearance with our Crisis Intervention team,

you could look at the specialty ( and team) from a very different perspective....

At my facility, as a new grad you are not going to be eligible for the ED, OB and surgery (including cath lab). The ICUs hire new grads as do all of the other units. A lot of which departments hire and which don't is dependent on the manager, some units that used to hire new grads (like OB) now don't, while some that didn't used to (like the ICUs) now do.

However, the most openings are going to be found in med/surg and tele because they are the units with the highest turnovers, but there is often a position available on neuro as well. The ICUs tend to ebb and flow on staffing, everyone leaves in waves so they tend to hire in waves as well. Ortho can be tough to get a spot on because they have the best nurse/patient ratios and their patients (per staff that work there) are there because they want to be and tend to be much more agreeable to care and willing to do for themselves. Good ratios and less "difficult" patients make it a desirable floor for many nurses. Peds isn't tough to get but we have a very low pediatric population most of the year so they do a lot of med/surg overflow and are pulled frequently making it undesirable for many staff.

sourapril:

However, from my perspective and experience, Psych is relatively easy to get into. I've witnessed some RN's merely need to undergo spontaneous respirations in order to work in Psych. If you're a warm body with an RN behaind your name, you can work Psych.

Dave

I've heard this, but if Psych is such an easy job then would'nt there be low turnover?

I've found that 90% of the people who make remarks about psych nursing being "easy" have never actually worked in psych. I've seen new nurses (both new grads and those new to psych) in tears because they were expecting the job to be a cakewalk but got a very rude awakening at that first code :lol2: We have a high turnover in psych because it's not what people think it'll be.

Good luck!

CODE? By code do you mean a code blue? Do you work at a Psych hospital or a psych unit within a regular hospital? Hm, so your saying psych is hard. I want to one day work in the psych unit. I've heard so many different things, I guess I'll find out one day when I get to work there.

OP: where I live LTC is the least competitive to get into. Some people don't like LTC because where I live a nurse can have about 20 patients ( or at least that is what I've heard).

I've heard this, but if Psych is such an easy job then would'nt there be low turnover?

CODE? By code do you mean a code blue? Do you work at a Psych hospital or a psych unit within a regular hospital? Hm, so your saying psych is hard. I want to one day work in the psych unit. I've heard so many different things, I guess I'll find out one day when I get to work there.

OP: where I live LTC is the least competitive to get into. Some people don't like LTC because where I live a nurse can have about 20 patients ( or at least that is what I've heard).

Yes, meaning CODE BLUE. Codes do happen in psych as well.

Specializes in Psych ICU, addictions.
CODE? By code do you mean a code blue? Do you work at a Psych hospital or a psych unit within a regular hospital? Hm, so your saying psych is hard. I want to one day work in the psych unit. I've heard so many different things, I guess I'll find out one day when I get to work there.

OP: where I live LTC is the least competitive to get into. Some people don't like LTC because where I live a nurse can have about 20 patients ( or at least that is what I've heard).

I work in a psych facility. Code there usually means out-of-control patient, though we do have some medical codes. I swear, some nurses come in with the attitude that all they'll be doing is babysitting overmedicated patients...then they orient on the ICU or stepdown units (all staff have to orient on every unit) and a shift or two there takes care of that fantasy :devil:

I wouldn't say it's hard as that's a relative term: what's hard to you may not be to me and so on. But there is definitely more to psych than just handing a patient their meds and a Kleenex. Of course, you can do the bare minimum anywhere, even in med-surg, so I'm sure there's a few nurses in the psych world who aim to just hand out meds and Kleenex.

The skill set you use in psych is different. You're not going to be doing as many medical procedures such as foleys, IVs, etc. (unless you're in geropsych, then all bets are off), but you will still have to do physical assessments and monitor their medical status as they don't check their medical problems at the door when they're admitted to a psych unit/facility. You do a lot more therapeutic communication with patients. You have to deescalate patients who are acting out, hallucinating or have lost control. You do give a lot of meds, but psychotropic medications have a whole host of side effects--some life threatening--that you need to be on top of. Neverminding that you still need to know a lot of your medical medications too.

The hardest part of psych is getting used to the fact that a lot of the time, the results of your interventions won't be seen immediately. For example, in med-surg, you can give some IV medications or insert a tube, and the problem improves before your eyes. It usually takes a little longer to see results from your interventions in psych patients.

Don't want this to turn into a psych vs. the rest of the world thread :) Each specialty is unique and you really can't compare them like apples.

So to pull this thread back onto the OP's original track: as a new grad getting into the psych specialty...well, it's mixed. There's high turnover, plus the fact that a lot of people are hesitant about going into psych, so there's always a demand for psych nurses. However, it's a tough learning curve for a new grad, and most psych facilities I know won't hire a lot of new grads in: they'd rather they get experience first. If one is serious about going into psych as a new grad, try to get a job as a tech: that will both give you firsthand experience as well as get your foot in the door.

Specializes in Psych (25 years), Medical (15 years).

Well, I guess this is why AN.com's moto is "Nurses talking about nursing." and not "Nurses talking about nursing while not ruffling feathers and agreeing on everything with everybody".

To those of you that may have taken my comments in a negative way, I apologize. But it is my perspective, and my perspective comes from working in the field for over 30 years. I won't go into detail about my trials, tribulations, failures and successes, but I've been there, done that, and have bought the T-shirt. So there.

EVERY field has its lackadasical lollygaggers. As well as those who perform exemplarily.

Actually, I intended to be humorous in my first comment. I guess some people just can't take a joke.

Hey- but thanks for being there. Let's do this again, sometime, real soon.

Dave

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