This is a question that has been nagging me for quite some time.
Why is it so horrible for us to plan out our route? I want to become a NNP and as stated in a previous thread, infants are the only reason I chose nursing instead of completing a tech degree. From what I have seen on this board and a couple of others say, nursing students shouldn't choose their route before clinicals. But many pre-med programs allow students to choose their route beforehand. I even have a close friend who is a pre-med major and they are writing research papers about their route.
Specializes in Nurse Leader specializing in Labor & Delivery.
You have to be accepted into a residency after med school. There are supply and demand issues and not everybody gets to specialize in what they want. The students with the top grades, high scores and good recommendations probably get what they want, the ones in the middle hope for the best, and the weakest students take anything they can get.
Nursing deals with supply and demand too. The desirable jobs and specialties come with competition.
Exactly. Not every physician gets "matched" into their desired area for residency.
The comparison really is apples and oranges, though. There are far fewer new physicians than there are new nurses, so it's far more likely that a new physician will get into their desired specialty. With nursing, that's a lot less certain, so it's good advice to caution students to keep an open mind about where they get that first job.
That said, I certainly hope it works out for you and you get the NICU position you desire right out of nursing school. There is another regular poster here who has been a nurse for a couple years, but I remember her posts from several years ago when she was in school, also speaking with the same black-and-white outlook that you show - NICU or bust. She did not get the coveted NICU position for over a year after she became an RN, and did have to "settle" on another area of nursing before the opportunity opened for her.
I am willing to do everything in my power to have placement in a Level III nicu even if that means I have to relocate or even get placement in a nursing residency program for NICU to gain experience. Which is what I might do seeing as though we don't have a clinical in a NICU at our school. The passion that I have for infants is incomparable.
So I don't see the problem at all. Many nurses have chosen their field before even starting school and is now working as NPs in their field.
Some people decide what they want to do in school, some decide after they graduate, some decide after they've been working for a while. There's no correct time table.
Some are lucky enough to land right in their specialty after graduation, while others have to start elsewhere and work their way over to it. And there's nothing wrong with either scenario.
Unfortunately, it doesn't matter how much passion, how much drive, how many sacrifices you are willing to make: if there's no job, there's no job. The fact is that NICU is one of the "glamour" specialties that a lot of people want to work in, so competition is very fierce. You're going up against other applicants who also have that incomparable passion, that drive, and are willing/have made those sacrifices.. But when there's 100 deserving applicants and only 5 positions, that means 95 of those applicants who deserve that job as much as the selected 5 do...well, those 95 have to stay benched. No way around it.
Don't get me wrong: if you have decided in school that want to pursue NICU or whatever path as a NP, then by all means, go for it! But be realistic and have a Plan B...and C...even a Plan D, just in case your dreams don't materialize as quickly as you'd like.
I would say the same exact thing to a pre med student. The fact of the matter is you go into school and really have no idea what these specialties are truly like. It's not bad that people are telling you to wait before you make any decisions.
For example i thought i knew i wanted to be an ER nurse, have you seen those TV shows??? I wanted all this adrenaline and i thought the ER was going to be a perfect fit for me. Little did i know until entered nursing school and did clinical rotations i HATED ER. It was not fit for my personality at all and i wasn't getting all these seriously sick patients that i wanted.Little to find out i excelled in different specialties. In fact almost all of my classmates had a specialty that they wanted to enter at the beginning and almost all of them changed their minds.
It is OK to be zealous and enthusiastic about a goal you have, but i think what many people are trying to say is just take nursing school as it comes. Invest yourself in you clinical rotations and try to enjoy them for what it's worth; even though it's not in areas you want.
Are you currently in nursing school? I have an interest in emergency nursing, and have since I started my program. Having an open mind has allowed me to explore other possibilities during clinical that peak my interest and may be a different possible direction for my career. When I started nursing school, I had no interest in working in mental health, but it ended up being one of my favourite placements. While I don't think its necessarily a bad thing that you have a long term goal, being inflexible on your career path may blind you to other options or set you up for despair when you can't fulfill that goal.
A decade or so ago, I was planning to go to medical school (to be a neonatologist, in fact), and spent a lot of time on forums geared for students interested in medicine. The consensus on those boards at that time was that, while it's great to have an idea of the field in which you want to specialize, you should still go in with an open mind because you may find what you think you want doesn't mesh with reality (e.g. someone interested in OB who wants cushy hours with no call). Pre-med students may have an idea of the specialty they want but there is no guarantee they'll even get into medical school, let alone have the grades and USMLE scores for that specialty (and it was also recommended at that time to choose an actual major over "pre-med" in case medical school didn't work out for some reason). Pre-med programs are not medical school adcoms and have no say over the student getting into medical school or their eventual residency match.
I understand your passion for the care of neonates because I share it myself. All I've wanted since my mid-teen years is to work with newborns, and that hasn't changed. But the reality is that even a willingness to relocate doesn't guarantee that you'll get a job in the NICU, or even working with babies. As a new grad, I found all the NICUs I was applying to wanted someone with some kind of nursing experience, and I got a lot of "no's." A nursing job in a field you don't really like as much is better than no nursing job at all, and if you're working at a hospital with a NICU, you can always look into transferring after 6 months to a year (depending on company policy, etc.), though I'd encourage you to stay at least a year if you can.
I haven't found that elusive NICU job yet, but I did spend two years working with newborns and found that I really enjoyed working with new parents as well as the babies (and working in NICU, you will absolutely be working directly with the parents of your patients). The poster who said have a plan B, C, and D is right. Keep your mind open as you're going into clinicals. Most of your patients in nursing school are going to be adults, and you may find, as I did, that you enjoy working with them more than you expected. If you have a senior capstone preceptorship, see if doing one in the NICU or a pediatric unit is an option. It may not be. I hope you get your dream job in a NICU, become an amazing NICU nurse, and go on to be a fabulous NNP. But if you don't get that NICU job right away, I hope you take something that will get you valuable experience that will benefit you in the future (rather than refusing anything but a NICU position). And whatever you do, I hope you give your patients the best care you can because babies aren't the only ones who deserve great care.
Why are you comparing medicine to nursing, they are completely separate things. Concentrate on your own business and don't worry about what other disciplines are doing.
They aren't shamed for knowing what they want to do with their career early on. It's encouraged.
You're right but you're also neglecting the WHY. Most pre-med and med students spend time doing a lot of grunt work in a research lab doing someone else's project. This increases their competitiveness for med school and for residency. They need to find a way to align their interests and research work with what they would like to do. They do, however, still rotate through many services in med school and then most residency programs require rotations among services.
I work with a surgeon who is on "bright idea" number three for their career path. They would have been good at whatever they decided to do, but ideas number one and two would have bored them to death. Idea number three suits them just perfectly. Took the long way to get there but learned a lot in the process. Another surgeon I work with admits their first choice when they started med school wasn't where they ended up. The number of anesthesiologists I know who started residency as a surgery intern? That group is quite large - but they all have found something that they're good at and that works for them.
In my own personal experience it's true too. I was absolutely positive I wanted to finish school and start in peds (specifically peds critical care - PICU or NICU). I was sure I would work a few years, before going to grad school. My first goal was NNP, but I realized how limiting that is (very small set of environments where the knowledge and skills are useful). I was then set on becoming a CRNA after my critical care experience. I absolutely did not want to work with adults or in med/surg. I was livid at my clinical practicum / capstone placement (I was placed in surgery, specifically pre-op).
I didn't see at the time what a rare opportunity my practicum placement was. Yes, it was a community hospital, but they had the time to teach me. I got to the point I was doing everything for my patients without the assistance of my preceptor (only being observed when absolutely necessary). I was afforded the opportunity to rotate through and spend time in phase I PACU. When we were done prepping patients, but there wasn't anything going on in PACU I was allowed to dress and observe in the OR. Anesthesia providers and the surgeons at this facility taught me things I never would have learned in another environment. The manager told me she would love to offer me a job, but she only had a per diem job available at the time and that would not have met my needs financially or educationally as a new grad.
I searched and searched for my first job. I interviewed for a NICU stepdown job. My interview was before I took the NCLEX. I was sure I was going to get that job, it was my *dream* job. They just *had* to pick me. It didn't work out and it crushed me. I was then forced to look outside my comfort zone and preferences, and started work in the adult world. I didn't love it but man I learned a lot. I interviewed for six other jobs during that year, one being the ED of a top rated pediatric medical center. The summer after I started work in the adult world I got three job offers - ED in a Level III trauma center, PICU in a community hospital (that when I researched it more is not a great place for patients or staff), and the new to the OR program at the hospital I work at now.
The thing is, though I never in a million years expected to be where I am today, it fits me perfectly. I have the most amazing coworkers, I have learned the most amazing things. I stumbled upon it totally by accident but I have the best physician coworkers (anesthesia and surgery). I applied to grad school in a totally different direction than I ever imagined going in (I'm in a MSN program focusing in administration). I believe that there are issues in healthcare and more of the same is probably not going to fix the issues for patients, or those providing care (at all levels). I personally think it's better to try to fix the problems and fail than to spend an entire career crowing about how things are always one way, will never get better or change.
I no longer have a job title in mind that I'll reach where I feel like I've "made it". Five years later and I could not have predicted that I'd be where I am now. It could have worked out just as I'd imagined, except it turns out that this is probably better. I am by no means saying you can't be right. I hope that your instincts for your career path are correct. But more than that, I hope that if it doesn't work out as you would prefer that you don't discount what you might learn on the journey (to what you want or what develops for you). You might just meet some incredible people and learn an incredible amount.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
They aren't shamed for knowing what they want to do with their career early on. It's encouraged.
I don't think anyone is "shaming you" for knowing what you think you want now, ahead of time. I think many may be cautioning you that you may not get exactly what you want when you want it, and that perhaps you may then decide that you want what you have rather than what you thought you wanted. I wanted to do oncology when I graduated. I landed in telemetry/CCU step down. I got that oncology job after two years in telemetry and burned out on it within a few years. I landed in MICU/CCU and loved it. From there on, ICU has been my passion. Exposure to clinicals and an actual nursing job may change your mind about what you want. It has for many.
As far as pre-med students being shamed for what they want to do with their career -- I don't hang out on any pre-med forums, med school forums or MD forums, so I don't know whether there's any shaming going on there or not. I suspect there might be because people are people, no matter what their career.
OP- I appreciate your determination, but there is no comparison to be made here. I worked in GME (Graduate Medical Education) in a medical residency for eleven years before leaving for nursing education. The path to NP vs. MD or DO are two completely different things. If you look into the competition for residencies among medical students- and the history and culture of this is fascinating- it is just a beast. There are a limited number of placements in different residencies, competition for "lifestyle" residencies such as dermatology being a case in point. You might want to read Match day: One day and one dramatic year in the lives of three new doctors by Brian Eule. It's really well-researched.
I always chuckle when someone tells me they're a pre-med major. I chuckle even more when they tell me what specialty they're going to go into. No one-nursing or medical- knows what their path will be.
.thumb.jpg.e7b5bd336d518053002d5b4dbeef882b.jpg){kind=small}
klone, MSN, RN
14,857 Posts
Exactly. Not every physician gets "matched" into their desired area for residency.
The comparison really is apples and oranges, though. There are far fewer new physicians than there are new nurses, so it's far more likely that a new physician will get into their desired specialty. With nursing, that's a lot less certain, so it's good advice to caution students to keep an open mind about where they get that first job.
That said, I certainly hope it works out for you and you get the NICU position you desire right out of nursing school. There is another regular poster here who has been a nurse for a couple years, but I remember her posts from several years ago when she was in school, also speaking with the same black-and-white outlook that you show - NICU or bust. She did not get the coveted NICU position for over a year after she became an RN, and did have to "settle" on another area of nursing before the opportunity opened for her.