Why wasn't I placed in the ED?

Specialties Emergency

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My cohort recently interviewed and received our placements for IP. I was one of the only students who did not receive their 1st choice, the ED. Instead I received my 4th choice, the CV ICU. While being placed in the CV ICU is flattering and a huge compliment, I've wanted to work in the ED for 8 years and have made this very clear to faculty since the beginning of my program.

I'm a straight A student, take a Gerontologic Nursing Honors class, successfully took on more patients (and more complex) than almost all of my classmates during Acute clinicals, participate in multiple extra circular activities, have 6 years of healthcare experience (including ED rotation), and have been told by multiple instructors that I would be a great fit for the ED. My interview for the ED wasn't my best, but I feel that it was adequate. I talked about teamwork, questioning physician orders, and how my personal practice affects the unit and the organization as a whole. Essentially, I've done everything possible to show that I'm a worthy candidate for the ED, yet only 4 of the 6 spots were filled! I'm having a difficult time understanding why, as one of the top students in my class, I was not given my first choice!?

One of my classmates who was placed in the ED dressed unprofessional for her interview, is a C student, has no healthcare experience, had difficulty connecting the dots in clinical and had no desire to work in the ED until she realized her friend was being placed there. I'm pretty sure she has no idea what she's getting herself into and just wants to hang out with her friend in the ED for the "adrenaline rush."

The whole situation feels like a slap in the face and I'm wondering what your perspective is, or what you would do??

Honestly, I know from working in the ED the last few years, some of the people who look best on paper are not offered jobs in the ED. I don't know exactly what they look for in ED nurses, but I don't think it's always the obvious. Keep your mind open. I never expected to be an ED or Trauma nurse, but LOVE it. I have a friend who wanted ED and ended up in the MICU and loves it.

I would probably just ask. It could be as simple as your professors thought you were more well rounded and able to adapt to any environment but they didn't think that of your friend and thought she'd stand the best chance being with a buddy. Who knows. Good luck, I hope you learn a lot and I feel like the CVICU will be good for you to get in to ED later, anyway.

Specializes in Medical/Surgical/Telemetry RN.

I totally feel you. Honestly though you gotta be open minded as a nurse. My instructor told me straight up that she thought I would be better in the ICU than in the ER due to the fast pace. I am an ER nurse at heart just like you and I to am a nursing student right now but I am still proud of the compliment that she gave me. If it wasn't for her giving me that advice I would probably have never considered ICU. I think any experience as a nurse is invaluable and ICU is hella bomb dude. ICU nurses I give mad respect to due to their incredible attention to detail. Mad props to all the nurses because they are outstanding. Honestly my advice would be to be proud of your accomplishments and focus on your ICU time. That time is where you can actually learn how to control and manage different body systems. It's pretty incredible. Best of luck to you. By the way I know how you feel. Believe me everyone compares themselves to others but at the end of the day nobody gives a crap because it doesn't help the patient care one bit. It doesn't help your relationships with your fellow nurses and it doesn't help your priorities which needs to be focused on excellent patient care! Be proud to be selected for an ICU position. Most of them are not given out to new grads. Be strong.

Specializes in Med-Tele; ED; ICU.
My interview for the ED wasn't my best, but I feel that it was adequate.
Perhaps it wasn't adequate, despite your feelings to the contrary.

Or, perhaps it was but the department wasn't ready to take on all 6 of the originally proffered spots.

Or, perhaps it was simply bad luck of the draw. A lot of selections, while offering the appearance of objectivity, are more about simply plugging people into spots as quickly as possible so that the decision maker(s) can move on to other tasks. It's a big thing to you but just another to-do for them.

why, as one of the top students in my class, I was not given my first choice!?
Would I be incorrect in presuming that you've already asked this question of the one(s) who can actually answer it?

The whole situation feels like a slap in the face and I'm wondering what your perspective is, or what you would do??
My perspective is that you're over-reacting to take it personally. What would I do? Throw myself into the CVICU assignment with gusto. I would BE the rockstar that I so fervently believe myself to be. You never know how things and people are connected. It just could be that the best friend of the nurse in the spot next to you happens to be the ANM from the ED.

And this I will add: Nobody is more of an ED junky than am I. It is simply *the* best place for a nurse of my disposition, attitude, and skill set. However, I also have a per diem gig at a large, academic medical center in which I float between the different ICUs, as well as PACU and rapid-response. I've got about as broad a perspective as one can have and I will say that if I were to choose a place to work outside of the ED, CTICU (cardiac and thoracic for us) would be the place.

I'll also add that many nurses in smaller EDs have very limited experience with critical patients and could benefit from time in an ICU such as the one where you will be.

Turn this pile of lemons into lemonade. You may end up looking back on this and being grateful that things worked out the way that they did. My own career trajectory has proved to be much different than I'd hoped or planned but it's worked out pretty well, nonetheless.

Cheers.

Not only did I not receive my first choice for preceptorship, I received none of my choices...it had a lot more to do with what the hospital was able to provide for preceptorship. There is so much that goes on behind the scenes that we don't know as students. It may look like those slots are open to you, but they may not be. I was also at the head of my class, had never missed a class meeting in 2.5 years, and never missed clinical. There were many other factors at work. You will learn SO much in the CV ICU! My preceptorship ended up being in the STICU and I learned a ton and got to work with an amazing nurse. After you graduate, just apply to lots of EDs if that is what you want to do. In the end no one ever asked me in my interview where my preceptorship was. In the moment it feels huge but just make the most of it no matter where you go...as a student I never had the chance to be in CV ICU but that sounds so interesting. Good luck to you!

Once you get some time under your belt, if nothing else, you could work per diem somewhere else in their ED. Also, CVICU experience I would imagine would set you up nicely for becoming a flight nurse if you think that might be your thing. That being said, you can learn a ton and have a blast in CVICU. Best of luck to you!

Specializes in NICU, ICU, PICU, Academia.

"Thank you for the feedback Pixie RN. I will definitely remember your advice as I continue through this process! My intent was not to make myself look better or put the other student down. I think my qualifications speak for themselves and there is nothing wrong with being a C student or struggling as you learn. I offered the information about the other student in hopes of gaining some better insight on why or how a decision like this is made. I don't understand why the school of nursing would set forth certain requirements and expectations for ED placements, but then not follow them. I suppose I will have a better idea after talking to the faculty who does placements, but was curious what others thought or have experienced."

And yet, the additional not-so-subtle dig. OP: This continuous "I deserve an ED placement/ Why can't I have what I want?" makes you seem VERY much like a Special Snowflake. You will do well to lose the attitude and remember that, as a student AND as a new grad, you DO NOT call the shots. Others with far more experience and knowledge than you do.

Specializes in Pediatrics, Pediatric Float, PICU, NICU.
And yet, the additional not-so-subtle dig. OP: This continuous "I deserve an ED placement/ Why can't I have what I want?" makes you seem VERY much like a Special Snowflake. You will do well to lose the attitude and remember that, as a student AND as a new grad, you DO NOT call the shots. Others with far more experience and knowledge than you do.

I thought I was the only one who was put off by what I perceived as the OP's entitlement. To be honest if you went into the interview with the same type of underlying tone of entitlement that your post appears to have, I am not surprised that you didn't get it. That being said, follow everyone else's advice, make the best of the clinical, and keep on moving.

Specializes in PeriOp, ICU, PICU, NICU.

Embrace it and make the most out of it. You may realize this is a better fit. If not, you will learn a lot and cherish it.

Specializes in Emergency Department.

Same exact thing happened to me! Everyone in my cohort got their first choice and I got my last choice and I'm like ****!! It made me feel like I'm not good enough or smart enough but my logic is we're all equally capable. I turned down the job and reapplied the next residency group. Just waiting to hear back from panel interviews. If I don't get it this time around then it's me I guess.

Specializes in NICU, ICU, PICU, Academia.
Same exact thing happened to me! Everyone in my cohort got their first choice and I got my last choice and I'm like ****!! It made me feel like I'm not good enough or smart enough but my logic is we're all equally capable. I turned down the job and reapplied the next residency group. Just waiting to hear back from panel interviews. If I don't get it this time around then it's me I guess.

Except OP is talking about capstone, not paid employment.

Specializes in Emergency Department.

I picked ED for senior capstones, but got Internal Medicine. Picked ED for residency but got Internal medicine since that's where my senior preceptorship was. Beggars can't be choosers I suppose.

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