Friday, April 08, 2005

Residency Toss-Up

As any nursing grad knows, finding the perfect residency is about as tough as getting into nursing school in the first place. I'm lucky to live in a top-twenty city with some seriously great hospitals. I have a great deal of selection in where I can go now that I've begun looking.

I am sort of torn in a few directions as to which path I'd like my career to take form this point. I'd love to be an ED nurse, and maybe someday a flight nurse. I'm working in the ICU/CCU right now, and a residency in CCU would be a really great chance to learn (and with some great people, too!). BUT I liked the ED when I worked down there last summer even better. If you've got good CCU experience, flight nurse jobs could be much easier to get. It's just that CCU is a bit boring - even as large as we are, and with the acuity of cases we see. I love the adrenaline rush of the ED. I love the experience I'd get in the CCU. I'm torn.

I was at a rally the other night for a levy to support the hospital and the CCU manager sort of casually asked me if I had chosen where I wanted to have residency. I told her that as much as I liked working with the people in CCU, I didn't know if it was a good place for a new grad. I told her nurses up there were the 'top guns' of nursing, and even though a few of them said they thought I could handle it, I wasn't so sure myself. She looked at me sort of like she was surprised. I wish I had it on video so that I could see the look on her face and check again, becuase I sort of got the feeling she would have said 'yes' without hesitation to my being up there. I am probably overly self-critical. Certainly already working there has given me a lot of knowledge about how things are.

The next day I was at another function and met up with my old manager from the ED. I told her I wanted to make an appointment to talk with her about a residency, and she seemed like she thought that would be a great idea, and we talked a bit more about family and other things. I know both of them like me, and now comes the hard part. Do what I like (ED), or do what would probably be best for my career in the long run (CCU). Sigh. The one thing I do know is that I would absolutely HATE med-surg. I'm really an adrenaline junkie.

This image shamelessly stolen from:
Posted by HypnoKitten at 8:43 PM

Anonymous azhar, at 11:23 PM  

hey, azhar from singapore here. final year nursing student of a three year diploma program. i'm facing the dilemma as you are now (ICU vs ED), but i've thought things through and i think i'll go get certification in critical care first before heading down to the ED.critical care gives you the knowledge that enables you to go anywhere in the nursing line, except for psych and ob/gyn.and your critical care skills will definitely come in useful in codes that take place in the resuscitation room.

Anonymous largemarj, at 12:40 PM  

Hey there... I can completely relate to your dilemma. As you know I'm going to start my nursing career in the OR. I have been given a lot of flack by some nurses and other students for specializing right out of school. However, some of my professors and nurses in my family who know me, tell me that I made the right decision. They know how dedicated I am to being a good nurse, I love learning, I'm not shy (i.e. I can handle the docs), and I'm not afraid of hard work. Ultimately, the choice is mine and I can live with it. I also know two important things: 1) no experience is a waste and 2) I can change if I want to.

Good luck on your decision!!! :)

Blogger HypnoKitten, at 4:15 PM  

Azhar, I have to agree with you. I spoke to a few of my nursing instructors and nurses in the ICU, and they felt I was able to handle the critical care job. I think I'm too critical of my own skills and still too doubtful of my own abilities. I always think there is so much I don't know - but I guess thats a good thing, and makes me more attentive to what I'm trying to do.

Blogger ICU 101, at 6:15 PM  

you know what? you have the rest of your life to worry about your career... i say do what you LOVE! taking a job in the Emerg isn't going to close any doors to you... any critical care experience is going to look fantastic to a potential employer...

Anonymous ResqRN2113, at 7:31 AM  

I had the same concern as a new nurse. I work part-time in the ED at first, but was offered a full-time job in the OR. I spent seven years specializing in Trauma surgery. I loved my job, but felt incredibly stagnant. I went back and got a EMT-IV certification and transferred to the ED two years ago. OH MY GOD, I had "forgot more than I ever knew". I had started an IV in seven years! Drugs, what drugs, I hadn't pushed a drug since nursing school! (our OR has a CRNA school and is very limited in what an RN does). I have just this week applied for a position with our Flight Program. I'm scared out of my mind, but I decided to make the jump regardless. If I don't push myself, I'll never know my full potential. Jump In! You might find that you love it.

Blogger Kjob, at 12:28 PM  

Thanks for blogging about this particular subject. I googled "ICU versus ED" to focus my anxiety over this dilemma. I agree with icu_101. I'm tired of doing things cause "they'd be good for my career in the long run." You're more likely to be successful in something you love to do. I started as an EMT-B, and you're right, nothing beats the pace of some ED's. You just have to find a place with a good critical patient load. Also, nursing faculty have told me that ED is a good place to sharpen those assessment skills and the basic techniques, making you an asset if you ever switch to an ICU.

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