im about to graduate next spring and was wondering how often ERs and psych hospitals hire graduate nurses? Those are the 2 most interesting areas of nursing for me, but i've heard from my friends that have alreay graduated that new nurses typically dont get those positions...we end up on a med surg floor for about a year or 2. Theres nothing wrong with that, but i would much rather be in the areas i truely enjoy...any advice on that????
Lori
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November 25th, 2008 at 4:29 pm
Lori,
I completely understand where you’re comming from, I graduated in May and am “killing time” on a med-surge floor until I can work in the ED where I “belong”! I’m not familiar with the requirements for working on the psychiatric units, but for the ED I know that just about every hospital requires at least 1 year nursing experience. About the only suggestion I have for you (regarding the ED) is what I’ve been able to find out ~ get a job on a busy floor (I’m on a cardiac unit) to get used to assessing patients and juggling several at a time, then look into transfering to the ICU to get some critical care experience. Good luck finishing nursing school & with your career beyond!!
November 26th, 2008 at 1:41 pm
you will use medical skills in psych hospital. I used to fill in when the psych ward was short of staff, in fact ended up doing two years in the pysch ward. And whenever the psych patients developed a medical problem they always gave the patient to me because they just weren’t up to scratch with basic medical care.
It is sad but true. You don’t want to go to psych and have no medical skills.
As for ED, well you know what they prefer, so put in the hard slog and get the ground work out the way. I think you’ll be a safer nurse going to ED with a bit of experience as no matter how good and thorough the orientation, nothing counts for a bit of experience.
November 27th, 2008 at 12:43 am
Kudos Nurses on you recent (and upcoming) graduations!
It’s great that you’ve found your niches and know what you enjoy doing in your career.
Some advice from a seasoned RN of 12 years – get that 1 – 2 years of experience on a med-surg floor; you will be glad you did.
IMO, all nurses need a minimum of 1 year on a med-surg type floor before they move on to a specialty such as ER/ICU. You need to know the basics before jumping into a specialty that requires you to be on your toes and know your stuff inside and out. I personally wouldn’t feel comfortable w/ a brand new nurse caring for me or a loved one in the ER / ICU. It’s nothing against the nurse personally, but we all know what is what like being new and fresh. Experience comes with time, and that first year is a defining time. Nursing is a continuous learning process; I still learn new things everyday from other nurses with more and less experience than me!
I equate the 1 year of med-surg experience to “Everything I need to Know I learned in Kindergarten”
Well, change it up a bit and you’ve got “Everything I needed to know for my nursing career I learned on a med-surg floor”
It will prepare you for life and give you the tools and knowledge to go anywhere and do anything in nursing. Again, IMO.
I did almost 2 years on a post-op surgical floor w/ telemetry beds after I graduated, and I learned so much more than they every taught us in school. I went on to do many different varied types of nursing including prison nursing, infection control, psych and working w/ children living in group homes.
The experiences from all the jobs further prepared me for the next; but it was that first 2 years that made me confident, knowledgeable and steadfast in my practice. I wouldn’t change it for a minute.
So, maybe look at your 1st year a little differently; don’t feel like you are parked on a med-surg unit. You will undoubtedly affect and change the lives of many people while you are there; you’ll also learn most of what will carry you through your career.
November 28th, 2008 at 11:17 am
Bryn!
In 15 years of psych I’ve never known nor been shown nor had to put up a drip. I can muster a BP and have a rough idea of how to do a blood sugar test thing for them diabetic people and once I had to put someone in a recovery position.
If the psych patient is that bad they need a medical nurse – send them to a medical ward for goodness sake!! ;o)
November 29th, 2008 at 12:12 pm
Ian,
The patient was catatonic and had a minor cough, not a pnuemonia…yet. I suggested a saline neb to loosen up her secretions so she could cough up that rasping noise at the back of the throat/and the nurses were in a bit of a panic. “We can’t do that” or “The doctor needs to see her first” or “Send her to the emergency room.” I saved us all a lot of time and effort. The patient coughed up some much needed gunk, and everyone was happy.
November 29th, 2008 at 11:35 pm
We had a guy early this year in the secure psych ward develop acute complex ascites. He was pretty unwell and required medical nursing above his psych needs. But rather than transfer him to the medical ward – they brought the medical ward to him. I was never comfortable with it and didn’t feel it gave him the best service.
Your scenario sounds a lot less complicated.
What’s a saline neb?
November 30th, 2008 at 8:46 pm
I am a May 2008 grad and I started right in the ER. If you choose a hospital that accepts you in critical care nursing, make sure you select one like I did that has a “nurse residency program” or something with 6 months of orientation. You need that much time to get on your feet! I love working in the ER and wouldn’t trade it for anything.
There is a lot of controversy about whether new grads should start out in critical care. All I can say is, either way, your first job is going to be tough! Find a hospital with a good orientation program, find a mentor, and be ready to work really hard! you can do it!
December 1st, 2008 at 7:14 pm
I recommend to all my grads that they spend at least a year on a Med Surg floor to gain strength in a basic foundation. If you enjoyed both psych and ED, have you ever thought about correctional nursing? I did it for 3 years and it was a nice mixure of both.
December 29th, 2008 at 5:50 pm
Okay, I am going to give you the advice that I give all my students. You do NOT HAVE TO do one or two years of med-surg. I came straight out of school almost 18 years ago and went into Psychiatric nursing. From there I have worked in a SNF, Physical rehab, Home Health, and School Health. I have been a unit manager, care-plan coordinator, a staff and patient educator. I now teach psych, peds and general med-surg at a University. You can do anything you set your mind to. I would much rather be in a job I love, than a job others thought I should do and I hate. With that said, remember that only YOU know what you like and do not like. You will be much happier (and smarter) to follow your heart and do a job you like. Remember that no manager wants a person on their unit who does not really want to be there. Recently a very dear friend graduated from nursing school and asked my advice on where to go and I told her the same thing. She felt pressure from her previous clinical instructors to do the obligatory one year on a surgical floor. Needless to say she is miserable and I feel for her. She is currently looking for another job.
December 30th, 2008 at 3:21 am
Lori,
As a new grad myself, I can certainly see where you’re coming from, I think it all depends on what the needs are in your area. I just graduated and will be starting out in the ER, but only after having spent a year as a nurse extern. After having been in the department for a year, I can see why experience is required to get into areas such as this. I think it can be difficult as a new grad to jump into these positions, not just because of the critical care aspect of it, but if you’ve never worked in an ER setting it can be quite intimidating. Unfortunately with the fast paced environment there’s not always time to ask or get questions answered. I would suggest if you are sure this is an area you would like to get into to, make sure they have extensive training and support available for you, and don’t be afraid to take on any opportunity to learn.
January 1st, 2009 at 2:40 pm
Lori-
I’m a new grad and I got hired into a residency in an ER. I just looked online at hospital openings and looked for residency spots. However, just to warn you its really really really crazy!! I mean like its kind of scary walking out of nursing school and into an ER where you basically know enough to be dangerous 🙂 Or at least thats how I feel a lot of the times. But I understand wanting to go right into the area you want to work in, thats what I wanted too. So my advice is to just look for residencies, they are out there! Especially for ER because burn out seems to be pretty high in that area.