Nursing Career Questions for all you RN's

[tidoublegger]

Hi everyone, I was wondering if some of you nurses on the DIS boards could give me some words of wisdom/advice! I am finishing nursing school in December and will have my RN (after the NCLEX). I am also a working EMT and have been so for 8 years. I have an interest in either the ER or Labor & Delivery.

My questions are these: 1) What kind of nurse are you? 2) What was your 1st job out of nursing school? 3) Do you suggest a med/surg or telemetry stint prior to going to a specialty area or starting right out of nursing school? 4) If you have kids, what shift(s) do you work and do you have daycare issues?

I have 5 kids...ages 18, 16, 13, 10 and 5. DH works 7-3p so I'm trying to figure out what shift to consider. I don't necessarily want to be 3-11p because I won't see my kids! If I also do the 7-3 shift, my 5 year old dd would have to do before and after school care, something I've never had to do before. The other option is to work 11p-7a and hope I get home before 7:45a so my kids can get off to school. Juggling this is going to be tough! Any advice?!?!? Thanks!!!!!!!!!

 

[Hillbeans]

I'm not a nurse, but just wanted to congratulate you for going into such a demanding, but extremely important field of work. Hope whatever you find - work related- is satisfying and fits well into your family routine.

 

[Puffy2]

Take the specialty area job if offered one. ER would give you a much more varied background (although working as an EMT has been really great experience for you and you might not feel that you need ER if you REALLY want L&D. L&D is very specialized as you know. Another option is Intensive Care if they offer an internship - take it.

Getting trained in a specialty area AFTER the fact is more difficult. They would rather have a few new grads than a veteran nurse who has worked on the floors for years.

Training in speacilty areas usually means several months on day shifts until you are trained, then you go to your regular shift.

Good luck.

By the way, I was an IV nurse. Turned down ICU when offered to me because they didn't have day shift available in that unit - stupid, stupid, stupid.....

 

[ilovepcot]

My very first job right out of nursing school was the ER on 11-7 shift. NOT a good choice for most brand new nurses.....things can move at a frenzied pace as it's no place for a novice! Looking back, I'm surprised the DON placed me there. But, with 8 years as an EMT, it just may be the very place for you. I think it's the most exciting area in all the hospital to work! Looking at t.v. shows now, it's hard to believe I once did that!

Also worked L&D a few years later in another hospital. Was a good experience but rather slow paced.....at least where I worked. Sometimes had to float and work the nursery if census dictated. Definitely not my favorite!

So hard to say about the shift thing.....everyones's home situation is so different. What works for one family won't work for another. I had a unique situation.....a mom, 2 grandmothers and a mother-in-law all fighting over who was going to keep the baby!!! Didn't realize how good I had it!

You'll probably find that as you change over the years, your ideal work area will, too. Yeah, I began in the ER but in the years to come I ended up doing home health with the terminally ill..... mostly respirator cases. That was my little niche.....you'll find yours! And by the way, CONGRATULATIONS!!!!!

 

[AZKathy]

I am an RN and I work in the Operating Room. I never did any floor work and went straight into a specialty course offered to train RN's for the Operating Room. I don't regret that decision.

Shifts? I work three 12 hour shifts to accomodate childcare. My DH does 4 10 hour shifts and we kinda work opposite so the kids don't do daycare. Ages of kids are 6, 9, and 13. I would love to do 8 hour shifts just because the 12 hours are very tough on my ole bod, but right now, this is what I am doing.

Good luck on your new career!

 

[DisOrBust]

I have been doing L&D since out of college 12 years now. I also have floated to ER since I am ACLS certified. Between the 2 I think ER is a better starting place. L&D is very specialized with a lot of stress. Personally a tele stink will give a better background for ANYTHING!! It would be what I would choose knowing now what I do. I also hate to tell, you unless you live at the hospital, there is no way you will be home at 7:45am espically if your in L&D or ER. You can't just leave in the middle of a code or delivery and the charting will keep you there past the shift. What about a weekend program? Also as a new grad you will probably have to rotate shifts.

 

[shopgirl72]

I went to a womens health-med-surg right out of school. I felt I got a well rounded back-ground there. We saw a bit of everything. I went to post-partum later, and enjoyed mom-baby care. I then went to school-nursing later, interesting, but looking for lice is no fun!
I know what you mean about 2nd. That was what I worked, missed my 4 kids terribly!!!

 

[bcvprincesses]

I am an RN and Medic and work in ER and L&D. I started in ER on the 7pm to 7 am shift. That shift was not for me. It took about 1 year to get a day job. I guess that you will just have to see what jobs are open to see what shift will work for you. Where I live there is not many nursing jobs available because we have a lot of Canadian nurses working.

I love both the ER and L&D. I would never work on a med/surg or telemetry floor. I do not think it is necessary. Do what ever will make you happy.

 

[DawnCt]

My first job out of Nursing school was adult psych. I was more or less drafted to that position because I did particularly well on my boards. I worked there for a year and then we moved. From there to the OR for 6 weeks (I hated it), then to a post op surgical floor (liked it) to asst head nurse on an adolescent psych unit. Then we moved and I worked in child psych at McLean Hospital in Belmont Mass. I liked that too. When we moved back home again, I returned to adolescent psych. After kids I worked PT in Adol. psych and post partum. For the last 16 years I have been an occupational health nurse and I like that the very best. I get to spend as much time as I need with patients and I have a good time. The best part is the hours. Mon thru Friday, 8 to 3:30, all holidays off!

 

[KristaTX]

I graduated with a BSN nine years ago, and I went straight into school nursing. I despised hospital nursing after going through nursing school and working as a nurse tech on a rehab unit between my junior and senior year. I was only interested in going into the field of public/community health. Fortunately for me, Dallas Public Schools was hiring that fall and advertised that new graduates were welcome to apply. I worked for 3 different school districts over the years - in an elementary school for 2 years, a high school for 2 years, and another elementary school for 3 years. My 2 years at Coppell High School were by far my favorite. I had a wonderful full-time aide and there was always something interesting going on. I was definitely busy and I was never bored there.

Some districts require a Bachelor's degree and some don't. The pay is not great (usually it is the same as for a teacher), but I was off every weekend, every summer, and for every school vacation. Plus I enjoyed having 9 months to get to know my patients (students and staff) instead of just a day or two. It is a very independent position - most likely there is no other medical professional on campus. I like that; some people want other nurses and doctors around.

There are 4 main responsibilites for a school nurse: day-to-day student visits, immunization record keeping, daily medications/procedures, and vision/hearing/spinal screenings. There are also other school responsibilities and also LOTS of counseling to be done. After my last 3 years of elementary school nursing I felt burned out, so I went into "semi-retirement" at age 31 (thanks to my wonderful DH). Now I just substitute for the nurses in the school district where I used to work. I would definitely consider returning to this career full-time in the future. I don't have kids, but this would be a great career for someone with kids.

 

[Disney Doll]

I will tell you what will probably happen, then I will tell you what my opinion is about what should happen.

Based on your EMT experinece, if you want an ER job right out of school, you'll get it. Same with L&D. Your emergency care background will stand you in a good enough stead to score a "specialty area" job right out of school.

Now what I think...I think most new grads should do a year of med/surg. I think it gives you a more well-rounded early experience. My closest friend is an ER nurse, and she has told me time and time again that she can tell the differenec between the nurses with med/surg experience and the nurses without. The nurses with med/surg experienece think beyond the "emergent" period, and into the rest of the hospitalization, because they know what at least some of the rest of the hospitalization will be like.

As far as shifts...probably depends on your family's needs and DH's job. Most of the moms I works with do 3pm-11pm or 11pm-7am. If they do 3-11, they only need to get a sitter for a couple of hours if Dad gets home from work around 5pm. Of course, as the kids get older, 3-11 means you miss a lot of their after-school activities. If they work 11pm-7am, they don't need to get a sitter at all, since Dad is home sleeping. Of course, doing 11pm-7am is tough if you have to stay up the next day because you have a little one that needs watching. 11pm-7am is better for Moms with school-aged children, since once you get them all off to school, the house is quiet for a while and you can get some sleep. Ideally, I would say 3pm-11pm until they start school, then 11pm-7am once they start school. In our area, a lot of places offer two 12 hour shifts on the weekends as an option too. You could also consider homecare, which would allow you to plan your day a little more, or school nursing, which would put you on basically the same schedule as your kids. I've known people who have done in-home insurance physicals(need phleb. experience for this, which I would assume you have being an EMT), which offers flexibility in terms of scheduling, similar to homecare. Have you considered a walk-in or urgent care ceneter? Sort of ER-like, but without the 24 hour commitment.

There are many options. I wish you good luck with your decision. Congratulations! We need good nurses.

 

[MScott1851]

I have to disagree with Disney Doll. I was told by my nursing instructors that I was a fool to take a job fresh out of nursing school in an ER, and a PEDIATRIC ER at that. They told me that I would be basically useless getting such specialized training, and I should get Med-Surg experience first, then move to an ER. But lateral moves don't usually happen after you've been a nurse for a while, and the place I worked at hired new grads or Peds office nurses instead of old MedSurg nurses.

But you know what? I had NO desire to EVER work Med Surg, and I WILL NEVER work Med Surg, so why should I spend a year doing something I HATE? I made the jump from Pediatric ER after four years to adult ER last February, and it only took a month or so to get my bearings and adjust to the new medications, problems, etc. My co-workers assume I've been an adult ER nurse for five years, because the transition was so smooth.

So do what you love, and love what you do... don't waste your time with something you think you'll hate, or you WILL get burned out, and quickly.

 

[crz4mm2]

I can't tell you what you SHOULD do. No one but you can decide that. I can give you my experience.
I thought I wanted to work NICU when I graduated. The hospital I applied at would hire (and loved!) new grads, so that's where I was going. I thought I should have some normal newborn experience first. ( I had worked on skilled care, and med surg as a LPN while finishing the RN program so I had some basics). I went to work in OB as a float between PP and Nursery. I HATED the nursery. Too boring. Made me rethink my NICU decision. Had to go to L&D one night to get a baby and I was sold. LOVED L&D. Worked L&D for several years before going back to school to become a nurse midwife.
I think you can go to work in a specialty area and do well. You don't 'have' to work Med surg first. Keep in mind that some specialty areas are high stress. It was very hard for me as a new grad to be the night time "Charge" nurse on L&D with no one else in house that knew how to read fetal monitoring......
I have worked all shifts. Of course everyone seems to want days. In many OB depts you almost need to be born there before you get days I worked nights to start (11-7 and some 7-7) and then worked 3-11. I never had days as a staff nurse. 3-11 was easiest on my body, but hardest for the family. I was never home to se the ball games, the school plays, the homework.... VERY tough when kids in school.
Have you had rotations in L&D and ICU and ER? which did you like as a student? OUr local college is doing some internships in various specialty areas. Soooo nice so students can actually see what they like or do not like.
Best of luck in whatever you decide. It is a rewarding (and very difficult) field.

 

[Tiggeroo]

Just out of curiousity, what is the starting pay for nurses in your various areas of the country. Do nurses get pensions and health care on retirement?

 

[tidoublegger]

Thank you for taking the time to reply to my post! With the nursing shortage right now, it seems like there may be more opportunity for new grads to start in their chosen area right out of school. I have had clinical rotations on med/surg floors (3), pediatrics (1), telemetry (1), oncology/med/surg (1), and await maternity, psych, and one last med/surg rotation. I really don't like med/surg and can't imagine *having* to do 6 mos to a year here prior to a specialty area. That seems like "doing time"! LOL! I will be attending a couple of seminars and job fairs this year. I am hoping to obtain some leads and job resources to try and help me make the decision. I know I have time...but I am just trying to think ahead! (that's the mom in me...I need to be organized! LOL!)

Again, thanks sooooo much for taking time out of your busy lives to share your thoughts with me! Any more nurses out there?? I'd love to get your thoughts too!

 

[kadaten]

I'm not a nurse, but my mom is, and I can tell you what I've been listening to for the last 25 years! She started out in ICU right out of school and stayed there for 18 or 20 years. She loves the pace of the unit and always said she'd quit before she worked in telemetry or some other regular floor units....it just bores her out of her mind. She *needs* the constant pace of the critical care environment, although it's not for everyone. Take a good look at what kind of work environment you enjoy before you make a decision!

The last 5 years she was there she was management, and she would *always* take a new grad over a nurse who'd worked on another (non-critical care) floor. She knew she could train the new grad, but many nurses who had worked on other floors had problems adjusting to the stress levels and frenzied pace in critical care.

She now works in CVICU (cardio-vascular recovery ICU) and likes it as well, although it is a little different paced. She's been there 5 years or so. She left the ICU when she resigned her management position. The new manager just couldn't come to grips with an old manager working for her and always had to make a point of "who's in power" despite the fact mom left management voluntarily to have more personal time. (That manager was later demoted for her awful behavior that cost the unit all of their experinced staff )

As for your child care questions, your best bet is to look for a hospital that has the "Baylor Plan". Under this plan (which my mom is on) you work every weekend, and I mean every weekend (you are only allowed two off every year, including sick and vacation time, and are removed from the plan if you are out more than that). You work 12 hour shifts Saturday and Sunday, for a total of 24 hours, but are paid for 36 hours, thus full-time pay and benefits!! Needless to say, this program is VERY popular with parents so they can be at home with their kids during the week. There is a waiting list to be on the plan at mom's hospital, for both the day and night shifts.

She also does PRN at the other hospital in town in the ICU to pick up extra money. There's a big nursing shortage in her area, especially CCRN's so she can call her shot on when she wants to work or not. Usually she does Baylor at her hospital Sat/Sun, is off Mon, PRN's on Tues, Wed, Thurs, and is off Friday. All 12 hour days, although an occasional 8 at the PRN job if that's all they need. Good schedule if you can get it.

Get all the certifications you can....CCRN, ACLS, etc....so if you decide you want to move jobs, you already have the certs. Mom made extra money and kept up her education hours by becoming an ACLS and BCLS instructor

If noone near you offers Baylor, is there any way your older 2 kids can get the little ones on the bus in the morning or get them after school? I know lots of my friends in high school were responsible for getting their siblings before or after school....it was just what families did. I know due to different school times they probably can't do both, but if they could do one or the other, then you'd only have to find child care for one of the gaps, morning or afternoon, rather than both.

Growing up, mom did all the shifts at one time or another, but we were lucky that we lived near family so I was always with an aunt or grandmother if she was at work (my dad didn't think childcare fell under his list of responsibilities ) so I never was in daycare or before or after school care. Now that we're a military family and don't have that luxury for my kids, I see how lucky we were! Anyway, all the shifts have their pros and cons...you just have to decide what's more important for you and your family....someone always at home with the kids, sleep, making ballgames, amount of time each allows you to have with family, etc....it's a very delicate balance!

Good luck to you!!

 

[wilderness01]

I never worked Med/Surg since graduating nursing school. I couldn't stand it while in school and refused to do it after I graduated. Oh wait, see I have blocked it out, I did have to float to MS on and off for about a month until I threatened to quit. That was about 5 years ago. I changed my status to reserve and no longer had to float anywhere. It was a beautiful thing to be able to say no and the supervisor could do nothing about it. They were float happy for a while where I worked! The MS nurses and I got along, and they told me I did a good job, even though I had footprints on my jacket! So good a job that they were trying to recruit me to pick up extra shifts. No thanks is what I told them, I would rather go and bag at the local grocery store!

Anyway, I started in OB at a medical center right out of school. I stayed there for 2.5 years. Everyone should work with residents, especially the new residents that start in July. You really have to know your stuff because 1st years are lost. I then went to a community hospital that did about 400 deliveries a month. Worked MB for about 5 years and have worked NICU ever since. We are a designated Level III so we get everything. I love the NICU. Actually the medsurg nurses that transferred to our unit had the hardest time. Much harder than the new grads that were more easily molded. Good luck with your decision.

 

[Dizkneenurse]

Great question!

I have been a nurse for 10 years. I started out on a general Med-Surg floor, right out of school. It was a difficult floor but I really feel that I learned so much from my years there. You learn to organize yourself ( I usually had 11 patients at night), learn so many skills and see many different people wth many different illnesses.

I worked on that floor until it closed about 5.5 years later. I choose a job in the cardiac and medical ICU and have been there since. Training was great to the unit and I felt that I was a much better nurse to go there after getting my basic ( some not so basic ) skills down first. I was given critical care classes and a pretty lenghty (about 12 weeks) orientation to the unit. Even then you need about 1 year until you feel confident in the ICU....IMHO.

In my hospital, we have to float until we have 15 years senority..no ifs,ands, or buts about it. The nurses who have only bee n ICU nurses their whole career are terrified and lost when they have to work a "regular" floor. To me, I just do it and my turn is over for a while..no big!

I hope you find the fit that is just right for you. There is always another position somewhere else to try until you find your niche.

Good Luck!


heidi

 

[Disney Doll]

I guess it's the same all over!!!! Med/surg is the silt at the bottom of the pond!!!!!!!!

I thought that was just at my hospital.

 

[RNMOM]

I've been a nurse for 29 years this summer. Whew.

I went right into the OR from school. I loved it. Worked that for 5 years and burned out on the on calls. It was a large inner city hospital and very busy OR. I then worked an IV team for 2 years, love that but hated the head nurse. Next I went to RR for 4 years. I had my two boys and lived in other states so I worked weekends in a nursing home, not my cup of tea, and hospice for a short time.

After returning to Ohio I worked 8 years at a lithotrypsy surgery
center. That was perioperative care. I now work at a nurse advice line and really like that. I am certified and am currently also doing documentation teaching and assesments for the staff.

As far as shifts. I think I made a mistake working days when my boys were little. When I took this job I chose to work 24 hrs/pay, every other weekend. I really like that. I am home nearly every day after school. I am also now working night shift and like that too. It is very expensive to put children in day care. I wish I had not done it.

I figure it this way, go interview, what ever feels RIGHT to you, do it. You will know when you are there. Open your eyes to the surroundings. Watch the staff interractions. Whatevery you choose, have fun.

Please forgive my poor grammer. I am just coming of nights and have not slept yet. I had a very busy night too. Good night all.......zzzzzzzz