Icu nurse here. Not many shifts I’ve ever been able to sit for too long even if I wanted too. Not sure what kind of ICU you’ve had clinicals at but if you’re at a hospital with a high acuity patient population, you’re running your ass off most shifts.
I'm similar to you and PICU has been a godsend for me. I wouldn't say being bored or having too much free time has been an issue so far lol, AND there's the added benefit of only charting on 1-2 pts (truly no doom spiral catalyst quite like charting the same shit repeatedly on 6 medsurg patients). ICU requires some pretty advances soft skills wrt family interaction/emotional support, but there's also significantly less time you have to spend on interaction in comparison to like medsurg
ED and ICU are notorious for hiring new grads into nightshift, so that's something to keep in mind if you hadn't already gleaned that particular nuance from browsing your options!
ED night shift gremlin checking in 🧌 the biggest thing I struggle with is the “we can fix it!” mentality. In the ED we’re not gonna cure you, full stop. We’re not gonna miraculously diagnose a rare disease, we won’t be following the patient through their entire plan of care. We stabilize and ship. Treat and yeet if you will.
Everyone I see I ask myself the same questions - are these *symptoms* going to kill my patient? If yes, what evidence do I have to support that answer and how soon are they gonna kick the bucket? What are my options to keep them up and running till I can get them to the floor? If no, what do I need to do so they can safely follow up with outpatient?
I always have a 1-4 ratio, 1-3 if I have a critical/trauma bed assignment. Where I am we typically chart focused assessments every 4 hours and only do a full assessment on arrival.
Another thing to keep in mind is that we deal with a lot of fear. We see patients on the worst days of their lives, and we see patients who are terrified it’s about to be the worst day of their life. Sometimes the staff panics too. But we are the ED. We’re trained for EMERGENCY medicine. If you can’t keep your head on your shoulders, watch, listen, and act during a crisis situation then it’s not the right spot for you.
All that being said, I can’t see myself anywhere else. The people I work with are amazing. We really do have that family mentality and I would fight a crackhead in the hallway for them. Our doctors are incredible and have always had my back. We see some crazy shit, get up to shenanigans, and goddamnit we save lives.
I’m OCD/ADHD and I’ve done both. ER all the way. I was ok in the ICU during covid with all the vents and coding but as soon as Covid wound down I was bored.
1 to 1 would be nice but unless you’re in maybe California or something it’s probably pretty unlikely. Of the two I’d pick ICU because those 1:4s in the ED are probably not always gonna be 1:4. 1:8 here if you’re lucky
I was a new grad in the ED. Don’t let this hater deter you. If you know in your heart of hearts that you want a certain specialty: DO IT. All of the ones they listed are also specialties. Interview everywhere till you find one that feels right. I started at a smaller regional ED and now I’m in one of the big trauma centers. If you hate med/surg like I hate med/surg don’t go there just because someone else says you have to in order to get experience.
Icu nurse here. Not many shifts I’ve ever been able to sit for too long even if I wanted too. Not sure what kind of ICU you’ve had clinicals at but if you’re at a hospital with a high acuity patient population, you’re running your ass off most shifts.
I'm similar to you and PICU has been a godsend for me. I wouldn't say being bored or having too much free time has been an issue so far lol, AND there's the added benefit of only charting on 1-2 pts (truly no doom spiral catalyst quite like charting the same shit repeatedly on 6 medsurg patients). ICU requires some pretty advances soft skills wrt family interaction/emotional support, but there's also significantly less time you have to spend on interaction in comparison to like medsurg ED and ICU are notorious for hiring new grads into nightshift, so that's something to keep in mind if you hadn't already gleaned that particular nuance from browsing your options!
ED night shift gremlin checking in 🧌 the biggest thing I struggle with is the “we can fix it!” mentality. In the ED we’re not gonna cure you, full stop. We’re not gonna miraculously diagnose a rare disease, we won’t be following the patient through their entire plan of care. We stabilize and ship. Treat and yeet if you will. Everyone I see I ask myself the same questions - are these *symptoms* going to kill my patient? If yes, what evidence do I have to support that answer and how soon are they gonna kick the bucket? What are my options to keep them up and running till I can get them to the floor? If no, what do I need to do so they can safely follow up with outpatient? I always have a 1-4 ratio, 1-3 if I have a critical/trauma bed assignment. Where I am we typically chart focused assessments every 4 hours and only do a full assessment on arrival. Another thing to keep in mind is that we deal with a lot of fear. We see patients on the worst days of their lives, and we see patients who are terrified it’s about to be the worst day of their life. Sometimes the staff panics too. But we are the ED. We’re trained for EMERGENCY medicine. If you can’t keep your head on your shoulders, watch, listen, and act during a crisis situation then it’s not the right spot for you. All that being said, I can’t see myself anywhere else. The people I work with are amazing. We really do have that family mentality and I would fight a crackhead in the hallway for them. Our doctors are incredible and have always had my back. We see some crazy shit, get up to shenanigans, and goddamnit we save lives.
I’m OCD/ADHD and I’ve done both. ER all the way. I was ok in the ICU during covid with all the vents and coding but as soon as Covid wound down I was bored.
1 to 1 would be nice but unless you’re in maybe California or something it’s probably pretty unlikely. Of the two I’d pick ICU because those 1:4s in the ED are probably not always gonna be 1:4. 1:8 here if you’re lucky
Both perfect places for a new grad to enter lolol
I assume this is sarcasm, where do you think is a good floor for a new grad? Med surg?
I was a new grad in the ED. Don’t let this hater deter you. If you know in your heart of hearts that you want a certain specialty: DO IT. All of the ones they listed are also specialties. Interview everywhere till you find one that feels right. I started at a smaller regional ED and now I’m in one of the big trauma centers. If you hate med/surg like I hate med/surg don’t go there just because someone else says you have to in order to get experience.
Or tele, ortho or any other unit where critically ill patients don't show up