A lot of people have been asking me lately about where I want to work once I graduate. By where, they mean area of nursing, not location. If it were location, I would quite easily be able to answer that by saying somewhere in SC or GA. OK, OK, I would choose IA or WI, too, since my sisters live there and I know they’ll be cranky if I don’t say something 🙂

But when it comes to an area of specialization, that is a bit more tricky. You see, there has not been an area of nursing that I haven’t enjoyed. I’ve actually liked bits and pieces of all of the things I’ve done and experienced. What helps to narrow it down is to weigh the positives and negatives in order to determine which area has more “bits and pieces” that I prefer. For example, I liked the OR, found it interesting, but don’t like that as a nurse you basically get equipment out, prep and drape the patient (who is unconscious), and chart, chart, and chart some more! I also thought Pediatrics was interesting, but did not enjoy being around some of the parents. Don’t get me wrong – if my kid was in the hospital, you can bet I’d be all up in that student nurse’s business, making sure she didn’t overdose my child. But I didn’t enjoy feeling like a babysitter at times.

I also liked Labor & Delivery, Post Partum, Newborn Nursery, and NICU. Yes, I know that a LOT of people love working with babies and that there are huge waiting lists to get in those areas. That is definitely a downside. A downside to Labor & Delivery, at least at the hospitals here in town, is that once that baby is delivered, you don’t see the patient any more and have little time for education and follow-up. Post Partum, you are dealing with a LOT of education (that is your primary role), and there isn’t much excitement. Please keep in mind that these are all generalizations. You can easily be working on PP and have a patient go into DIC (very bad – as one professor summed it up, DIC = Death is Coming).

Newborn Nursery is cute and sweet, and you get to do a lot of preventative things (screenings, immunizations, etc). NICU is also amazing d/t the complications you get to see and the complexity of the patients. You also get to really build relationships with the patient and families, since most of those babies are in there for a while. But it is emotionally taxing, too, and requires a great deal of finesse and dedication. You often lose patients.

I like Med-Surg. Yes, I’ll admit it, I enjoy Med-Surg. These units consist of a lot of patients who were admitted for more general reasons (e.g., an elderly patient who is dehydrated, an adult following an appendectomy or gall bladder surgery, someone who has a bad case of influenza – that sort of thing). I like these floors because there is a lot of comorbidity. You might have a patient who came in for a colon resection, who also has a history of type II diabetes, high cholesterol, TIAs, some orthopedic issues – I like the conglomeration. It keeps things interesting.

I also like Orthopedic and Neurologic floors. You get to work with patients who have had knee replacements or hip replacements, patients who have had strokes, that sort of thing. A lot of it is re-learning how to do ADLs (activities of daily living – walking, taking a shower, dressing your self, etc.). These patients also have comorbidities, which keeps you on your toes.

ICU & CCU are intimidating, but that is kind of why I like them. I question my ability to work on those floors, because they are difficult areas. Patients here are REALLY ill. You have to know your stuff and be on it. Because it intimidates me and challenges me, I am drawn to it. I like to see if I have what it takes, and thankfully, ICU/CCU (and all floors, actually) give new nurses a lengthy orientation time, so you aren’t just thrown out there. You have a preceptor who works with you and acts as your reference. ICU/CCU also has a high patient involvement. Even though you may only have 1-2 clients, you are in those rooms constantly. Not to say that the other areas don’t have nurses who are ever-present in the patient’s rooms, but most floors you are able to do 15 min, 30 min, or hourly rounding as ordered. Not in the ICU.

So what do I want to do? I think that the best areas for me to start would be Med-Surg, Orthopedics, Neurology, or ICU/CCU. So I will probably apply in those areas. Maybe in Oncology, too, but we’ll see. I’ll let you know how it turns out 😉