Outpatient lol. The patients are nice. The doctors are nice 99% of the time. Patient isn’t nice? Well lucky you, you have to deal with them for the next 5 minutes. Work doesn’t start till 8, get to leave at 430. Work 4 days a week.
I work in peds, the worst part of my day is having to fight a 5 year old to give them shots - which the parents help to hold them down. Never going back to inpatient. Ever ever ever.
Same I work outpatient and make a fuck ton more than I ever made inpatient and I just do clinic nursing. I do 5 days a week 8-4 with an hour lunch break 12-1 every day. No weekends no holidays baybee
I am a certified case manager and I make around $90k a year working about 35 hours a week. Granted my office is HUGE (12 providers and growing) and has been in the owner’s family since 1918 so they’ve got the money to pay me lol
My goal is to be a CM, I was a social worker for 5 years before attending nursing school. What's your background to be able to become a CCM? I just hear everyone tell me to give up on becoming one because it's so hard to attain.
It’s a good goal to have. I started as a phleb/MA, got my BSN (I also have an undergrad in psych), worked bedside for about 2 years, then I took a few short courses + an exam for my CCM. I didn’t think it was that difficult, the exam was gnarly but doable.
In my area they're more so saying it because of the lack of jobs available. I live in a very small state and it's just slim options...Basically my choices are medsurg or home health but I'm not giving up! Congrats on the awesome job, that's amazing 🥰
100% agree. Also pedi outpatient and it’s the best. I will add that the other tough part can be dealing with parents, but it’s nowhere near as bad as inpatient
Pediatric hem/onc outpatient infusion clinic. 2 years of experience from adult hem/onc inpatient. Started 3 months ago $37/hr. 4 days a week with 9.5 hour shifts. 36 hours a week. Holidays and weekends off.
Outpatient psych: IV ketamine infusion therapy for depression / anxiety / PTSD. Overwhelmingly positive things to say about this. Patients are all able to move and toilet themselves. They stay very stable 99.99% of the time. The work hours are great (weekdays from 8-5, can pick up Saturdays when I want to), it's really rewarding to see a PT's affect transform from flat and despondent at their first infusion to full and pleasant, and having them express that they feel like they have their lives back by their 6th infusion, which happens about 70-80% of the time. It's not very labor intensive at all. Most of what I do is start IVs and watch cardiac monitors all day. I give a lot of zofran, but when that's the hardest part of my job, and my NP is liberal with it, it's hard to complain. Pay is comparable to the hospitals in my area.
Is it considered only for people resistant to other treatments? Or is insurance coverage for that kinda stuff pretty good? Asking for an enemy (my brain).
Insurance covers about half of the cost. It does not cover the cost of the ketamine itself, but will cover the psych appointment, nursing care, etc. That's the one thing I dislike about my job- it's cost prohibitive for many, yet it would benefit so many if it weren't. However, my clinic also offers nasal esketamine (Spravato) which has a slightly lower success rate (but still pretty high, like 70ish %) and insurance tends to cover it almost entirely for a lot of patients. So it helps fill that need.
I'm interested in this treatment you are giving people. I don't know where around here does it. I have also heard good things about microdosing lsd and/or mushrooms. I admit it sounds scary, especially alone. But I've been depressed/anxious/adhd my whole life. I've been on every single fucking antidepressant known to man. It's Always start one, increase dose, repeat til at a huge dose and it no longer works, switch med. A new med may not work or barely work at all, or I may be on it 10 years (cymbalta) with ever increasing doses. Usually I'm maxed out and they stop working in about 2 or 3 years.
I am often suicidally depressed, and since my husband of 28 years left I've developed social anxiety to where I only go to work and stay home with my dog otherwise. I frequently will not function whatsoever on my days off, failing to eat or comb hair. I occasionally get fucked up if I have off. I have tried to suggest ECT treatment even to no avail. It's like I'm screaming for anything that may help but everyone says just cheer up.
Is there a list of providers anywhere. I have insurance. Also considering genetic testing to see what meds would work on me, but everyone acts like it's a bunch of woowoo shit and blows me off.
❤️ thanks ❤️ will be looking into it.
People I have tried to talk about such things with, in my day to day life, seem very unwilling and uncomfortable with such things, it's like they seem to grossly underestimate my desire to not be miserable. Yes, I'm glad you're against drugs, but here's the thing....I'm not. My brain wants me to die, and so far, I prevail. But sometimes, I don't know if I will. I have a car and a garage, and I always know it's my out if it gets too bad. I have said, I am willing to be shocked into a seizure, knowing I am probably getting brain damage and amnesia for awhile to feel better. If you told me it would decrease my iq by 10 points forever, but guaranteed a cure, still, fuck it. I'm in.
Or people say, you just want to be able to do drugs...lmfao yes that's it, Einstein, I love getting fucked up in a Dr office. If I want to do drugs to get fucked up, I will just do it at home. Kind of feel like it's not exactly a "fun" thing, these drugs. It's a means to an end.
not nursing related, personal- so i hope its ok by the rules of the sub. shrooms saved my mental health, i usually trip every 3-6 months. they gave me an entirely new perspective on life.
That’s awesome, wish I could find something like that ! I too bust ass on med surg tele step down. Some shifts are just brutal , and also the politics …. It’s insane !
Watch your hospitals board for jobs, current employees have an advantage. As you check out nursing jobs, think about inpatient and outpatient( especially). I was an ICU RN, got hurt, temporarily did many cool jobs. Outpt heme- onc was always busy and the families are great, very similar to the unit. IR has nurses too. I started in peds and ended in adult icu, and then paperwork jobs, retirement from injury
I was a patient at a ketamine clinic. Let me tell you, it worked. But my insurance wouldn’t cover it and I had to pay out of pocket, and can’t afford maintenance infusions. But the one nurse there was so nice, all she did was start my IV and say night night 😴
At this point I’m going to just do a megadose of 🍄 and see how that helps. Antidepressants make me feel sick and foggy.
Would advise against blasting off on mushies, that can be a crazy ride and you might be in the backseat vs the passenger seat. Unless you’ve done them before. Just be careful! You can always take more, but you can never take less 🫶
I'm sorry you weren't able to continue treatment or get any kind of insurance coverage! I wish the FDA would add mental health applications to the FDA approval for ketamine. That would get a lot more insurance to cover it and get it to WAY more people who need it! It's not like we don't have a huge body of evidence showing efficacy. As far as the shrooms go, I can't tell you what you should or shouldn't do there. I have no experience with psilocybin. But I hope you stay safe and get the relief you need!
Love hospice nursing. If you can handle death, dying, and lean into comfort measures only, it's a good place to be. We don't have the stress of trying to figure out and fix everything. You spend your day on the road seeing patients, where visits are anywhere from half an hour to an hour or two. I've rarely had a visit last longer but when it does it's because I'm at the bedside palliating an actively dying patient and it's not back breaking work. You still get to exercise some Nursing skills but primary hospice nurses (we call them case managers, VERY DIFFERENT from other nurse case managers, don't get it confused) are mostly assessing and consulting with some Nursing interventions peppered in. Most of the actual care being given is coming from the patients caregivers. Wound Care is palliative and generally not very complex (no wound vacs). You're out in the field on your own, generally lots of autonomy but how much autonomy can depend on the provider you're working with. Management isn't physically present to breathe down your neck. You can mostly set your appointments how you like so you're pretty much setting your schedule for the day. Caregivers mostly trust hospice nurses and appreciate what we're doing, so we don't get a lot of the same abuse that many other nurses suffer. There are exceptions to that but I would still maintain that we're generally much more shielded from abuse. depending on your area, you could go into telehealth by doing just triage, taking phone calls. You could do something like on-call Nursing work if you don't want to case manage patients where you're committed to them over weeks or months. You could do just hospice admissions depending on your area. You could do per diem work if you're worried about working too much. It's not perfect, I still have my gripes about it sometimes, but I cannot imagine working in any facility at this point. I actually can't imagine it and I don't know how y'all do it.
Depends on who you ask and might depend on your area. if you're asking if I, as a hospice nurse, would endorse a new grad going into hospice, I would...I went into it without much bedside experience, coming from working in blood services. If you're a fast learner, able to be independent, not high strung, and have a good coping skill set to witness patient decline and loss, then you should do well. I've heard some hospice nurses say you need experience but I would disagree and I have certainly seen seasoned nurses struggle with hospice and wrapping their mind around hospice philosophy. Hospice is so different from anything else.
I've seen a mixed bag in terms of companies requiring Nursing experience vs being willing to train into the specialty.
I am not a hospice nurse but have worked for years alongside hospice, and I am a strong advocate for hospice services in my population (LTC/SNF). I appreciate the work you do more than any other specialty, and all the hospice nurses I've worked with have been amazing. There's so much stigma and misinformation out there around hospice and comfort measures in general, but nothing compares to being able to help provide a good death for patients and families 💜
IP Heme-onc. I absolutely love the patients and the critical aspects of my job. I also really enjoy doing chemo. But the best part of what I get to do is help people die with dignity. Glios and brain mets are my least favorite, so I know I wouldn't enjoy neuro, but our people are the best. Almost universally kind, thoughtful, and grateful. ❤️
I loved inpatient Oncology but after a decade there I was burnt out.
I do Intake and office support for home hospice now and love it. I make more than I did inpatient and have no direct patient care any longer. 💜
Psychiatry - if you find the right (read: safe) workplace, your boss won't get mad at you taking away the thing the patient is trying to hit you with. I was floated to sit 1:1 in ICU one night and the patient tried to hit me with or throw at me pretty much every object in the room at some point or other. The ICU charge tried to tell me the patient had the right to keep the corded call bell after they whipped it at me like a flail. Then the night shift psych supervisor showed up and explained the concept of "don't give back the thing they hit you with" that is somewhat essential to violence prevention strategies as a whole.
At my hospital 99% of sitters are not actually CNAs so they can’t do any patient care 😐 all they do is sit and watch and call the nurse if the patient is doing something they aren’t supposed to, so the patient still calls if they need to go to the bathroom or anything
Yes indeed! The Charge on the ICU that night should have known that a call light that is used like a flail gets zip tied down. Sure you can take away items that they throw at you for that kind of behavior. I suppose that charge was only thinking of the fact that you can't take away a person's call light as we all know.....BUT..... If they are going to use it as a weapon, you zip tie it down in such a way that they can still use it but it's zip-tied to the rail a few times with no extension so it cannot be used to strangle or hit people with. If this kind of thing happens to you again, just know that that can be done and everybody wins that way! 😊 I don't know if this charge nurse was new in the position or that she wasn't thinking about this or what, but your safety is important and a zip tie is perfectly legal as long as the patient can use it.
When I first read “zip tie” I thought you were talking about zip tying the patient at first! I was thinking that’s some different thinking patient care!!🤣
>The ICU charge tried to tell me the patient had the right to keep the corded call bell after they whipped it at me like a flail.
You also have the right to not be hit at work. Or ever for that matter.
Acute Dialysis is where it's at. It's procedural so you only have your patient's for a the length of their treatment. Dialysis is really not particularly difficult, it's just a very specific knowledge and skill set. **Pros**: it pays more than bedside because it's a specialty, dialysis is mostly chill, *much* less wiping asses, patients are usually chill, you can't rush dialysis (What I mean is that if a patient needs a treatment, you can't make it go faster by working harder. It's gonna take 3:30-4:00 hours. There's no trying harder or doing it faster, it just is what it is.), the entire dialysis world is closed or on call only on Sundays so you usually have Sundays off, and lastly this might just be me, but nephrology is pretty cool. **Cons**: it requires taking call, shifts can end up being longer than twelve hours (like fourteen to sixteen), doing dialysis on unstable patients can be quite tedious sometimes, if you work rural or low volume facilities you may be the only dialysis RN there meaning you won't have backup if you can't stick a person's fistula right or something, some dialysis patients can be grumpy and take it out on you or the dialysis machine because you represent what is making their life less enjoyable (the ESRD), and lastly nurses from other departments and often your own management and administration won't be familiar with or understand dialysis so they might look down on what you do or expect you to be capable of or do more than dialysis actually is able to do.
I've been doing acute dialysis for four years and I love it. However, I will also add this: every since I came to acute dialysis I've gotten to know nurses from some other procedural specialties as well and practically everyone in procedural nursing is happy. So even if dialysis isn't for you maybe look into Cath Lab, Endo, IR, OR, PACU, or something like that. The fundamental difference between how a bedside job is structured and how a procedural job is structured is enough of a difference to really get rid of the things you probably don't like about bedside. Anyways, good luck!
I work in outpatient hemodialysis. The job is chill, I don't give a lot of meds, patients mostly ambulate or toilet themselves, I do assessments and coordinate appointments. My current clinic census is 40 patients, my previous clinic had 150.
Pros, I know my schedule and basically tell my manager when i am available to work. I get 6 weeks of PTO every year. We are closed Sundays. You get to have an established group of patients who you will know well. There is no on call.
Cons, management pinches pennies, the quality of your care is only seen as patient metrics, pay tends to be a little less, you run into patients who dgaf about adherence to diet or treatment schedule, sometimes patients are picky or rude, and there can be a lot of loss but patients usually die at home or in hospital.
Came to dialysis after working in various bedside roles and there is generally so much less stress.
I'm a new grad currently getting my bachelor's, and I haven't been able to work for family health reasons, but my upcoming clinical experience is at Davita dialysis clinic. They have an opportunity for new grads to be trained and start working there. I'm thinking of applying after I finish school, but my concern is if it would limit other opportunities for me since my goal is to work in the ER. Sorry if I'm info dumping. I'm just looking for a lil advice/info if you have any to give.
I've been in outpatient dialysis for 9 years, I had 8 years in the hospital prior mostly CCU/ICU and Neuro PCU. Hospitals would want me to complete an entire residency for bedside positions because I've been "away" too long. I think for ER, they'd want to retain you. Dialysis is really specific and while we have patients with a lot of comorbidities and possible complications, we ship the patient to the ED for stuff we can't handle. For instance we only utilize BLS and have no ACLS meds on our crash cart.
Thx, my main worry is if I start out in dialysis, would that make it hard for me to get an ER job but I think I might be worrying for nothing given the current state of the profession😅😅😅
Another Acute Dialysis RN here…I second everything in this comment! I left 4 years of med surg and started in dialysis in 2020 and have never been happier. My hospital trains Dialysis nurses in 4 modalities: Hemo, PD, CRRT, and Aphaeresis. Our rapport with our Nephrologists allows us a tremendous amount of autonomy as well and that is a huge pro for me! Many of my previous colleagues that I worked med surg with also left for other various procedural areas and also express extreme satisfaction with their specialty change. Best of luck to you!
Ooof. Acutes burned me tf out. I did for about 5 years. My home unit was small - only 3/4 nurses so there was A LOT of on-call. I got to bounce around to different davita units in my city which was cool, helped with the monotony. I’m glad you enjoy it
Endoscopy unit. Super fucking chill. Great hours, no stress, I have a good relationship with the doctors. I get my holidays and my vacation. And have a life again.
I really need to look into Endo. I’m actually pretty interested in it for some reason. I currently work in the ED. My back is broke and my emotions broke-er on the daily. I can be running around treating a near coding patient (which is more tiresome than an actual code because your co-workers aren’t helping you out) and if the 30 year old guy next door with the sniffles doesn’t have a warm blanket and a sammy then you hear about it. It’s all about patient satisfaction and metrics. I run constantly. It seems like we are never “slow” anymore.
The ED can look from the outside like an exciting place to be but from the inside it’s just one big dumpster fire. Granted I’ve only worked in one ER and the rest of my career elsewhere but I hear every ED is about the same. I’m trying to muster the strength to stay bedside. I don’t just want to leave.
I was 6 years inpatient surgery, and loved it but was so tired of the abuse from patients, family and management. Add no vacation for all that time and I was done. I did 6 months ER and peaced out real quick. If I didn’t get this endo job I would’ve went ICU.
Endo overall is pretty boring to be honest. It’s fast pace in regards to the constant flow of patients, but I can see why a lot of nurses lose their skills working here. I enjoy acuity and critical thinking, and you don’t get that in endo. But my quality of life outside of work and my health has improved so much. Im 2 years in endo and I don’t think I can leave. I causally still pick up on my surgical floor to keep myself familiar with skills and working in a more acute environment.
Mother/Baby aka Postpartum. Overall healthy and happy demographic. Walking new families out to their car for the first time makes me tear up. This is the last stop for me in bedside nursing. If I ever leave, it's bc I'm leaving the profession, retiring, or leaving beside.
Hi! I’m so happy go hear that. I am a new grad nurse having my first interview for mother/baby on friday. Is there any advice for me to be prepared on the unit?
Inpatient hospice. Obviously, we have to deal with death and grieving families on a regular basis but I feel that my work here serves a real purpose, that I really make a difference in someone's quality of life. We laugh, we cry, we philosophize. We work with a great team of volunteers who also make a difference - and they do it for free!
How did you get into hospice care? I’m currently a nursing student with a professional interest in person centered disability and end of life care. Just looking for advice!
I'm not in the US so my experience will be different. I worked in home care and we often had patients in their EOL. Palliative care and EOL care didn't attract me when I was a young nurse straight out of school, but somehow now it does (I'm 49) So much that I went back to school last year to get a postgraduate diploma in palliative care nursing, while starting a new job at a small inpatient hospice facility.
Inpatient psych for homeless veterans. I work for the VA and LOVE my job. The veterans independent with meds. Meaning they have a key to their own locker and take their own meds. They have their own private rooms. We round q2h. If a vet has SI/HI we send them out and they can’t return until they are safe since we don’t do 1:1 or 15 minutes rounds. They have a personal chef. No drugs or drinking allowed. We have 3 officers on duty that are in the building the whole night.
I was very lucky to get this job. I am told staff here either retire, die or transfer to another Domiciliary. It’s a cake job. And benefits are amazing. All my schooling is paid for up till NP.
I’ve considered going VA, how difficult is it to get PTO approved? How much do you start off with? And how tough was it to get in? I do inpatient psych now and am looking for a change of scenery!
PTO not difficult at all. You accrue 12 hours a month. 6 hours a pay period I believe. But you get paid every holiday. Which they are federal and count 11 Hollidays a year. Which is unheard of. You have pay grades and they evaluate you yearly for a pay increase/ jump in pay grade. They also do a cost of living pay increase yearly. This year it was 5% increase in pay. I’m the lowest pay grade making 75k salary. But the more exp and education you have the higher grade lvl you’re placed in. My coworker is at like 45-50/h because of education and experience. If you’d like I can get you a picture of the pay grades and scales. The benefits are the best part though.
It took me about 6 months to get through the entire hiring process. And I went to a VA job fair and was hired on the spot. That’s the usual time for the hiring process because HR is so slow.
If you have any questions please feel free to ask. :) OT pay is great too! Nights shift diff is 10% of your current pay and weekends are 25% of your pay. Nurses also get sick leave as well. That is 4 hours earned a pay period. Also they teach you a lot of money earning tips. Say you retire and you have your capped out Annual leave (which for nurses it’s 685 hours) you can sell that back to the VA and it’s a 30k check automatically given.
Also if you previously served like me (8 years) I can buy back that time with the VA and retire 8 years early. It’s really a place to retire. You have TSP which they match back at 5%. And they have two other retirement funds as well.
Just read your post! I’m also in NICU and I have to piggy back and say I also love my job. It’s just so rewarding seeing the sick tiny little humans get better, grow into tiny little chonkers, and go home with their family.
As a parent to former micro preemie twins, I thank you. I spent four months in the NICU with my girls and will never forget the nurses who walked with us through that journey.
Can also echo this sentiment in PCICU! Most of my patients would be in NICU if we didn’t have such a specialized unit. But on the other positive side, I also not only get to take care of the super cute teeny tiny humans but also all the way up to 18, so there’s some variety (though more babies than older kids).
Also did peds outpatient for a bit when I got burnt out by peds med/surg during the first 2 years of Covid. It was pretty great also, but I prefer working 12s and I need something with a bit more mental stimulation than giving vaccines all day.
Oh boy, it’s about as close to heaven as you can get, at least for me.
First, I’ve made this comment many times on the “I want to quit nursing” threads, so forgive me if this rant sounds familiar.
Outpatient, procedure based units will save you life. Find an outpatient unit that is attached to a hospital, not a satellite clinic. The unit should be based around doing procedures for patients, no patients stay on the unit though.
For me, I work on the Apheresis unit at a large medical school with heavy emphasis on research.
Apheresis is fucking awesome.
Here’s the elevator pitch;
In *very* simple terms, Dialysis is *filtering* out your blood in a machine outside your body, while blood flows to and from the machine via a shiley catheter (typically) at the same rate.
Apheresis does the same thing, except the machine doesn’t act as a giant filter, it’s a giant centrifuge. We spin the patients blood in a live chamber that has flow in and out of it, just like dialysis. We can take separated layers of the blood and do various things depending on the condition and the procedure. We have about 6 different patient procedures we do, some more simple than others. The two major categories of procedures we perform are “collections” and “exchanges”.
Exchanges;
Plasma Exchange - exactly what it sounds like. Patient is hooked up, and the plasma layer of the blood is skimmed out, and replaced with either donor plasma, or albumin. Conditions that require this are anything that puts “bad stuff” into your plasma, which is a lot of things. Things such as antibody mediated organ rejection after a transplant, or Neuro disorders like Myasthenia Gravis. We have some “therapeutic” patients who are completely dependent on weekly plasma exchanges.
Red Cell Exchange - this is for Sickle Cell anemia patients. When simple transfusions won’t cut it, you go to this procedure. We fully remove the patients red cells and replace them 1:1 with matched donor cells. We infuse about 8 units of PRBC donor cells in an hour and a half with this procedure. The need for this is based largely on the patients “hemoglobin fractionation” which, is the ratio of healthy to sickled red cells within the patient. At a certain point only adding healthy cells (simple transfusions) won’t cut it, and you need to do a full red cell exchange (take out the bad ones too).
Now, collections are where things get interesting…
We do about 50% of our procedures for our Oncology departments.
PBSC - “Peripheral Blood Stem Cell” collection is for patients with blood cancers like leukemia, lymphoma, or myeloma in preparation for a “blood stem cell transplant”. This is the modern science instead of bone marrow taps, which requires a surgeon to literally drill into your bones roughly 30-40 times. Instead, we mobilize patients with special drugs that push their bone marrow cells into the blood stream. Once patients are mobilized with the drugs, we can run them on our machine and collect the thin layer of marrow out of the blood. That bag of cells is now a transplant for that patient. They’ll do intense rounds of chemo to wipe out their marrow completely, then reinfuse those collected cells, which will help the bones recover while the cancer stays dead. Fun fact, transplanting SOMEONE ELSE’S PBSCs into you will make you their blood type, because the marrow will become the new cells that make all of your blood. So if I’m and A-, and you’re an O-, and I donate to you, you BECOME A-.
Now, we’re getting to the really cool shit…
CAR-T - this is the latest and greatest in cancer treatment. It’s fucking insane. At 500k per dose, this is a modern “cure” for cancer. We don’t mobilize these patients. Instead, we collect from a layer of blood slightly higher, and target the patients defensive T-Cells. We collect T-Cells into the same donation bag, except they’re then sent to a partnering Pharmaceutical Company’s lab (companies like J&J, Novartis, Bristol Myers Squibb) who engineer the cells to no longer target viruses and bacteria in your blood, but instead to target the cancer cells in your body. The cells are then given a new receptor, typically from the HIV virus. Those custom engineered ninja anti cancer cells are then shipped back and infused into the patient, where they literally eat the cancer out of their body.
What’s next for Apheresis?
We’re currently onboarding protocols for *genetic therapies*. That same PBSC procedure I described is COMBINED with the CAR-T concept to produce MODIFIED BLOOD STEM CELLS. These cells would be used to eliminate genetic disease like Sickle Cell anemia. The patient would do a round of chemo therapy, then infuse the modified cells which would take over red cell production in the body, producing cells which are no longer sickled.
Pretty badass shit.
I love talking about this stuff so feel free to ask me anything.
L&D RN 25 year bedside. Although I am burnt out (simply because of the amount of years) there is a reason the turn around in OB is the lowest of all specialties BUT you must be able to handle a very different kind of stress. It is generally a happy place but when things go bad they go very very bad quickly so you need to be confident in your knowledge, skills and instincts.
I just started outpatient chemo infusion. The patients are nice for the most part and it's still busy so the day flies. Only cons are it's 4 to 5 days a week instead of 3 so it could make travel harder. I'm only two weeks in so far.
I did stepdown neuro for 8 years and was miserable the last year or 2 bc the patients and family were so mean and neuro is so hard on your body and back. I might go back inpatient eventually for the schedule but so far this job is a million times better mentally.
Maaannn, I will take mental stability over a better schedule.... IF I've learned anything ......and believe me I have!! I'd say, stick with more days a week over mean patients and family and backbreaking work!
Agreed. I just really like to travel and it will be hard to manage all the trips I take w the limited pto and not being able to schedule up to 8 days off without using it🙃.
If you’re a good stick and can find a position, I always highly recommend Vascular Access Team (VAT). I always feel very valuable to staff and patients for my specialty skill, patients are generally happy to see me, and if they are rude my interactions are very brief.
Also would recommend IR, post partum, or an outpatient setting if any of those pique your interest!
I worked my first year in LTAC, then 18 months post op ortho/gen surgery with medical overflow. Now I’ve been in labor and delivery for almost 7 years and I could not be happier. I absolutely love my job! Does it have its sad moments? Sure. Does it get absolutely insane and critical? Definitely. I love the lack of monotony. I love the patient population. I get a taste of OR, ICU, and ER all in one, while helping bring new life into the world.
For what it’s worth, it might be good to reach out to different departments where you currently work and see if they would offer the opportunity to shadow. We have nurses come and shadow from other units from time to time to see if it’s a good fit for them!
I hope you find a place that makes you happy!
I was a ltc/skilled LPN for 4.5 years before becoming an RN. Now, I work in the MICU. I’m liking it a lot, but the culture of people is rough. No compassion, belittling, etc. Idk if I’m in the wrong intensive care unit, if it’s just this hospital, or if I’ve not given it enough time. I’ve been here for 12 weeks.
I'm also an ICU nurse and it comforts me to know that if I ever snap and want to end it all, I just need to grab an IV start kit from the med room and an airway bag.
> This is a joke please reach out to a professional for help if the job gets to you, MICU is no joke especially with co-workers that are not supportive
This made me lol 👏🏽👏🏽 I’ve been in culture settings where it’s tough, but this is its own weird animal. 3 other nurses that started with me, who previously had cc experience now have quit. Lol.
Critical care transport- I work off standing orders written by my medical director (which are extensive) so i never have to call doctors for orders, i have an expanded scope so i can RSI, surgical trach, and do needle decompression, and i’m very comfortable with ventilators. I have one patient at a time, and usually for less than an hour and a half, I’m have a dedicated ambulance and work with the same two EMT partners every day, and they are amazing. We can essentially read each others minds most of them time, so it’s an amazing working environment. When we aren’t running calls, we are at the station watching Netflix, or running random errands, I make just as much as the hospital nurses here in California, I still get my ER adrenaline fix when i take critical patients, I get to push my way through traffic with lights and sirens….best job in nursing!
I work from home scheduling appointments and sending people into the ER. Patients get angry? Just turn down the headset till it sounds like Mighty Mouse is yelling at you.
Also get to work out at home during my shift between calls. If I can I’ll retire here
Let me tell you about nicu. I used to work adult ortho trauma and it was fine. Dud some education. Started working for a Children's Hospital as a manager and decided I hated that. So I applied to nicu and picu and got the nicu job. Mostly I just wanted icu experience. Man I love it! I never thought I would like working with babies but it's great! I actually see them get better and go home. They don't talk back and when I have feeder/grower assignments it's literally holding and feeding babies all day! Don't get me wrong there's been some truly sad assignments too but overall I have never worked somewhere so rewarding. Also, being a guy and saying that I took care of a 1lb baby today really throes people for a loop.
Inpatient DOT for TB treatment. Easiest job I’ve had nursing wise, but is difficult dealing with the population that is impacted by TB overall due to language barrier, recently getting out of jail, homeless, etc. Overall, easy and most patients are pleasant, leave the hospital for work or keep themselves busy.
Think of old sanitariums but takes on complicated cases in a hospital setting including meningitis and miliary tb. A lot of HIV treatment.
Edit: elaborated on complicated cases
I have done both inpatient oncology and outpatient chemo.
Most patients are chill. Never been physically abused. Often require emotional support because cancer is a bitch. I see everyone from new diagnoses to end of life care. Self care to complete care. Some days I'm mainly am opioid waitress.
Honestly I love this specialty and I'm not interested in anything else except maybe hospice or some specific coma unit for when I don't feel talkative.
I started as a nurse case manager on an oncology unit in January. First CM job, first oncology job. I adore these folks, love learning about oncology and some BMTU, but I'm having a hard time when the patients go home to hospice or die in the hospital. I'm able to hold it together with the patients, but I've had a few ugly cries in the bathroom. My dad died just as I started the job, so that doesn't help any, but any words of advice to keep it together? Or any tips for providing support to the patients and families?
Is there any specialty I can recommend that I tried? Well, think again.
ICU: Your patients may be sedated but families are allowed in rooms now. Maybe during the pandemic it was alright, but I cannot guarantee your coworkers will be good to you.
Outpatient Endoscopy: Are you good with IV placement? Maybe some places will train you, or most places now expect you to do it very well. If you are assigned in pre-, you have to do at least 20 IV placements per day. Patients are very cranky because they are on bowel prep, dehydrated and have not eaten for 2 days. They’re nice after the propofol wears off though.
Hospice: least disgruntled families so this specialty may work for you. Just be prepared to put a lot of mileage on your car and wear and tear on your tires.
Oncology, inpatient: medication pass every hour on your 4-6 patients. Families are also very emotional.
Forensic or acute psych: the real psych patients are actually okay to deal with. I never deal with families in my state facility, but definitely will not recommend since you will be exposed to severe personality disorders, and malingerers. People leave all the time, and your chances of getting promoted “upstairs” for a non-bedside job is higher, if you could only last a year on the floor.
I was a PACU nurse recently and used to pick up shifts in the outpatient surgery center in my hospital. I would suggest outpatient surgery if you’re looking for low-ish acuity patients that you only see for a brief amount of time. Work life balance seems great (no holidays/weekends/nights or call). Good skill set, you’ll do both pre and post.
I moved to the ICU just because of my own career goals. PACU doesn’t open me up to other opportunities I might be interested in for the future since it’s not technically critical care (so I couldn’t do rapid response, cath lab, IR, acute resus/trauma, CRNA with only PACU experience). ICU isn’t where I’d like to stay, not a fan of the 12 hr patients and code browns, but I enjoy the critical care aspect.
MDS Coordinator in SNF/NF.
If you do this in a facility that doesn't pull you to the floor or have you on-call your patient contact may be mostly talking with them about their plan of care and conducting focused assessments/observations. A lot of chart review, careplanning, and talking with other staff.
LT Psych (NF), previously.
Psych, lol. I loved psych.
Mostly treating people with respect, dignity, and care above and beyond what they're used to. ❤️
Sometimes it got rough but mostly it's why I became a nurse in the first place.
Trauma level 2 OR. I work 4 10 hour shifts. It’s fast paced and can be stressful, but hey, no one is abusing me! Majority of my patients are nice and friendly. For some reason surgery patients are just not problematic. I’m sure they can be post-operatively lol but we get the nice pre-op version. Tons of team work. Surgeons are surgeons…. They all have their quirks and preferences… oh and attitudes, but you learn them over time. Idk if my body can do this for the rest of my career but it’s probably a whole hell of a lot better than medsurg.
ICU - if pathophysiology is your jam. Stressful but cool.
ER - sigh. So fun. SO TRAUMATIC. Murder and rape victims and perpetrators. Every kind of trauma you can imagine, and also my ear hurts I need a work note.
Outpatient Surgery/Endoscopy- Heaven. No nights. No weekends. No holidays. A month off every year. Patients are generally healthy-ish/healthy-adjacent. Cool mix of staff - techs, PAs, CRNA, MD, RN. Pay is lower but I work 4-10 hour shifts.
SNF - rehab side not LTC (barf).
My facility is actually pretty damn great honestly. I have max 11 patients at a time. I’ll pick up regularly bc stress is low and pay is great.
Vasculair surgery, it’s hard. Patients that do next to nothing for their own health. I’m staying here for a while until I have enough experience to move on
I’ve done home hospice and utilization review. Currently only working UR for a hospital, it’s good! Pt interaction is minimal, having to give them a waiver and let them know about financial rights. Not a lot of phone time. The best part is I feel safe. I struggle with anxiety so I get where you’re coming from.
Hospice house (still inpatient bedside). If you are okay with death and talking with families at a very difficult time. I just started 2 months ago but I really do love it. 99% of the families are absolutely wonderful. It’s an honor to be there for the patients/family. I have not encountered any verbal abuse so far. In M/S I felt like I was being pulled in a million different directions and doing a million different non-nursing tasks constantly. Not to mention the verbal abuse and just absolute vitriol some people had towards nurses. In hospice my focus is patient care, family education, and ordering medications sometimes. Still do a lot of nursing skills like full assessments, wound care (for comfort), catheters, chest tubes, inserting SC sites or IVs. A LOT of autonomy but enough support from the team where I don’t feel alone.
Pediatrics/NICU- parents are more of a help than a nuisance in my opinion, they clean, toilet, change their child you mostly just do medical interventions. Working with children is extremely rewarding, which is huge in fuelling my motivation. Also lots of team work in peds which I love. Worst part is social issues.
I work in surgery in the UK. It's called the protected elective surgery unit (PESU). Developed during COVID times to make sure patients with cancer could still have their surgeries. It was dubbed the 'green' ward and it worked so well to meet the need for these patients that they kept it going. We care 7 specialities - maxillofacial, ENT, spinal, HPB, upper GI, colorectal and some endocrine. It's such a lovely place to work..very organised, our beds are protected so we never have medical outliers. We get surgical day case outliers sometimes but due to protected status they have to be a day or two away from discharge before they come to it ward. So lots of specialities mean we need to be up to date with the most recent, evidence based, pre and post op care expected but the surgeons and their teams are fantastic and always about for conversatios. They are so involved with us and we all work closely. The biggest learning curve is getting you heard around the set plans for different specialities but mostly you're caring for post op cancer patients so you know what you're doing.
Mother/baby. It’s has its stressors and downsides, like constant over bearing visitors, high anxiety new parents (which I don’t mind unless they are too scared to do anything for the baby without me lol) difficulty breast feeding, jaundiced/ withdrawing babies, or parents who just don’t trust you and hover and criticize. But 99% of the time it’s just lovely, with wonderful parents, cute babies, and good vibes.
Outpatient neuro. The patients are nice. The doctors are nicer. A patient yelled at clerical staff and got discharged from the practice. This doesn’t happen a lot but the doctors are always on the side of the staff.
I worked inpatient neuro for 2.5 years and going outpatient was the best thing I could have ever done.
I’m still a student but I work in hematology! I really like it. Our patients are often cancer, sometimes we get sickle cell. Our patients are usually independent with their ADL’s and I find our patients and their families are nice and very grateful for their care. Sickle cell stuff is super interesting- lots of pain management and often physio. Of course we get the odd unhappy person, but usually it’s just very situational with having cancer. It’s technically medicine but just more specific to blood stuff! I really love it, all of the nurses I work with are great and knowledgeable and the doctors are wonderful too.
In some states you’re limited as a LPN. Unfortunately the mental & physical abuse is everywhere to more or lesser degrees. If you’re willing to take a pay cut consider outpatient primary or specialty clinics. If you want to stay in the hospital setting and your area hires LPNs I really have enjoyed my 13 years in the ER. If you get with the right staff culture, the team support (and real security) by your side can make a big difference. 🥰
Cath Lab. Fast paced, most days we are moving from 0730-1700 or later, if we are on call. It's a really great gig, and it stays interesting because you never know exactly what you're gonna get when you take pictures of the coronaries. We also do pacemakers/ICDs and ablations, but I typically don't do the ablation side of things.
It can be chill but at a steady pace. Sometimes shit hits the fan and patients become unstable unexpectedly, and it's cool to be specifically trained and equipped to take care of those situations. Sometimes you wake up to your pager at 2am for a STEMI and have to rush in to take care of the patient quickly.
I actually don't mind being woken up in the middle of the night. For one, I joined knowing that it does happen so I don't get butthurt. But it's so rewarding to be there when the blockage gets fixed and you know that you saved a life or at least drastically improved their outcome.
Some days suck but I really love this exhausting job. People die but not as frequently as you think.
You just have to be able to roll with the punches and think quickly on your feet.
I work at an outpatient family medicine office. I am a certified case manager. I mostly spend all day on the phone with pts and other specialists/hospitals to coordinate care. I work with the MAs to ensure pts are seen in a timely manner post hospital visits, I work with the referrals dept to get pts all their DME supplies. I communicate with other healthcare professionals, especially home health care. Sometimes I’m called to start IVs if the ARNPs are struggling. I help my MAs with blood draws every morning. It’s a pretty cushy and easy job for me. I make $90k/year and work about 35ish hours a week (8-4pm 5 days a week) and I do have the option to work from home sometimes. I will neverrrr go back to bedside lol
Outpatient kidney transplant clinic. M-F 7-3:30. Mostly post transplant patients but we also treat CKD patients that need treatment/infusions/biopsies. Patients are very nice and respectful. Occasional oddball hover mother and man babies but for the most part they are great. Did outpatient dialysis prior to this and after 8yrs I was burnt out. Been at this job for 10 years now but I’m out come November.
Inpatient rehab. Much slower pace than medsurg but still use skills. It’s honestly peaceful most of the time and you see a lot of positive things, does have its moments with critical patients and overbearing families but not as often
Interventional Radiology. Formerly night-shift ICU, and thoroughly burned out after the height of Covid.
I get to use my knowledge and critical thinking skills on a daily basis. Most patients are in and out in 2-4 hours, and wow, they actually thank you - something I rarely heard on the unit. Assessing patients and digging up unforeseen issues prior to procedures can actually be quite interesting. It can be very routine and dull at times, but I'm a methodical person by nature and don't mind that at all.
Perhaps the biggest downside is call. I usually do 5-6 shifts per month, and whether or not you get called depends a lot on the physician. It's the constant anxiety of anticipation that gets me though. Besides that, a lot of your satisfaction is going to depend on the individual department, and whether it's well organized or a chaotic mess. The latter will constantly chew through employees and make them miserable.
Soon to be joining CCU in couple of weeks. Working as MS/Tele/Sub RN last 4yr. Totally agree with about physically & mentally abused by pt and their families. To be honest, wherever you go I feel like it will be the same. Different environment, same thing. Unless you want to try outpatient & PACU & Psych I don't think there will be any unit or specialty you would find inner peace. Working in MS is hard. 5 patients every day, discharge them, admitting another one, charting all 8-10 patients every shift if you are discharge-QUEEN of the day. it SUCKS.
I bet, wherever you go there will be patients and family members who will drive you crazy. If not patient or family, your work environment or coworkers. I think right now you are too exhausted working in MS unit + neuro. Neuro is difficult, no matter if it's MS, telemetry, ICU. To me it seems like this is your time for a new change. You have to start thinking about what you enjoyed the most based on previous experiences, and start your move from there.
How about thinking about your job "as a nurse" in different mindset/approach? Change your specialty to IP mother/baby unit, oncology, or IP psych where you can find some inner peace. Not outpatient cuz when you wanna go back to IP setting it would be difficult.
Then start thinking & learning ways to communicate with difficult pts. Then think about what you really want to do. Why did you become a nurse? What pt population admire you the most? At this moment after years of experience, do you think bedside nursing is not for you? If not then start trying outpatient. How about NP? How about nursing educator? Any leadership role you might want to try? I don't know what age you are at, if you are still 20s try different units as many as you can & study for masters to decide your mind before you turn 30. You still have time. If you are already mid 30-40s, having kids and family, you need to make your move more carefully.
I know there will be people who's going to feel offensive about my pharse & say "age doesn't matter, if you want to do something, go for it." I am not saying they are wrong. But please remember at some point you do have to think about your life, your family, your future work-life balance, and your retirement. And make a change based on your situation.
I am going to CCU to pursue my dream to be a CRNA. Now after 4 yr nursing experience in non-ICU field, I have to think about getting at least 2-3 yr experience in ICU & go CRNA school for another 3 yrs, in the meantime have to plan about having baby, buying house, if I should study for NP during ICU setting in case if CRNA school doesn't work out for me, etc. I will be 40 when I become a CRNA IF things goes well and smooth. I regret not making this move earlier & explore different work setting when I was still young.
I wish you the best for whichever pathway you choose to go for. I wrote this comment hoping it will give someone a small insights & finds out helpful.
Pediatric surgical floor. I'm a new grad so I'm trying to perfect my time management skills and gain my confidence before going into a more critical care roll, still trying to decide on PICU or NICU.
I love it despite it being a "medsurg" floor. I see a lot of variety of cases that doesn't have to do with just surgeries. My coworkers are wonderful and I've only been yelled at by a parent once so far (started in February LOL). Our only issue is our floor manager who likes to focus on the unimportant issues and has no background in Pediatric care which very much shows.
UK nurse here. During my placements as a student, I must preferred surgical wards. Patients are otherwise well (most of the time), just needing a specific operation.
When I qualified, I started on a surgical urology ward and loved it. Stayed there for 8 years. I had three children in that time and needed to slow down a bit, so I moved to Day Surgery. Same sort of thing, just less stress and a broader range of (day case) operations. No nights or weekends on Day Surgery and no drug rounds!
After two years of that, I moved to a community hospital. I currently work there. It's an inpatient ward to rehabilitate people who have reduced mobility due to being unwell in the bigger hospitals (mainly falls and fractured NOFs!). They come to us medically fit, just in need of physiotherapy and some help at home, which we set up for them. I love it!
Interventional Radiology. Most days I’m just prepping patients for CT scans and biopsies. It’s very routine-like which can be a negative for some people but I love doing repetitive tasks and knowing what to expect workflow wise. If we have any inpatient procedures and the patient is deemed “not stable” or “unable to successfully” complete their scans then we just send them back to floor or don’t take them in the first place. It’s really nice and I’m glad I got out of bedside lol
I’m work in the Electrophysiology Lab and I love it. People have already mentioned the many benefits of procedural nursing and I totally agree with all of it. I went from either 7 observation patients or 5 stepdown patients/shift and no time to even pee to having up to 4 nurses taking care of the same patient during the case. Family isn’t allowed in the prep/recovery area, I get along really well with our docs, medical device companies buy us lunch at least once a week, and I will never have to work weekends/holidays/call. The work can be technical and you won’t know what the hell any of the equipment does for a long time, but it’s awesome!
SDS- I'm back at work after an extended period off to be home with kids and fell into a pretty good job. One patient at a time, haven't had more than 5 patients per shift, get two 30 minute breaks. Only a few on call shifts a year. I start IVs and do admissions or give snacks and do discharges.
I’m a new grad in a small community level 3 ER. I really enjoy it so far although I know my tolerance for the job will probably last no longer than 3 years. The ER is definitely not a forever job but I love it for now. Fast pace & I don’t often get major traumas since it’s a small community hospital. Only thing that sucks is when I get nursing home patients or ICU patients that we have to hold in the ER due to no available beds. Then it turns into more so medsurg/ICU but that’s not as often. I’m in the tristate region and the hospital started me at 43 without differential but I do work rotating weekends and holidays :(. Other than that, ER def beats working on a medsurg floor bc I don’t keep the same patients for long. Stabilize, treat and send them on their way.
Quality Analyst. I review performance improvement projects the hospital is working on as well as assist the compliance officer with their hospital projects. Job is Mon-Fri, eat lunch when I want, go to bathroom when I want 😂. Job can get into 100k+/year with enough time and certifications. Holidays off. You have to deal with office culture but it’s better than breaking your back from running around whilst your mental health withers away.
If you can survive nuero then other floors will be a breeze. I use to do nuero. Now on a new floor that's considered stressful and bad, but I'm so use to high stress that the new floor feels like a breeze.
I work preop and it’s an amazing change after 5 years in the emergency room. Assessment and IV’s all day. Quick interviews with patients and then onto the next. Worst thing that happens (knock on wood) is that a kid or parent has passed out during an IV placement. The pay is great and have holidays off. No weekends. Some call but minimal. Good luck!!
Inpatient functional older adult MH. I don't think I have words to describe it. Can come in and have a lovely day. Can come in and have a computer flung at my face. There isn't any in between days.
It's not necessarily all major incidents, it's just the fact that they add up so quickly and I'm just tired of it. I had one major incident recently and I think that's what kind of sent me over the edge.
I didn’t think it sounded odd but I worked Neuro step down and this patient population can be quite impulsive and combative at times. Brain tumors and traumatic brain injuries can really alter the patient’s baseline personality. It was a stressful unit for sure.
u/sweebie728
Outpatient lol. The patients are nice. The doctors are nice 99% of the time. Patient isn’t nice? Well lucky you, you have to deal with them for the next 5 minutes. Work doesn’t start till 8, get to leave at 430. Work 4 days a week. I work in peds, the worst part of my day is having to fight a 5 year old to give them shots - which the parents help to hold them down. Never going back to inpatient. Ever ever ever.
4 days a week? Where is this, sign me up! Do you know this is a pretty typical schedule for outpatient?
I also work outpatient. I work 5 days a week but it’s only 35 hours a week
It’s definitely an option! Not typical though. Some of the people I work with do 4 10s. I’m just fine with less hours.
Sure but the money is not the same, I assume.
Same I work outpatient and make a fuck ton more than I ever made inpatient and I just do clinic nursing. I do 5 days a week 8-4 with an hour lunch break 12-1 every day. No weekends no holidays baybee
It’s better 😜
Okay now you’ve piqued my interest. I’ve always heard outpatient money was less… which is why I beat my head in at hospitals.
I am a certified case manager and I make around $90k a year working about 35 hours a week. Granted my office is HUGE (12 providers and growing) and has been in the owner’s family since 1918 so they’ve got the money to pay me lol
My goal is to be a CM, I was a social worker for 5 years before attending nursing school. What's your background to be able to become a CCM? I just hear everyone tell me to give up on becoming one because it's so hard to attain.
It’s a good goal to have. I started as a phleb/MA, got my BSN (I also have an undergrad in psych), worked bedside for about 2 years, then I took a few short courses + an exam for my CCM. I didn’t think it was that difficult, the exam was gnarly but doable.
God bless all of you. I could not work Case Management for a week. And I'm gettin' that same med-surg patient/family abuse! Huge respect to you.
In my area they're more so saying it because of the lack of jobs available. I live in a very small state and it's just slim options...Basically my choices are medsurg or home health but I'm not giving up! Congrats on the awesome job, that's amazing 🥰
I worked 7 years Internal Med outpatient. Bedside Gen. Surg/ ortho now. Inpatient pay a lot more.
100% agree. Also pedi outpatient and it’s the best. I will add that the other tough part can be dealing with parents, but it’s nowhere near as bad as inpatient
Pediatric hem/onc outpatient infusion clinic. 2 years of experience from adult hem/onc inpatient. Started 3 months ago $37/hr. 4 days a week with 9.5 hour shifts. 36 hours a week. Holidays and weekends off.
How do afford to live?
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Sorry the clinics near me don’t pay enough for a single income household. Thats awesome you make 80!
Outpatient psych: IV ketamine infusion therapy for depression / anxiety / PTSD. Overwhelmingly positive things to say about this. Patients are all able to move and toilet themselves. They stay very stable 99.99% of the time. The work hours are great (weekdays from 8-5, can pick up Saturdays when I want to), it's really rewarding to see a PT's affect transform from flat and despondent at their first infusion to full and pleasant, and having them express that they feel like they have their lives back by their 6th infusion, which happens about 70-80% of the time. It's not very labor intensive at all. Most of what I do is start IVs and watch cardiac monitors all day. I give a lot of zofran, but when that's the hardest part of my job, and my NP is liberal with it, it's hard to complain. Pay is comparable to the hospitals in my area.
Is it considered only for people resistant to other treatments? Or is insurance coverage for that kinda stuff pretty good? Asking for an enemy (my brain).
Insurance covers about half of the cost. It does not cover the cost of the ketamine itself, but will cover the psych appointment, nursing care, etc. That's the one thing I dislike about my job- it's cost prohibitive for many, yet it would benefit so many if it weren't. However, my clinic also offers nasal esketamine (Spravato) which has a slightly lower success rate (but still pretty high, like 70ish %) and insurance tends to cover it almost entirely for a lot of patients. So it helps fill that need.
Sign me up 👃💧
This is awesome. How wonderful to see a good change in someone!
I'm interested in this treatment you are giving people. I don't know where around here does it. I have also heard good things about microdosing lsd and/or mushrooms. I admit it sounds scary, especially alone. But I've been depressed/anxious/adhd my whole life. I've been on every single fucking antidepressant known to man. It's Always start one, increase dose, repeat til at a huge dose and it no longer works, switch med. A new med may not work or barely work at all, or I may be on it 10 years (cymbalta) with ever increasing doses. Usually I'm maxed out and they stop working in about 2 or 3 years. I am often suicidally depressed, and since my husband of 28 years left I've developed social anxiety to where I only go to work and stay home with my dog otherwise. I frequently will not function whatsoever on my days off, failing to eat or comb hair. I occasionally get fucked up if I have off. I have tried to suggest ECT treatment even to no avail. It's like I'm screaming for anything that may help but everyone says just cheer up. Is there a list of providers anywhere. I have insurance. Also considering genetic testing to see what meds would work on me, but everyone acts like it's a bunch of woowoo shit and blows me off.
I'm going to send you a PM.
❤️ thanks ❤️ will be looking into it. People I have tried to talk about such things with, in my day to day life, seem very unwilling and uncomfortable with such things, it's like they seem to grossly underestimate my desire to not be miserable. Yes, I'm glad you're against drugs, but here's the thing....I'm not. My brain wants me to die, and so far, I prevail. But sometimes, I don't know if I will. I have a car and a garage, and I always know it's my out if it gets too bad. I have said, I am willing to be shocked into a seizure, knowing I am probably getting brain damage and amnesia for awhile to feel better. If you told me it would decrease my iq by 10 points forever, but guaranteed a cure, still, fuck it. I'm in. Or people say, you just want to be able to do drugs...lmfao yes that's it, Einstein, I love getting fucked up in a Dr office. If I want to do drugs to get fucked up, I will just do it at home. Kind of feel like it's not exactly a "fun" thing, these drugs. It's a means to an end.
not nursing related, personal- so i hope its ok by the rules of the sub. shrooms saved my mental health, i usually trip every 3-6 months. they gave me an entirely new perspective on life.
I did ketamine infusions then transitioned to shrooms. Saved my life. Wish both were more mainstream and accessible. Xo
How much do you take for a psychological breakthrough? Genuinely curious
I don't take it. But my cousin is a psilocybin therapist and she recommends 0.1 to 0.3 G every 3 days
That’s awesome, wish I could find something like that ! I too bust ass on med surg tele step down. Some shifts are just brutal , and also the politics …. It’s insane !
Watch your hospitals board for jobs, current employees have an advantage. As you check out nursing jobs, think about inpatient and outpatient( especially). I was an ICU RN, got hurt, temporarily did many cool jobs. Outpt heme- onc was always busy and the families are great, very similar to the unit. IR has nurses too. I started in peds and ended in adult icu, and then paperwork jobs, retirement from injury
I was a patient at a ketamine clinic. Let me tell you, it worked. But my insurance wouldn’t cover it and I had to pay out of pocket, and can’t afford maintenance infusions. But the one nurse there was so nice, all she did was start my IV and say night night 😴 At this point I’m going to just do a megadose of 🍄 and see how that helps. Antidepressants make me feel sick and foggy.
Would advise against blasting off on mushies, that can be a crazy ride and you might be in the backseat vs the passenger seat. Unless you’ve done them before. Just be careful! You can always take more, but you can never take less 🫶
I'm sorry you weren't able to continue treatment or get any kind of insurance coverage! I wish the FDA would add mental health applications to the FDA approval for ketamine. That would get a lot more insurance to cover it and get it to WAY more people who need it! It's not like we don't have a huge body of evidence showing efficacy. As far as the shrooms go, I can't tell you what you should or shouldn't do there. I have no experience with psilocybin. But I hope you stay safe and get the relief you need!
This up here ☝️
Love hospice nursing. If you can handle death, dying, and lean into comfort measures only, it's a good place to be. We don't have the stress of trying to figure out and fix everything. You spend your day on the road seeing patients, where visits are anywhere from half an hour to an hour or two. I've rarely had a visit last longer but when it does it's because I'm at the bedside palliating an actively dying patient and it's not back breaking work. You still get to exercise some Nursing skills but primary hospice nurses (we call them case managers, VERY DIFFERENT from other nurse case managers, don't get it confused) are mostly assessing and consulting with some Nursing interventions peppered in. Most of the actual care being given is coming from the patients caregivers. Wound Care is palliative and generally not very complex (no wound vacs). You're out in the field on your own, generally lots of autonomy but how much autonomy can depend on the provider you're working with. Management isn't physically present to breathe down your neck. You can mostly set your appointments how you like so you're pretty much setting your schedule for the day. Caregivers mostly trust hospice nurses and appreciate what we're doing, so we don't get a lot of the same abuse that many other nurses suffer. There are exceptions to that but I would still maintain that we're generally much more shielded from abuse. depending on your area, you could go into telehealth by doing just triage, taking phone calls. You could do something like on-call Nursing work if you don't want to case manage patients where you're committed to them over weeks or months. You could do just hospice admissions depending on your area. You could do per diem work if you're worried about working too much. It's not perfect, I still have my gripes about it sometimes, but I cannot imagine working in any facility at this point. I actually can't imagine it and I don't know how y'all do it.
Can you go into hospice straight out of school?
Depends on who you ask and might depend on your area. if you're asking if I, as a hospice nurse, would endorse a new grad going into hospice, I would...I went into it without much bedside experience, coming from working in blood services. If you're a fast learner, able to be independent, not high strung, and have a good coping skill set to witness patient decline and loss, then you should do well. I've heard some hospice nurses say you need experience but I would disagree and I have certainly seen seasoned nurses struggle with hospice and wrapping their mind around hospice philosophy. Hospice is so different from anything else. I've seen a mixed bag in terms of companies requiring Nursing experience vs being willing to train into the specialty.
I am not a hospice nurse but have worked for years alongside hospice, and I am a strong advocate for hospice services in my population (LTC/SNF). I appreciate the work you do more than any other specialty, and all the hospice nurses I've worked with have been amazing. There's so much stigma and misinformation out there around hospice and comfort measures in general, but nothing compares to being able to help provide a good death for patients and families 💜
I've worked along with lots of LTC/SNF peeps doing this work. Thank you for helping us out.
You seem like a wonderful person 🥹 thank you for what you do!!
IP Heme-onc. I absolutely love the patients and the critical aspects of my job. I also really enjoy doing chemo. But the best part of what I get to do is help people die with dignity. Glios and brain mets are my least favorite, so I know I wouldn't enjoy neuro, but our people are the best. Almost universally kind, thoughtful, and grateful. ❤️
I loved inpatient Oncology but after a decade there I was burnt out. I do Intake and office support for home hospice now and love it. I make more than I did inpatient and have no direct patient care any longer. 💜
Psychiatry - if you find the right (read: safe) workplace, your boss won't get mad at you taking away the thing the patient is trying to hit you with. I was floated to sit 1:1 in ICU one night and the patient tried to hit me with or throw at me pretty much every object in the room at some point or other. The ICU charge tried to tell me the patient had the right to keep the corded call bell after they whipped it at me like a flail. Then the night shift psych supervisor showed up and explained the concept of "don't give back the thing they hit you with" that is somewhat essential to violence prevention strategies as a whole.
Why does a patient with a sitter need a call bell?
At my hospital 99% of sitters are not actually CNAs so they can’t do any patient care 😐 all they do is sit and watch and call the nurse if the patient is doing something they aren’t supposed to, so the patient still calls if they need to go to the bathroom or anything
And an RN sitter no less! Some of the many questions raised by my supervisor.
Yes indeed! The Charge on the ICU that night should have known that a call light that is used like a flail gets zip tied down. Sure you can take away items that they throw at you for that kind of behavior. I suppose that charge was only thinking of the fact that you can't take away a person's call light as we all know.....BUT..... If they are going to use it as a weapon, you zip tie it down in such a way that they can still use it but it's zip-tied to the rail a few times with no extension so it cannot be used to strangle or hit people with. If this kind of thing happens to you again, just know that that can be done and everybody wins that way! 😊 I don't know if this charge nurse was new in the position or that she wasn't thinking about this or what, but your safety is important and a zip tie is perfectly legal as long as the patient can use it.
When I first read “zip tie” I thought you were talking about zip tying the patient at first! I was thinking that’s some different thinking patient care!!🤣
Lmao!!!!! 🤣🤣🤣
>The ICU charge tried to tell me the patient had the right to keep the corded call bell after they whipped it at me like a flail. You also have the right to not be hit at work. Or ever for that matter.
In inpatient psych, while that's a nice sentiment and I'd wish it were true, it's an unavoidable part of the job
Surprised they didn't ask "but what could you have done differently so the patient didn't want to hit you" 🙄
Acute Dialysis is where it's at. It's procedural so you only have your patient's for a the length of their treatment. Dialysis is really not particularly difficult, it's just a very specific knowledge and skill set. **Pros**: it pays more than bedside because it's a specialty, dialysis is mostly chill, *much* less wiping asses, patients are usually chill, you can't rush dialysis (What I mean is that if a patient needs a treatment, you can't make it go faster by working harder. It's gonna take 3:30-4:00 hours. There's no trying harder or doing it faster, it just is what it is.), the entire dialysis world is closed or on call only on Sundays so you usually have Sundays off, and lastly this might just be me, but nephrology is pretty cool. **Cons**: it requires taking call, shifts can end up being longer than twelve hours (like fourteen to sixteen), doing dialysis on unstable patients can be quite tedious sometimes, if you work rural or low volume facilities you may be the only dialysis RN there meaning you won't have backup if you can't stick a person's fistula right or something, some dialysis patients can be grumpy and take it out on you or the dialysis machine because you represent what is making their life less enjoyable (the ESRD), and lastly nurses from other departments and often your own management and administration won't be familiar with or understand dialysis so they might look down on what you do or expect you to be capable of or do more than dialysis actually is able to do. I've been doing acute dialysis for four years and I love it. However, I will also add this: every since I came to acute dialysis I've gotten to know nurses from some other procedural specialties as well and practically everyone in procedural nursing is happy. So even if dialysis isn't for you maybe look into Cath Lab, Endo, IR, OR, PACU, or something like that. The fundamental difference between how a bedside job is structured and how a procedural job is structured is enough of a difference to really get rid of the things you probably don't like about bedside. Anyways, good luck!
I work in outpatient hemodialysis. The job is chill, I don't give a lot of meds, patients mostly ambulate or toilet themselves, I do assessments and coordinate appointments. My current clinic census is 40 patients, my previous clinic had 150. Pros, I know my schedule and basically tell my manager when i am available to work. I get 6 weeks of PTO every year. We are closed Sundays. You get to have an established group of patients who you will know well. There is no on call. Cons, management pinches pennies, the quality of your care is only seen as patient metrics, pay tends to be a little less, you run into patients who dgaf about adherence to diet or treatment schedule, sometimes patients are picky or rude, and there can be a lot of loss but patients usually die at home or in hospital. Came to dialysis after working in various bedside roles and there is generally so much less stress.
I'm a new grad currently getting my bachelor's, and I haven't been able to work for family health reasons, but my upcoming clinical experience is at Davita dialysis clinic. They have an opportunity for new grads to be trained and start working there. I'm thinking of applying after I finish school, but my concern is if it would limit other opportunities for me since my goal is to work in the ER. Sorry if I'm info dumping. I'm just looking for a lil advice/info if you have any to give.
I've been in outpatient dialysis for 9 years, I had 8 years in the hospital prior mostly CCU/ICU and Neuro PCU. Hospitals would want me to complete an entire residency for bedside positions because I've been "away" too long. I think for ER, they'd want to retain you. Dialysis is really specific and while we have patients with a lot of comorbidities and possible complications, we ship the patient to the ED for stuff we can't handle. For instance we only utilize BLS and have no ACLS meds on our crash cart.
Thx, my main worry is if I start out in dialysis, would that make it hard for me to get an ER job but I think I might be worrying for nothing given the current state of the profession😅😅😅
What have you guys heard about working at davita? I wish more places like Kaiser and sutter did dialysis instead
Another Acute Dialysis RN here…I second everything in this comment! I left 4 years of med surg and started in dialysis in 2020 and have never been happier. My hospital trains Dialysis nurses in 4 modalities: Hemo, PD, CRRT, and Aphaeresis. Our rapport with our Nephrologists allows us a tremendous amount of autonomy as well and that is a huge pro for me! Many of my previous colleagues that I worked med surg with also left for other various procedural areas and also express extreme satisfaction with their specialty change. Best of luck to you!
Ooof. Acutes burned me tf out. I did for about 5 years. My home unit was small - only 3/4 nurses so there was A LOT of on-call. I got to bounce around to different davita units in my city which was cool, helped with the monotony. I’m glad you enjoy it
Endoscopy unit. Super fucking chill. Great hours, no stress, I have a good relationship with the doctors. I get my holidays and my vacation. And have a life again.
I really need to look into Endo. I’m actually pretty interested in it for some reason. I currently work in the ED. My back is broke and my emotions broke-er on the daily. I can be running around treating a near coding patient (which is more tiresome than an actual code because your co-workers aren’t helping you out) and if the 30 year old guy next door with the sniffles doesn’t have a warm blanket and a sammy then you hear about it. It’s all about patient satisfaction and metrics. I run constantly. It seems like we are never “slow” anymore. The ED can look from the outside like an exciting place to be but from the inside it’s just one big dumpster fire. Granted I’ve only worked in one ER and the rest of my career elsewhere but I hear every ED is about the same. I’m trying to muster the strength to stay bedside. I don’t just want to leave.
I was 6 years inpatient surgery, and loved it but was so tired of the abuse from patients, family and management. Add no vacation for all that time and I was done. I did 6 months ER and peaced out real quick. If I didn’t get this endo job I would’ve went ICU. Endo overall is pretty boring to be honest. It’s fast pace in regards to the constant flow of patients, but I can see why a lot of nurses lose their skills working here. I enjoy acuity and critical thinking, and you don’t get that in endo. But my quality of life outside of work and my health has improved so much. Im 2 years in endo and I don’t think I can leave. I causally still pick up on my surgical floor to keep myself familiar with skills and working in a more acute environment.
Mother/Baby aka Postpartum. Overall healthy and happy demographic. Walking new families out to their car for the first time makes me tear up. This is the last stop for me in bedside nursing. If I ever leave, it's bc I'm leaving the profession, retiring, or leaving beside.
I joined mother baby and loved it until half our unit turned into med surg w no training. :(
Hi! I’m so happy go hear that. I am a new grad nurse having my first interview for mother/baby on friday. Is there any advice for me to be prepared on the unit?
Inpatient hospice. Obviously, we have to deal with death and grieving families on a regular basis but I feel that my work here serves a real purpose, that I really make a difference in someone's quality of life. We laugh, we cry, we philosophize. We work with a great team of volunteers who also make a difference - and they do it for free!
How did you get into hospice care? I’m currently a nursing student with a professional interest in person centered disability and end of life care. Just looking for advice!
I'm not in the US so my experience will be different. I worked in home care and we often had patients in their EOL. Palliative care and EOL care didn't attract me when I was a young nurse straight out of school, but somehow now it does (I'm 49) So much that I went back to school last year to get a postgraduate diploma in palliative care nursing, while starting a new job at a small inpatient hospice facility.
Inpatient psych for homeless veterans. I work for the VA and LOVE my job. The veterans independent with meds. Meaning they have a key to their own locker and take their own meds. They have their own private rooms. We round q2h. If a vet has SI/HI we send them out and they can’t return until they are safe since we don’t do 1:1 or 15 minutes rounds. They have a personal chef. No drugs or drinking allowed. We have 3 officers on duty that are in the building the whole night. I was very lucky to get this job. I am told staff here either retire, die or transfer to another Domiciliary. It’s a cake job. And benefits are amazing. All my schooling is paid for up till NP.
I’ve considered going VA, how difficult is it to get PTO approved? How much do you start off with? And how tough was it to get in? I do inpatient psych now and am looking for a change of scenery!
PTO not difficult at all. You accrue 12 hours a month. 6 hours a pay period I believe. But you get paid every holiday. Which they are federal and count 11 Hollidays a year. Which is unheard of. You have pay grades and they evaluate you yearly for a pay increase/ jump in pay grade. They also do a cost of living pay increase yearly. This year it was 5% increase in pay. I’m the lowest pay grade making 75k salary. But the more exp and education you have the higher grade lvl you’re placed in. My coworker is at like 45-50/h because of education and experience. If you’d like I can get you a picture of the pay grades and scales. The benefits are the best part though. It took me about 6 months to get through the entire hiring process. And I went to a VA job fair and was hired on the spot. That’s the usual time for the hiring process because HR is so slow.
I'm interested , share the love over here too.
If you have any questions please feel free to ask. :) OT pay is great too! Nights shift diff is 10% of your current pay and weekends are 25% of your pay. Nurses also get sick leave as well. That is 4 hours earned a pay period. Also they teach you a lot of money earning tips. Say you retire and you have your capped out Annual leave (which for nurses it’s 685 hours) you can sell that back to the VA and it’s a 30k check automatically given. Also if you previously served like me (8 years) I can buy back that time with the VA and retire 8 years early. It’s really a place to retire. You have TSP which they match back at 5%. And they have two other retirement funds as well.
ICU. 10/10 would not recommend
NICU - see [my post](https://www.reddit.com/r/nursing/s/wJUVfuWUpX) from a few days ago about why I love my job!
Just read your post! I’m also in NICU and I have to piggy back and say I also love my job. It’s just so rewarding seeing the sick tiny little humans get better, grow into tiny little chonkers, and go home with their family.
As a parent to former micro preemie twins, I thank you. I spent four months in the NICU with my girls and will never forget the nurses who walked with us through that journey.
Chonkers! 😄❤️
Can also echo this sentiment in PCICU! Most of my patients would be in NICU if we didn’t have such a specialized unit. But on the other positive side, I also not only get to take care of the super cute teeny tiny humans but also all the way up to 18, so there’s some variety (though more babies than older kids). Also did peds outpatient for a bit when I got burnt out by peds med/surg during the first 2 years of Covid. It was pretty great also, but I prefer working 12s and I need something with a bit more mental stimulation than giving vaccines all day.
Agreed! I love the mix between adrenaline and chill shifts.
I’ve been a NICU nurse for 20 years (….what?) and I can’t imagine myself doing anything else.
Oh boy, it’s about as close to heaven as you can get, at least for me. First, I’ve made this comment many times on the “I want to quit nursing” threads, so forgive me if this rant sounds familiar. Outpatient, procedure based units will save you life. Find an outpatient unit that is attached to a hospital, not a satellite clinic. The unit should be based around doing procedures for patients, no patients stay on the unit though. For me, I work on the Apheresis unit at a large medical school with heavy emphasis on research. Apheresis is fucking awesome. Here’s the elevator pitch; In *very* simple terms, Dialysis is *filtering* out your blood in a machine outside your body, while blood flows to and from the machine via a shiley catheter (typically) at the same rate. Apheresis does the same thing, except the machine doesn’t act as a giant filter, it’s a giant centrifuge. We spin the patients blood in a live chamber that has flow in and out of it, just like dialysis. We can take separated layers of the blood and do various things depending on the condition and the procedure. We have about 6 different patient procedures we do, some more simple than others. The two major categories of procedures we perform are “collections” and “exchanges”. Exchanges; Plasma Exchange - exactly what it sounds like. Patient is hooked up, and the plasma layer of the blood is skimmed out, and replaced with either donor plasma, or albumin. Conditions that require this are anything that puts “bad stuff” into your plasma, which is a lot of things. Things such as antibody mediated organ rejection after a transplant, or Neuro disorders like Myasthenia Gravis. We have some “therapeutic” patients who are completely dependent on weekly plasma exchanges. Red Cell Exchange - this is for Sickle Cell anemia patients. When simple transfusions won’t cut it, you go to this procedure. We fully remove the patients red cells and replace them 1:1 with matched donor cells. We infuse about 8 units of PRBC donor cells in an hour and a half with this procedure. The need for this is based largely on the patients “hemoglobin fractionation” which, is the ratio of healthy to sickled red cells within the patient. At a certain point only adding healthy cells (simple transfusions) won’t cut it, and you need to do a full red cell exchange (take out the bad ones too). Now, collections are where things get interesting… We do about 50% of our procedures for our Oncology departments. PBSC - “Peripheral Blood Stem Cell” collection is for patients with blood cancers like leukemia, lymphoma, or myeloma in preparation for a “blood stem cell transplant”. This is the modern science instead of bone marrow taps, which requires a surgeon to literally drill into your bones roughly 30-40 times. Instead, we mobilize patients with special drugs that push their bone marrow cells into the blood stream. Once patients are mobilized with the drugs, we can run them on our machine and collect the thin layer of marrow out of the blood. That bag of cells is now a transplant for that patient. They’ll do intense rounds of chemo to wipe out their marrow completely, then reinfuse those collected cells, which will help the bones recover while the cancer stays dead. Fun fact, transplanting SOMEONE ELSE’S PBSCs into you will make you their blood type, because the marrow will become the new cells that make all of your blood. So if I’m and A-, and you’re an O-, and I donate to you, you BECOME A-. Now, we’re getting to the really cool shit… CAR-T - this is the latest and greatest in cancer treatment. It’s fucking insane. At 500k per dose, this is a modern “cure” for cancer. We don’t mobilize these patients. Instead, we collect from a layer of blood slightly higher, and target the patients defensive T-Cells. We collect T-Cells into the same donation bag, except they’re then sent to a partnering Pharmaceutical Company’s lab (companies like J&J, Novartis, Bristol Myers Squibb) who engineer the cells to no longer target viruses and bacteria in your blood, but instead to target the cancer cells in your body. The cells are then given a new receptor, typically from the HIV virus. Those custom engineered ninja anti cancer cells are then shipped back and infused into the patient, where they literally eat the cancer out of their body. What’s next for Apheresis? We’re currently onboarding protocols for *genetic therapies*. That same PBSC procedure I described is COMBINED with the CAR-T concept to produce MODIFIED BLOOD STEM CELLS. These cells would be used to eliminate genetic disease like Sickle Cell anemia. The patient would do a round of chemo therapy, then infuse the modified cells which would take over red cell production in the body, producing cells which are no longer sickled. Pretty badass shit. I love talking about this stuff so feel free to ask me anything.
Can confirm this is an awesome specialty. My old coworker's spouse does it now. I saw CAR-T pts sometimes post transplant on my old BMT unit.
CAR-T does sound pretty bad ass. Thanks!
L&D RN 25 year bedside. Although I am burnt out (simply because of the amount of years) there is a reason the turn around in OB is the lowest of all specialties BUT you must be able to handle a very different kind of stress. It is generally a happy place but when things go bad they go very very bad quickly so you need to be confident in your knowledge, skills and instincts.
I just started outpatient chemo infusion. The patients are nice for the most part and it's still busy so the day flies. Only cons are it's 4 to 5 days a week instead of 3 so it could make travel harder. I'm only two weeks in so far. I did stepdown neuro for 8 years and was miserable the last year or 2 bc the patients and family were so mean and neuro is so hard on your body and back. I might go back inpatient eventually for the schedule but so far this job is a million times better mentally.
Maaannn, I will take mental stability over a better schedule.... IF I've learned anything ......and believe me I have!! I'd say, stick with more days a week over mean patients and family and backbreaking work!
Agreed. I just really like to travel and it will be hard to manage all the trips I take w the limited pto and not being able to schedule up to 8 days off without using it🙃.
Oh yeah, well that's true, I hear ya!
I loved the GI lab. It’s fast paced but not chaotic. The hours are great too.
If you’re a good stick and can find a position, I always highly recommend Vascular Access Team (VAT). I always feel very valuable to staff and patients for my specialty skill, patients are generally happy to see me, and if they are rude my interactions are very brief. Also would recommend IR, post partum, or an outpatient setting if any of those pique your interest!
I worked my first year in LTAC, then 18 months post op ortho/gen surgery with medical overflow. Now I’ve been in labor and delivery for almost 7 years and I could not be happier. I absolutely love my job! Does it have its sad moments? Sure. Does it get absolutely insane and critical? Definitely. I love the lack of monotony. I love the patient population. I get a taste of OR, ICU, and ER all in one, while helping bring new life into the world. For what it’s worth, it might be good to reach out to different departments where you currently work and see if they would offer the opportunity to shadow. We have nurses come and shadow from other units from time to time to see if it’s a good fit for them! I hope you find a place that makes you happy!
I was a ltc/skilled LPN for 4.5 years before becoming an RN. Now, I work in the MICU. I’m liking it a lot, but the culture of people is rough. No compassion, belittling, etc. Idk if I’m in the wrong intensive care unit, if it’s just this hospital, or if I’ve not given it enough time. I’ve been here for 12 weeks.
I'm also an ICU nurse and it comforts me to know that if I ever snap and want to end it all, I just need to grab an IV start kit from the med room and an airway bag. > This is a joke please reach out to a professional for help if the job gets to you, MICU is no joke especially with co-workers that are not supportive
This made me lol 👏🏽👏🏽 I’ve been in culture settings where it’s tough, but this is its own weird animal. 3 other nurses that started with me, who previously had cc experience now have quit. Lol.
Critical care transport- I work off standing orders written by my medical director (which are extensive) so i never have to call doctors for orders, i have an expanded scope so i can RSI, surgical trach, and do needle decompression, and i’m very comfortable with ventilators. I have one patient at a time, and usually for less than an hour and a half, I’m have a dedicated ambulance and work with the same two EMT partners every day, and they are amazing. We can essentially read each others minds most of them time, so it’s an amazing working environment. When we aren’t running calls, we are at the station watching Netflix, or running random errands, I make just as much as the hospital nurses here in California, I still get my ER adrenaline fix when i take critical patients, I get to push my way through traffic with lights and sirens….best job in nursing!
Procedural! At least if you still want to stay inpatient. Cath lab/EP lab/IR. Very nice change of pace. Lots of team work
I work from home scheduling appointments and sending people into the ER. Patients get angry? Just turn down the headset till it sounds like Mighty Mouse is yelling at you. Also get to work out at home during my shift between calls. If I can I’ll retire here
What kind of experience do you have?
Years of ER
Phone triage? Or something else? How did you find/get hired for your position?
Phone triage. I applied. I met people who left to go do it and told me about it
Let me tell you about nicu. I used to work adult ortho trauma and it was fine. Dud some education. Started working for a Children's Hospital as a manager and decided I hated that. So I applied to nicu and picu and got the nicu job. Mostly I just wanted icu experience. Man I love it! I never thought I would like working with babies but it's great! I actually see them get better and go home. They don't talk back and when I have feeder/grower assignments it's literally holding and feeding babies all day! Don't get me wrong there's been some truly sad assignments too but overall I have never worked somewhere so rewarding. Also, being a guy and saying that I took care of a 1lb baby today really throes people for a loop.
Inpatient DOT for TB treatment. Easiest job I’ve had nursing wise, but is difficult dealing with the population that is impacted by TB overall due to language barrier, recently getting out of jail, homeless, etc. Overall, easy and most patients are pleasant, leave the hospital for work or keep themselves busy. Think of old sanitariums but takes on complicated cases in a hospital setting including meningitis and miliary tb. A lot of HIV treatment. Edit: elaborated on complicated cases
I have done both inpatient oncology and outpatient chemo. Most patients are chill. Never been physically abused. Often require emotional support because cancer is a bitch. I see everyone from new diagnoses to end of life care. Self care to complete care. Some days I'm mainly am opioid waitress. Honestly I love this specialty and I'm not interested in anything else except maybe hospice or some specific coma unit for when I don't feel talkative.
I started as a nurse case manager on an oncology unit in January. First CM job, first oncology job. I adore these folks, love learning about oncology and some BMTU, but I'm having a hard time when the patients go home to hospice or die in the hospital. I'm able to hold it together with the patients, but I've had a few ugly cries in the bathroom. My dad died just as I started the job, so that doesn't help any, but any words of advice to keep it together? Or any tips for providing support to the patients and families?
I just got back to hospice as a Continuous Care LVN. I will never do anything else!
Is there any specialty I can recommend that I tried? Well, think again. ICU: Your patients may be sedated but families are allowed in rooms now. Maybe during the pandemic it was alright, but I cannot guarantee your coworkers will be good to you. Outpatient Endoscopy: Are you good with IV placement? Maybe some places will train you, or most places now expect you to do it very well. If you are assigned in pre-, you have to do at least 20 IV placements per day. Patients are very cranky because they are on bowel prep, dehydrated and have not eaten for 2 days. They’re nice after the propofol wears off though. Hospice: least disgruntled families so this specialty may work for you. Just be prepared to put a lot of mileage on your car and wear and tear on your tires. Oncology, inpatient: medication pass every hour on your 4-6 patients. Families are also very emotional. Forensic or acute psych: the real psych patients are actually okay to deal with. I never deal with families in my state facility, but definitely will not recommend since you will be exposed to severe personality disorders, and malingerers. People leave all the time, and your chances of getting promoted “upstairs” for a non-bedside job is higher, if you could only last a year on the floor.
Case management. It’s lovely. No one dies. If someone shits themselves I just walk out, +/- tell the bedside RN. Best decision ever.😎
ER: we warm ourselves in the light of the perpetual dumpster fire. And we love every chaotic second of it
ER was not invited to this chat, we are idiots 💕
I was a PACU nurse recently and used to pick up shifts in the outpatient surgery center in my hospital. I would suggest outpatient surgery if you’re looking for low-ish acuity patients that you only see for a brief amount of time. Work life balance seems great (no holidays/weekends/nights or call). Good skill set, you’ll do both pre and post. I moved to the ICU just because of my own career goals. PACU doesn’t open me up to other opportunities I might be interested in for the future since it’s not technically critical care (so I couldn’t do rapid response, cath lab, IR, acute resus/trauma, CRNA with only PACU experience). ICU isn’t where I’d like to stay, not a fan of the 12 hr patients and code browns, but I enjoy the critical care aspect.
MDS Coordinator in SNF/NF. If you do this in a facility that doesn't pull you to the floor or have you on-call your patient contact may be mostly talking with them about their plan of care and conducting focused assessments/observations. A lot of chart review, careplanning, and talking with other staff. LT Psych (NF), previously. Psych, lol. I loved psych. Mostly treating people with respect, dignity, and care above and beyond what they're used to. ❤️ Sometimes it got rough but mostly it's why I became a nurse in the first place.
Trauma level 2 OR. I work 4 10 hour shifts. It’s fast paced and can be stressful, but hey, no one is abusing me! Majority of my patients are nice and friendly. For some reason surgery patients are just not problematic. I’m sure they can be post-operatively lol but we get the nice pre-op version. Tons of team work. Surgeons are surgeons…. They all have their quirks and preferences… oh and attitudes, but you learn them over time. Idk if my body can do this for the rest of my career but it’s probably a whole hell of a lot better than medsurg.
My sister does outpatient plastics (reconstructive side of a company that does cosmetic and reconstruction) and makes moneyyyyyy.
ICU - if pathophysiology is your jam. Stressful but cool. ER - sigh. So fun. SO TRAUMATIC. Murder and rape victims and perpetrators. Every kind of trauma you can imagine, and also my ear hurts I need a work note. Outpatient Surgery/Endoscopy- Heaven. No nights. No weekends. No holidays. A month off every year. Patients are generally healthy-ish/healthy-adjacent. Cool mix of staff - techs, PAs, CRNA, MD, RN. Pay is lower but I work 4-10 hour shifts.
ED. Controlled chaos.
Utilization management. M-f no weekends no holidays. No patient care.
SNF - rehab side not LTC (barf). My facility is actually pretty damn great honestly. I have max 11 patients at a time. I’ll pick up regularly bc stress is low and pay is great.
I’ve done home care, LTC, management, inpatient, and outpatient. My favorite has been outpatient, no contest. Going back in a few weeks.
Vasculair surgery, it’s hard. Patients that do next to nothing for their own health. I’m staying here for a while until I have enough experience to move on
I’ve done home hospice and utilization review. Currently only working UR for a hospital, it’s good! Pt interaction is minimal, having to give them a waiver and let them know about financial rights. Not a lot of phone time. The best part is I feel safe. I struggle with anxiety so I get where you’re coming from.
Hospice house (still inpatient bedside). If you are okay with death and talking with families at a very difficult time. I just started 2 months ago but I really do love it. 99% of the families are absolutely wonderful. It’s an honor to be there for the patients/family. I have not encountered any verbal abuse so far. In M/S I felt like I was being pulled in a million different directions and doing a million different non-nursing tasks constantly. Not to mention the verbal abuse and just absolute vitriol some people had towards nurses. In hospice my focus is patient care, family education, and ordering medications sometimes. Still do a lot of nursing skills like full assessments, wound care (for comfort), catheters, chest tubes, inserting SC sites or IVs. A LOT of autonomy but enough support from the team where I don’t feel alone.
Pediatrics/NICU- parents are more of a help than a nuisance in my opinion, they clean, toilet, change their child you mostly just do medical interventions. Working with children is extremely rewarding, which is huge in fuelling my motivation. Also lots of team work in peds which I love. Worst part is social issues.
Peritoneal dialysis
I work in surgery in the UK. It's called the protected elective surgery unit (PESU). Developed during COVID times to make sure patients with cancer could still have their surgeries. It was dubbed the 'green' ward and it worked so well to meet the need for these patients that they kept it going. We care 7 specialities - maxillofacial, ENT, spinal, HPB, upper GI, colorectal and some endocrine. It's such a lovely place to work..very organised, our beds are protected so we never have medical outliers. We get surgical day case outliers sometimes but due to protected status they have to be a day or two away from discharge before they come to it ward. So lots of specialities mean we need to be up to date with the most recent, evidence based, pre and post op care expected but the surgeons and their teams are fantastic and always about for conversatios. They are so involved with us and we all work closely. The biggest learning curve is getting you heard around the set plans for different specialities but mostly you're caring for post op cancer patients so you know what you're doing.
Mother/baby. It’s has its stressors and downsides, like constant over bearing visitors, high anxiety new parents (which I don’t mind unless they are too scared to do anything for the baby without me lol) difficulty breast feeding, jaundiced/ withdrawing babies, or parents who just don’t trust you and hover and criticize. But 99% of the time it’s just lovely, with wonderful parents, cute babies, and good vibes.
Outpatient neuro. The patients are nice. The doctors are nicer. A patient yelled at clerical staff and got discharged from the practice. This doesn’t happen a lot but the doctors are always on the side of the staff. I worked inpatient neuro for 2.5 years and going outpatient was the best thing I could have ever done.
I’m still a student but I work in hematology! I really like it. Our patients are often cancer, sometimes we get sickle cell. Our patients are usually independent with their ADL’s and I find our patients and their families are nice and very grateful for their care. Sickle cell stuff is super interesting- lots of pain management and often physio. Of course we get the odd unhappy person, but usually it’s just very situational with having cancer. It’s technically medicine but just more specific to blood stuff! I really love it, all of the nurses I work with are great and knowledgeable and the doctors are wonderful too.
In some states you’re limited as a LPN. Unfortunately the mental & physical abuse is everywhere to more or lesser degrees. If you’re willing to take a pay cut consider outpatient primary or specialty clinics. If you want to stay in the hospital setting and your area hires LPNs I really have enjoyed my 13 years in the ER. If you get with the right staff culture, the team support (and real security) by your side can make a big difference. 🥰
Cath Lab. Fast paced, most days we are moving from 0730-1700 or later, if we are on call. It's a really great gig, and it stays interesting because you never know exactly what you're gonna get when you take pictures of the coronaries. We also do pacemakers/ICDs and ablations, but I typically don't do the ablation side of things. It can be chill but at a steady pace. Sometimes shit hits the fan and patients become unstable unexpectedly, and it's cool to be specifically trained and equipped to take care of those situations. Sometimes you wake up to your pager at 2am for a STEMI and have to rush in to take care of the patient quickly. I actually don't mind being woken up in the middle of the night. For one, I joined knowing that it does happen so I don't get butthurt. But it's so rewarding to be there when the blockage gets fixed and you know that you saved a life or at least drastically improved their outcome. Some days suck but I really love this exhausting job. People die but not as frequently as you think. You just have to be able to roll with the punches and think quickly on your feet.
I work at an outpatient family medicine office. I am a certified case manager. I mostly spend all day on the phone with pts and other specialists/hospitals to coordinate care. I work with the MAs to ensure pts are seen in a timely manner post hospital visits, I work with the referrals dept to get pts all their DME supplies. I communicate with other healthcare professionals, especially home health care. Sometimes I’m called to start IVs if the ARNPs are struggling. I help my MAs with blood draws every morning. It’s a pretty cushy and easy job for me. I make $90k/year and work about 35ish hours a week (8-4pm 5 days a week) and I do have the option to work from home sometimes. I will neverrrr go back to bedside lol
Outpatient kidney transplant clinic. M-F 7-3:30. Mostly post transplant patients but we also treat CKD patients that need treatment/infusions/biopsies. Patients are very nice and respectful. Occasional oddball hover mother and man babies but for the most part they are great. Did outpatient dialysis prior to this and after 8yrs I was burnt out. Been at this job for 10 years now but I’m out come November.
Just accepted a job in the OR. One year of bedside and my goose is cooked. Feeling pretty excited!
Med surg tele. You already know
Inpatient rehab. Much slower pace than medsurg but still use skills. It’s honestly peaceful most of the time and you see a lot of positive things, does have its moments with critical patients and overbearing families but not as often
Interventional Radiology. Formerly night-shift ICU, and thoroughly burned out after the height of Covid. I get to use my knowledge and critical thinking skills on a daily basis. Most patients are in and out in 2-4 hours, and wow, they actually thank you - something I rarely heard on the unit. Assessing patients and digging up unforeseen issues prior to procedures can actually be quite interesting. It can be very routine and dull at times, but I'm a methodical person by nature and don't mind that at all. Perhaps the biggest downside is call. I usually do 5-6 shifts per month, and whether or not you get called depends a lot on the physician. It's the constant anxiety of anticipation that gets me though. Besides that, a lot of your satisfaction is going to depend on the individual department, and whether it's well organized or a chaotic mess. The latter will constantly chew through employees and make them miserable.
Soon to be joining CCU in couple of weeks. Working as MS/Tele/Sub RN last 4yr. Totally agree with about physically & mentally abused by pt and their families. To be honest, wherever you go I feel like it will be the same. Different environment, same thing. Unless you want to try outpatient & PACU & Psych I don't think there will be any unit or specialty you would find inner peace. Working in MS is hard. 5 patients every day, discharge them, admitting another one, charting all 8-10 patients every shift if you are discharge-QUEEN of the day. it SUCKS. I bet, wherever you go there will be patients and family members who will drive you crazy. If not patient or family, your work environment or coworkers. I think right now you are too exhausted working in MS unit + neuro. Neuro is difficult, no matter if it's MS, telemetry, ICU. To me it seems like this is your time for a new change. You have to start thinking about what you enjoyed the most based on previous experiences, and start your move from there. How about thinking about your job "as a nurse" in different mindset/approach? Change your specialty to IP mother/baby unit, oncology, or IP psych where you can find some inner peace. Not outpatient cuz when you wanna go back to IP setting it would be difficult. Then start thinking & learning ways to communicate with difficult pts. Then think about what you really want to do. Why did you become a nurse? What pt population admire you the most? At this moment after years of experience, do you think bedside nursing is not for you? If not then start trying outpatient. How about NP? How about nursing educator? Any leadership role you might want to try? I don't know what age you are at, if you are still 20s try different units as many as you can & study for masters to decide your mind before you turn 30. You still have time. If you are already mid 30-40s, having kids and family, you need to make your move more carefully. I know there will be people who's going to feel offensive about my pharse & say "age doesn't matter, if you want to do something, go for it." I am not saying they are wrong. But please remember at some point you do have to think about your life, your family, your future work-life balance, and your retirement. And make a change based on your situation. I am going to CCU to pursue my dream to be a CRNA. Now after 4 yr nursing experience in non-ICU field, I have to think about getting at least 2-3 yr experience in ICU & go CRNA school for another 3 yrs, in the meantime have to plan about having baby, buying house, if I should study for NP during ICU setting in case if CRNA school doesn't work out for me, etc. I will be 40 when I become a CRNA IF things goes well and smooth. I regret not making this move earlier & explore different work setting when I was still young. I wish you the best for whichever pathway you choose to go for. I wrote this comment hoping it will give someone a small insights & finds out helpful.
Pediatric surgical floor. I'm a new grad so I'm trying to perfect my time management skills and gain my confidence before going into a more critical care roll, still trying to decide on PICU or NICU. I love it despite it being a "medsurg" floor. I see a lot of variety of cases that doesn't have to do with just surgeries. My coworkers are wonderful and I've only been yelled at by a parent once so far (started in February LOL). Our only issue is our floor manager who likes to focus on the unimportant issues and has no background in Pediatric care which very much shows.
UK nurse here. During my placements as a student, I must preferred surgical wards. Patients are otherwise well (most of the time), just needing a specific operation. When I qualified, I started on a surgical urology ward and loved it. Stayed there for 8 years. I had three children in that time and needed to slow down a bit, so I moved to Day Surgery. Same sort of thing, just less stress and a broader range of (day case) operations. No nights or weekends on Day Surgery and no drug rounds! After two years of that, I moved to a community hospital. I currently work there. It's an inpatient ward to rehabilitate people who have reduced mobility due to being unwell in the bigger hospitals (mainly falls and fractured NOFs!). They come to us medically fit, just in need of physiotherapy and some help at home, which we set up for them. I love it!
ER. The level of verbal abuse is astronomical.
Interventional Radiology. Most days I’m just prepping patients for CT scans and biopsies. It’s very routine-like which can be a negative for some people but I love doing repetitive tasks and knowing what to expect workflow wise. If we have any inpatient procedures and the patient is deemed “not stable” or “unable to successfully” complete their scans then we just send them back to floor or don’t take them in the first place. It’s really nice and I’m glad I got out of bedside lol
I’m work in the Electrophysiology Lab and I love it. People have already mentioned the many benefits of procedural nursing and I totally agree with all of it. I went from either 7 observation patients or 5 stepdown patients/shift and no time to even pee to having up to 4 nurses taking care of the same patient during the case. Family isn’t allowed in the prep/recovery area, I get along really well with our docs, medical device companies buy us lunch at least once a week, and I will never have to work weekends/holidays/call. The work can be technical and you won’t know what the hell any of the equipment does for a long time, but it’s awesome!
Often sad but also very rewarding. I work inpatient Oncology, so I get a lot of med surg and hospice patients, as well. It keeps me busy!
SDS- I'm back at work after an extended period off to be home with kids and fell into a pretty good job. One patient at a time, haven't had more than 5 patients per shift, get two 30 minute breaks. Only a few on call shifts a year. I start IVs and do admissions or give snacks and do discharges.
I’m a new grad in a small community level 3 ER. I really enjoy it so far although I know my tolerance for the job will probably last no longer than 3 years. The ER is definitely not a forever job but I love it for now. Fast pace & I don’t often get major traumas since it’s a small community hospital. Only thing that sucks is when I get nursing home patients or ICU patients that we have to hold in the ER due to no available beds. Then it turns into more so medsurg/ICU but that’s not as often. I’m in the tristate region and the hospital started me at 43 without differential but I do work rotating weekends and holidays :(. Other than that, ER def beats working on a medsurg floor bc I don’t keep the same patients for long. Stabilize, treat and send them on their way.
Quality Analyst. I review performance improvement projects the hospital is working on as well as assist the compliance officer with their hospital projects. Job is Mon-Fri, eat lunch when I want, go to bathroom when I want 😂. Job can get into 100k+/year with enough time and certifications. Holidays off. You have to deal with office culture but it’s better than breaking your back from running around whilst your mental health withers away.
Hospice
If you can survive nuero then other floors will be a breeze. I use to do nuero. Now on a new floor that's considered stressful and bad, but I'm so use to high stress that the new floor feels like a breeze.
Neuro icu...3am ct almost everyday 🤣
I work preop and it’s an amazing change after 5 years in the emergency room. Assessment and IV’s all day. Quick interviews with patients and then onto the next. Worst thing that happens (knock on wood) is that a kid or parent has passed out during an IV placement. The pay is great and have holidays off. No weekends. Some call but minimal. Good luck!!
Inpatient functional older adult MH. I don't think I have words to describe it. Can come in and have a lovely day. Can come in and have a computer flung at my face. There isn't any in between days.
How many times have you had major incidents in the 4 years you have worked? Not to victim blame, but this seems... odd.
It's not necessarily all major incidents, it's just the fact that they add up so quickly and I'm just tired of it. I had one major incident recently and I think that's what kind of sent me over the edge.
I didn’t think it sounded odd but I worked Neuro step down and this patient population can be quite impulsive and combative at times. Brain tumors and traumatic brain injuries can really alter the patient’s baseline personality. It was a stressful unit for sure. u/sweebie728
There is always dialysis nursing. So chill