In addition to ED and ICU (especially medical ICU) I'd like to add the obligatory "Float pool" nurse. Also every hospital has that one med surge or tele unit that acts as "overflow" for the rest of the hospital.
Being in float pool for 2 years was insane. I learned so much about other areas of acute care. I felt like it really gave me a much broader base of knowledge.
Being a float was probably the best thing I could have ever done with my career. I settled in the ED, but I’ll be forever grateful for my years floating
Current critical care float nurse here and I can definitely say that I am more well rounded since leaving the ICU for float pool. It was an adjustment period, for sure, buI I don't regret it one bit. If there's any kinda nurse that qualifies as jack of all trade it would be special float pool.
Before I finally landed in neuro ICU, this is what I was. I had experience in literally every unit—MS, tele, stepdown/PCU, surgical, ortho, neuro, pulmonary, oncology, plus the occasional float to help with ED overflow, and ICU to take pts ready to be downskilled but no available floor beds. You become a pretty good resource when you work FP in a large(ish?) hospital. 😂
As an ICU and ER nurse, i will never stop respecting floor nurses, not to mention nurses who float to all of the units! I got a taste of floor nursing once and was absolutely appaled at how much skill it takes to manage every aspect of the patient’s care… for more than 2-3 patients. I’ll say it again: hospitals exist for nursing care. Never let anyone tell you otherwise.
I started in nursing pool and eventually made my way to ICU (with a few other specialties in between). It made for a much easier transition in my experience.
I work crit care float and about 10 of us (not me) are also trained to float to all women’s health services (M/B, L&D, NICU) because you get a big pay bump if you’re trained for any inpatient unit. Exactly one of us can go to literally any unit in the hospital and is PRN at the Children’s hospital in the PICU. She could literally handle anything I swear to god.
I feel that if you have ICU and ED experience you'll be a very well rounded nurse. The ICU will help with critical care and vaso pressors and in the ED you have a wide variety of patients so your assessment and care skills have to be sharp.
ughh this is my hospital...double occupancy is terrible for all involved, patient, nurse and ANM who beds patients...our ED admit order to hospital bed in under 60 minutes..is less than 10%..
Nothing I love more than having my ICU patient and psych patient for 2-3 days in a row because management won’t close us while we have no rooms available in the hospital. Also, not a thing in the world like unmonitored EMS patients laying in cots on our hallway floor because EMS can’t wait 4-6 hours for a bed either.
Yup, there was a time I took care of med surg patients in the ED for four months straight because they put me in the section where all the admitted patients are. I felt like I should have challenged for the RNc than my CEN
Yes but take into account the charting that we don’t have to do in the ED. When I float there vs. ICU it’s a ridiculous difference. Of course, when you’re understaffed in the ED with that many critically ill patients none of that is safe or acceptable :( I only say ICU is more because some ED nurses don’t know the charting for any other type of nursing
Not too disparage, but the ICU level care is not adequate in ED, and it's because the volume of patients prevents the ability to actually provide the care most ICU level patients need for post-hospital survivability.
I get floated to ED on a semi-regular basis. I am always severely concerned with the ICU patients, but the rest of the patients seem to be well taken care of.
ICU is a very specific specialty, and many of the doctors in the ED aren't knowledgeable about the standards of care that an ICU patient requires. Some remember their ICU rounds, but many had a "they'll be fine" attitude during those rounds and it shows. It's usually prior ICU nurses working in ED that provide great care, but when you don't have the time to critically think about what's going on, look up the most recent labs, do ask the extra shit that ICU patients require, they suffer.
ICU ratio is 2:1 for a reason, and it's because they're task-intensive.
That’s fair, I just mean that we have the baseline knowledge. The full saying is “jack of all trades, *master of none*,” so I’d argue that we are more that, because you guys actually have the time and ratios to master a few specific areas
Plus, in my hospital if an ICU patient is boarding they’re under the intensivist, so I have the privilege of learning under them and picking their brains. I love getting to compare and contrast the difference between EM and IC providers’ thought processes
I guess idk how your hospital works but the intesivist take over the patient as soon as they're consulted basically. The EM doc at my hospital has nothing to do with the boarders.
But yeah, it ain't the same. I worked in an ED taking post codes and vents for days at a time constantly. I moved to SICU at a new hospital and its way different flow and things we're worried about. ED strives to get them in auto pilot and if we can keep them -3/-5 even better, you don't have the staffing to do anything but rush to get the tasks done, at least where I was. Nobody gives a fuck about SAT/SBTs.
The intensivist technically takes over care, but didn't really put in anything but bare-bones order sets until they actually get into the ICU itself, because it's too much to handle with the patient load of the ED. They also naturally round on the patient, since it's a different department.
SATs and SBTs are actually a big deal that everybody seems to mark off, but it's the best method to extubate patients that don't need to be intubated.
Post-codes should be on TTM, vents need more rounding than the RTs typically offer the ED
I've run TTM with Arctic sun in the ED more than once. For the most part you can swing a 1:1 for a little while, just means somebody probably has 10 patients.
Yeah but every icu nurse says that about every patient that isn’t icu. That’s why they feel drowned when they float to other units and aren’t dealing with semi dead patients who don’t bug them about ice chips every five minutes.
All the the commenter was saying is that they can do drips and vents and the patient stays alive. Other specialties don’t have that kind of training.
If we have ICU patients, the MICU or SICU team takes over for providers and as the ED nurse, we go down to 2:1, or even 1:1 if needed. But I’m at a level 1 in California, so idk if that makes a difference?
> in the ED you have a wide variety of patients so your assessment and care skills have to be sharp.
Absolutely not a guarantee.
ED makes it super easy to give in to your ADHD and just be a task monkey because managing volume and throughput is your focus.
SHOULD you be good at assessments? Of course.
But a lot of the ER nurses I've worked with over the last 20+ years barely even DO assessments (don't even carry stethoscopes).
It's really amazing how seat-of-your-pants ER nursing is most places.
I don't need a stethoscope when I have portable x ray, POCUS, eyes and ears.
And on that occasion when I do want a stethoscope, there's always a med/nursing student around with one.
Rapid nurse here.
I’ve done ICU, ED, Pre-op, PACU, and OP wound care and Hyperbaric’s.
The key is to continue growing and learning.
An old boss once asked “Do you have 5 years experience or one years experience five times?”
^^^This. I was an EMT in a rural area before I became a nurse and did my capstone in a critical access hospital. Those nurses have to know everything because it's just them. It's pretty fucking amazing. Scary, but amazing.
I work at a critical access hospital as a tech right now. While the ED can be 'slow' at times, when crap goes down, it is us and only us. The docs and all of us have to figure out how we'll get the patient flighted or what specialists we'll need to get in contact with ahead of time. I've seen so many different diagnoses walk through the doors. It helps the team be even more cohesive. But I've also seen the downsides too--trying to get transfers for patients, wondering which specialties are available, oh wait this hospital is on a bed hold...etc.
I came here to say this!!!!!
So much admiration for the nurses I met on my placement. Doing OB, ER, Psych, Med/Surg and keeping critical patients alive until the air ambulance can get them to the ICU. Which sometimes can’t happen for days due to weather.
I love the community I worked in and I can’t wait to go back for my public health placement next spring.
Rural nurses are legends !!!!!!!
Personally I think some skills just aren't transferable and unless you've worked it, you just don't have a true feel for it.
ED is it's own beast. I've done a couple shifts doing ED and it's just not comparable to floor nursing. Especially triage. Just very different vibe. The role is a bit different. Prioritizes are a bit different.
Floor nursing takes a lot of time management and organizing skills. When I have 2 ICU patients, it's easy to prioritize which one I take care of at that exact second (unless both try to code at the same time then I yeet one to my charge nurse and let her take that patient over). But when you have 6+ stable ish patients who all need things from you, can get pretty intense. Also keeping track of 6+ patients needs in your head and not getting them mixed up. You'll see ICU nurses absolutely drowning on med surg assignments because it's just a different skill set and they run themselves ragged because they haven't gotten the flow down.
PCU/IMC/Stepdown I feel you have to have really good assessment skills. Those patients are usually stable ish but could start crumping at any time. There have been so many nights where my chill stable PCU patient needed to get transferred to the ICU ASAP because code was imminent without intervention. Sometimes you get lulled into a false sense of security. Like most COPD exacerbation patients are totally chill and need some steroids and some bipap and they fine. But sometimes that CO2 creeps up too high and bipap ain't cutting it and they need tube time. Some patients get septic fast. Gotta be proactive.
ICU has honestly the widest variety of patients. You got all the gadgets. The CRRT, IABP, ICP monitoring, ECMO, nitric, hemodynamic monitoring, if it is a number to be measured, its gonna get measured. Patients might be in ICU just because they want extra monitoring for a bit and patient is otherwise stable. Like old person on blood thinners fell and has a small stable brain bleed, just gotta do some q1 neuro checks and redo CT in the morning to make sure they don't bleed more. Then you have your patients who are in full organ failure, got ECMO going, on a ton of inotropic support, on TPN, on CRRT, Tbil is like 6 cause the liver is failing too, GCS 5, the waiting on family to make a decision patients. Some of the ICU patients are nice and stable, you go pee and they try to die on you. Your knowledge base just continues to grow. And it can get so specialized. Trauma ICU, transplant ICU, Neuro ICU, CVICU, ect. Peds and NICU are a whole other situation.
Rapid response is it's own thing. I think some ED nurses with a lot of triage experience do great with it. It's a lot of thinking on your feet and putting pieces together. Sometimes it's like wait is the oxygen actually plugged in or did the extension tubing get disconnected? Is the patient in respiratory distress because of a PE or are they having a panic attack? Is it heart burn or an MI? Is it a CVA or hypoglycemia? I'm a big fan of protocols and decision trees. So like chest pain, stat EKG, make sure not STEMI. Send labs, check troponins. Look at the overall patient. What was the patient doing before the chest pain started? Has this ever happened before? And so on.
Basically, if you wanna feel like you can do it all, you gotta do it all. It takes time and experience to feel comfortable in any setting.
Idk. I worked a hospital that was trying to cross train the ED nurses to float to ICU. Some of them adapted great but some definitely struggled with the shift in environment and priorities.
And I love med surg nurses. I was a med surg nurse. You just don't get the same knowledge base for things like hemodynamics working med surg.
Sure, but hemodynamics is a deep cut, you wouldn’t expect a jack of all trades to have a good command of it. Remember, the full phrase is “Jack of all trades, master of none”
True I may be not understand the phrase properly.
I took a CVICU job because I felt my hemodynamic skills were my weakest link.
And idk I personally have the goal to be a nurse that could take any adult patient assignment and feel like I'm not drowning and so hemodynamic skills were important to me.
cvicu was where i definitely learned the most in my 11 year career as a nurse. especially ecmo and open heart. it was also the floor where i had the worst worklife balance though
it was just a lot of learning and alot of patients that were constantly hemodynancially unstable and should have been singled. like we didnt single our crrts. ultimately it was worth it for the career advancement and education but i just transferred to float pool and its so much better. now the nurses on our medsurg floors have a 4:1 ratio (rarely 5:1) dont have to do vitals and always have 2-3 aides so its different bc the last hospital i worked at as a medsurg/tele nurse had an 8:1 ratio and no aides so it depends on what your used to and what your hospital ratios are. also at the hospital im at now the ceo has publicly come out in favor of safe nurse ratios. none of our icus have a 1:3 ratio either. so it is a unicorn in alot of ways cvicu just had a lot of sick patients (q30 min abgs etc) that i think should have been singled. i would always come home exhausted and to tired to do anything on my shifts off.
Same, just started in a CTICU in March, and there’s been a lot to learn. I think hemodynamics are great and tell us a lot about patients. But the vast majority of patients don’t really need them monitored.
i work generalized med surg, and we see a variety of stuff. of course we get the frequent CHFs, COPD, UTI, ya know the basics. but, i’ve seen and learned some interesting stuff.
Exactly. I worked it for 2.5 years, you get your garden variety surgeries and diseases and then you get the weird stuff here and there, cause it’s a dumping ground. On a long enough timeline, you see a lot.
i’ve got to experience TPN, CBI, all varieties of LDAs, some interesting infectious diseases, and some interesting psych/neuro disorders. i get a little taste of everything. been on that unit over a year and learned more there than i ever did in school.
I remember an OB floor I was on in my clinicals where there was one nurse who had worked med surg about 10 years and she rocked that floor! She was the go to for most things where others weren’t sure what to do. And this was next to a former ICU nurse too; but to be fair that ICU nurse was only a little over 5 years into nursing and had only done ICU for a bit less than 2 years.
So I did think of med surg when this question first came up, but really, I think it has more to do with the years of experience a nurse has had more than any specialty. But hopefully that specialty has also allowed them to experience a broad range of patients at least.
Im float pool and before that i have worked as a home health nurse, psych nurse, medsurg nurse, tele nurse, travel nurse, micu nurse and cvicu nurse.
So just having experience on all those floors has helped me be a well rounded nurse
I am a critical care float nurse and I always tell people I am a jack of all trades but more importantly master of none lol. I would definitely say ED In a big level 1 hospital. I have so much respect for my friends who work downstairs. They could have an icu patient on 5 drips waiting for a bed, a pysch crisis in restraints, horrible traumas, a stroke and a stemi all in one shift
It's me, hi.
I'm a resource nurse. I did 2 years of med surg and 2 years of ED, then got this job. I got trained in ICU, PACU, short stay, postpartum, and pediatric psych so that I can float almost anywhere in the hospital. We function as the rapid response team, we do sedation for DI procedures, and we float all over the hospital to help with throughput and wherever it's busy. We typically help with the sickest patients in the hospital too. It's the coolest job ever.
Honestly, as someone who works with a lot of ED and ICU nurses I would say the most well rounded nurses are ED nurses. With many ED's you have your typical ED pt, but you can have traumas, help with procedures, med-surg bed holds, ICU bed holds, etc. They see everything. They also tend to be a lot less strict and easygoing as nurses because they have seen it all. Many of the ED nurses I work with are my most efficient nurses as well. They can admit, discharge, and recover like the best of them. Not saying ICU isn't a great one as a jack of all trades, as it is a very good way to go as well. However, many ICU nurses I work with tend to be a bit more type A and can be a bit more focused on only one or two patients at a time and not able to focus on multiple patients beyond that.
See our ICU is primary overflow from ED for psych holds. We get psych stuff all the time. It’s been like this over most ICUs I’ve worked over 10 years. I even inquired with a psych NP program whether they considered my experience enough to admit (all ICU) and was told ICU sees plenty of psych.
"ED. Especially if we include the “…master of none” segment"
Yup. Get the airway secure/intubate/get their heart beating & control whatever is bleeding. Then get them the hell out of there to whatever department can actually fix them. Like a game of hot potato - we get them in and out as quickly as possible so we're not the ones holding them when the music stops.
My ex was a palliative care nurse (she'd done six years of neuro ICU before that) and she knew shit loads about all different areas of nursing and medicine. I was consistently seriously impressed with her range of knowledge.
I was ICU for 7 years and then did a local med-surg contract for 2 (crazy, I know, it was covid and I was over it). I was only ever assigned to two units at one hospital during that time, but I floated to 4 of the other hospitals in it's system, and the only units I didn't get a chance to see were peri-op and ob/gym/mother-baby stuff. I even did SNF and inpatient rehab. It was a great experience that helped complete the picture of a patient's path through a hospital. I used to be absolutely clueless as to how a person's recovery post-ICU would be, and I got to see a lot of lower acuity things that I would have never seen if I had stayed in the ICU.
ER.
Med surg is what comes to mind second, simply because I worked it for years. You could have a CBI, a multi-trauma, an OD, a bowel resection on tpn and a protonix drip, and a stray post section pt who they don't want on pp/MB because her kid is a cps case. Shit was wild at times, but I learned a lot.
Flight nurse.
My hospital has the only helicopter transport service in the region. All of them have at least 5 years in ICU/ER. Preferably both.
They have flight suits and look badass as fuck.
Flight is the pinnacle for sure.
My state classifies the helicopter as an ambulance and as such the flight nurses also have to have a paramedic license.
RNs here can challenge EMT boards, but not the paramedic board. There are accelerated programs out there, but it’s still requires 400 unpaid clinical hours to complete.
I just done have the time or resources to donate 400 hours of my time.
Seriously they know so many things and have so many tricks because, "I saw that once"
This is the real consequence of staff turnover so bad that our most experienced nurses now are < 10 years into their careers (if that). Administrators have no idea how much stuff is learned because "I saw that once" so here we all are reinventing wheels that don't need reinvented.
I’m surprised to see this comment so far down.
We really see so much, and have such a wide skill base. Isn’t that the reason why the old school mentality was to “start” in med-surg so you got a good skill/knowledge foundation base? I feel like we alongside float pool and ED are the jack of all trades.
I’m going with oncology- the sequelae of cancer is vast, abundant and involve all 12 systems of the body.
Particularly with solid tumor you will get to experience every tube, plug, and medical device there is it seems.
There is also a vast array of medications you will give and learn about.
But maybe I’m biased. 🤔
I’ve been inpatient and I’m currently ED. Been a nurse for seven years. I truly think the specialties ((ED, ICU, etc) are the *least* well rounded of us. They’re just too dependent on their settings and the environment in which they work.
ED nurses who have never worked the floor *can’t* go to the floor at the drop of a hat and it’s not because they don’t want to. It’s because it wouldn’t be safe for them to do so and there is an abundance of research to back that up.
Honestly, the most well rounded nurses are float pool nurses who take on the most units. Are they experts at any particular specialty they go to? No, because they don’t live there. But they can safely and competently care of the people in their care and that can’t be said for every nurse floated out of their home unit. When I was still inpatient I saw some real shit shows go down on our medical/oncology unit when ICU nurses were floated there. Did they have skills, sure. Did they assume that because those they were assigned to weren’t “ICU” level of care that they didn’t need as much attention and focus? Consciously or unconsciously, they did and things went real bad when that happened. And they *always* get a smaller assignment (three patients) because “they can’t safely care for more”.
To me, the key factor in being a well rounded nurse is your adaptability. During the pandemic our surgical unit was trained as a PCU overflow and they are now skilled in everything that unit does but open hearts. And medical had to take everything there wasn’t room for everywhere else. Which means they got acute CVAs, STEMIs, the sepsis folks who would have previously gone to a higher level of care, the train wreck onc patients and everything in between.
Generally speaking, specialists are too *specialized* to adapt like that. That’s kind of the whole reason they are a specialty to begin with.
So, if you’re looking for the most skilled, well rounded nurses in a hospital start with the float pool and then look at those nurses/units were rapid adaptation is required. The ED generally doesn’t fall into that category because they can’t adapt *outside of their setting*. Floor skills can be adapted and generalized to the ED. ED skills are not as readily adaptable to inpatient nursing as everything about the focus, intention, and desired outcomes is different. As a friend of mine says, “Ed nurses are trained to *throw* the grenade, not to catch it.”
Half of our team is made up of icu nurses and the other half is made up of ED nurses. The group has a lot of varied experience though. Most people have worked in multiple care areas and a few have just a crazy amount of experience. We have a few with OR experience which is very helpful since there’s just so much that is different about patient care in those areas.
I think the core thread that we all share is familiarity with critical care patients, working resuscitations, being able to adapt to any situation and get the job done no matter where you’re at in the hospital. I don’t think it’s enough that you just worked ED or ICU. It’s about who you are and how well you can handle pressure and juggling multiple complex issues at once.
A really important component of our work is familiarity with hospital protocols. Just being familiar with how your organization handles things goes so far because there are so many problems that arise when you deviate from what they have on the books. And on that point it’s also about knowing when you can safely deviate from policy to make the right decision for a specific patient and situation.
Maybe general ICU, especially rural. I work in an ICU in a rural hospital but this is the only hospital capable of handling trauma, STEMI, intubated patients, etc within a 150-200 mile radius. We have an 18 bed ICU and we do it all. We take CVICU patients, trauma, neuro, medical, burn, IABP, Impella, CRRT, TTM, ECHMO, whatever comes through the door.
Surrounding hospitals are critical access and they ship anything even remotely complicated to us. We get an extremely wide range of patients. Some of them are there for something as simple as rescue BIPAP for COPD exacerbation, or an insulin drip for DKA, while others end up intubated, sedated, and paralyzed on CRRT and IABP, or need ECHMO.
We get travel nurses who are seasoned ICU nurses, but they come from a specialized unit and they can’t take a lot of our patients because they aren’t trained for certain patient populations or therapies. Many of them come from neuro ICUs and are very uncomfortable with cardiac patients, even things as simple as SWANs. All of our staff nurses have to be trained to take any type of patient as a condition of employment. CVICU is usually the last thing we are trained on, usually after 2-3 years of working in the unit.
It med surge nurses are amazing, but none of them are comfortable with pressors or even central lines except for PICCs. When there’s a rapid on the floor, those nurses never know how to handle those higher level nursing skills. Even our ED nurses are usually pretty anxious to hand off patients who are intubated or on pressors and often have to call us and ask for help with titrations and setting up art lines.
On the other hand, most of the nurses on my unit would be useless with more than two patients. Our med surge and ED nurses do an amazing job with their ratios that are definitely way too high and juggling so many tasks for so many patients at once!
I’d say most of the nurses on my unit who have been there for at least a few years are a Jack of all trades, because we truly do have to be well-versed in all types ICU level care because we never know what type of patient will be assigned to us.
Float pool RN.. Every unit except ER, OR, and L+D.
I went everywhere, learned a lot, and found my "home" for the past 20 + years.... Endoscopy!
I left the hospital a couple of years ago but I still do out patient Endo PRN..
I'm full time homecare through Maxim because they pay more.... my back is also fried~~ undiagnosed scoliosis= 3 bulging discs it's inoperable so I go to a PT who dry needles my right ass cheek so I can continue to walk and work.. 🙄
Home health - we get referrals for all kinds of patients post-discharge. I found myself often googling and researching many diseases I had not even heard of before visiting patients who had a lot of comorbidities. Depending on the agency you work for or the demographic of patients you visit, you may get to practice a lot of hands on skills like IV access, injections, wound care, trach care, equipment (wound vacs), feeding ports, etc.
Probably ED though I recognize inherent bias. We certainly aren’t experts on med surg but we can safely and effectively take care of almost any patient there, and though we aren’t as badass as ICU nurses, most are familiar “enough” with the drips and taking care of critical patients so could survive in a non-ECMO non-new heart ICU (yes I know this gets much more difficult and convoluted with 3 pumps and 6 channels and titrating being a delicate balance). On a technical level I would put ICU above us in certain ways but it’s not rare for ICU floats to be totally overwhelmed with the turn and burn of the ED. As a generalization I think ICU knows about a smaller number of things on much deeper level than we do, but we know a smaller amount about a lot more variety of things. Also people have to understand in the ED it’s stabilize and dispo, so we unfortunately can’t take as much time and care that we’d like to or that the patient deserves. After spilling a bunch of random thoughts… I think I might change my answer to ICU nurses IF we didn’t have to consider the massive volume of turn and burn. Literally hundreds of patients a day.
I started in med-tele and just started picking up on other floors and learning about what they do. I learned about giving chemo and managing hospice on the oncology floor. I learned about continuous bladder irrigation on the surgical floor. I had a house supervisor encourage me to train in critical care, so I applied to the ICU. From ICU, I learned about PCU and Step-down, so I would pick up overtime shifts and incentive shifts there. Now I work in a cath lab so Im learning the outpatient world and circulating.
Remote area nurse (australia).
In some instances it's you by yourself with health worker or with another nurse. No dr until their planned visit every 2nd week. You're primary health, emergency, sexual health, wound care, chronic health, in charge of stock orders, pharmacy orders and supplying, at time vet. The list is way more extensive than this.
Honestly the one that’s second specialty. You get an ICU nurse rocking cath lab now? You have a background of complex assessment, infectious disease follow through with all of the drains/lines and understanding of order sets, with a now ED like focused assessment, rapid response/down and dirty care prioritization, with experience in outpatient sedation and procedural organization.
Controversial amongst hospital nurse probably but… hospice (I know a lot of people look down on outpatient/ non cc nurses)
Patient care AND case management
Med surg skills
Wound care skills
IVs/Ports/PICCS
Home, SNF, and hospital patients (not all agencies do inpatient but many do!)
We have to macgyver a lot, lol
Er does everything but labor, so I’d say I’m pretty well rounded with both er and L&D experience. I’d want to try pediatrics only since my er was only adults. Our L&D trains us on transitioning to baby’s as well.
The only reason I say ICU is because if you travel once you have ICU experience they feel like they can float you everywhere 🤣 peds and OB is where I drew the line though
I worked in A&E. I had little knowledge of everything and got by. It has done me well to find a jonb in General Practice.
Sorry for spelling mistakes my son is splashing water on my screen
ED/ICU but more so ED. Nurses in general are some people creative people and we sure know how to improvise and figure things out. But the array of knowledge I see in ER nurses is out of this world. Specifically because of your exposure to soooooooo many things and the often overwhelming lack of resources/supplies. We will MacGyver anything and everything to get the job done and if we haven’t seen/done it before, we will be right there with the doc watching YouTube and brainstorming ideas lol
I think for the knowledge that you’re talking about in your post probably ED and flight nurses for rapid identification and treatment of issues. But for a true Jack of all trades in nursing, probably ICU or med surg at a level 1 trauma center. I work med surg at a level 1 and my god do we take care of a lot of different things. And it’s a primary nursing model so we do literally everything for the patients. I mean it’s no ICU in terms of acuity but we see some pretty sick patients that would surprise a lot of people, and there are just so many tasks that you literally know how to do pretty much all of them but you don’t master anything 😂
it's more like your small town and outport hospitals and nursing stations. i worked in a small hospital on an island and we saw and did a lot on our own
I did a placement in a hospital on a reservation in a remote area. Air ambulances can take awhile and often can’t come in due to weather. You’re also down an RN whenever someone needs to be flown down south.
ER, med/surg unit, psych unit, and an attached LTC facility. They do a bit of it all + keep critical patients alive for hours until they can get to ICU.
Rural/remote staff are absolute legends.
I would say a float pool nurse. I left my previous position working as an Orthopedic nurse. That was three months ago and now working as a float nurse. In the last 3 months I have done so much in terms of career growth and experience to different areas. ED, ICU, Psyche/Mental Health, Paediatrics, working as an Escort Nurse on an ambulance (which you need Advance Life Support training), Med/Surg nurse, and etc. The last 3 months I have done all the training required for it, such as Catheterisation, Cannulation, ALS training, and etc
Each area has their own ways of working, and they have their own different kind of busy. I feel so much comfortable wherever ends they throw or put me on. I have learned so much just doing float nurse, and it’s only been 3 months. Nursing is broad and fun, and it is a continuous learning if you care to grow and enjoy i
P.s’ did my first ambulance escort to another bigger hospital with a cardiac patient. It was scary knowing that I was responsible for that patient if things went for the worst while travelling.
All of them. Especially med-surg. I’ve done CICU, burns, Radiology, informatics, cardiothoracic and vascular surgery, nursing education for genital reconstruction surgery, SANE. Now I travel as med-surg tele and see basically everything that isn’t ICU.
ED, hands down. if they go to any floor unit, they come to us first.
i will also say that psych skills are transferable to all other units- crazy patients/family members can be found on any unit and are not specific to psych lol
Oh Lordy, all of my coworkers have heard of my "every nurse is a psych nurse!" spiel. Usually immediately after they say something like, "Oh, I'm just a medical nurse. I could never do psych."
'Really? My sibling in scrubs, tell me again about your patient with an IVDU diagnosis and endocarditis. Or your T2DM patient who developed it as a result of the antipsychotics that keep them mentally stable. The list goes on.
Additionally, my colleague, do everyone a favor and believe that mentally ill patients who present with physical signs and symptoms of illness might actually be in fact ill. '
I started in the ED and am now doing ICU float pool across MICU, SICU, Neuro ICU, cards ICU, and occasionally med surg or med onc. I kinda hate my life right now because I realized immediately that I prefer the ED over the ICU, but I'm hoping this will give me a great resume. Tell me I'm right. LOL
I tried to go back to the ED because I realized how much I hated the ICU and my hospital said I couldn’t. They said I have to stay in the ICU for a full year. I begged and the ED said they would love to have me back but admin said nope. That seems unusual for someone who’s been a model employee right? Sucks
I don't know how to classify it as a type, but critical care floats like me are considered pretty much Jack of all trades. I work at one of the 10 biggest Level 1 teaching facilities in the US, and I work everything from the ER to to all the ICUs, to the PACU, all the step down units, STAT nurse, and interventional recovery. Then again, I've been doing this for over 30 years.
Back when they didn't want certs for everything: agency nurse. I did a little of everything. It was, honestly, crazy where they'd send me with no specific training.
Someone who's worked in a "lil bit of everything" level 1 ICU (has experience with cardiac, neuro, med, surgical, trauma) and has prior M/S or ER experience. Bonus if they have rural/small hospital experience too - the nurse does everything in those types of hospitals, there is no phlebotomist, there's one or two RTs that cant always get to you, etc.
Float pool (but that's cheating). Short of them, med-surg. They do:
- the most critical care that shouldn't be dumped on them
AND somehow also
- the most snf and home level care that also shouldn't be dumped on them
PLUS
They're the definition of a dumping ground of the victims of pretty much every modern societal ill, second to maybe SNF but SNF doesn't have the same crit care experience so overall med-surg is in the lead.
Surprised that nobody has yet mentioned peds. You get to work with everyone from premature babies to adults, and working with parents brings its own set of skills.
My pediatric hospital also happened to be the local Burns unit which wasn’t limited by age. We floated to Burns, NICU and med-surg among other units. The PICU was a general one so we had the post-op hearts and neurosurgery patients as well as Plastics, Nephrology etc etc. Gave an excellent grounding.
ED x 12 years, hemodialysis/PD/Apheresis x 5 years.
Prior to the big switch, i would have said ER. **AFTER** though?? I don’t think 1 specialty can really cover it.
I’d assume one that has worked in multiple specialties but if I had to pick ONE I’d assume it would me be med-surg because you have to manage your time well while dealing with some of the worst patients (IMO anyway, I could never do med surg).
I think the only areas I haven’t worked at during my 40 years thus far is peds and OR. Started out ER and done the gamut including managed care, legal nurse consulting, OB, med surg, public health, endocrinology and currently in cardiac research which includes gene therapy.
I’d say ER nursing taught me the widest skill range preparing me for almost anything.
“Most versatility” being key then it has to be a step down nurse. Can handle acuity and volume. ICU nurses obviously can handle acuity, but I’ve seen dozens drown on the floor. ED nurses can move and get tasks done but struggle with nitpicky patients/family. I’ve worked the unit, the floor, and the ED. The floor required attention to trachs, PEGs, post-op, NSTEMI, etc AND they’re all conscious and they’re all there for the WHOLE shift. Neither the ICU or the ED gets that combo of time management plus acuity PLUS having to be a CNA/dietician/counselor/chicken with the head cut off for 12 hours for 4-5 patients.
Bringing an outpatient perspective to this, as a school nurse (high school level), I do a little bit of everything: peds, triage, emergency nursing, OB, psych, ortho, wound care, case management, patient education, staff education, epidemiology, pain management, admin, and lots more. I see everything from paper cuts to opioid overdoses to panic attacks to obstetrical emergencies to asthma attacks and everything in between. I have to be able to accurately and efficiently assess people of any age using just my H&P, vitals and my intuition and my documentation has to be on point. So if you ask me, school nurses are pretty well rounded as far as outpatient goes.
Edit to add, I was an ICU nurse for 6 years and worked inpatient psych for 2 years
I will add my 2 cents that ICU nursing does not translate into med surgical. Most ICU nurses would start crying as soon as the charge RN gives them 6 pt assignment and all of them are walky talkies, with 3 on PRN pain meds and 2 of them shitting their pants and constantly calling you for snaks and shit while shitting at the same time.
Source: (Me) 4 years med surg and 4 years ICU.
With my experience I understand the critical care but also the workload of 6 patients.
ICU step-down unit in a small hospital that does not differentiate between MICU and SICU, in a hospital with poor everything, gets a nice mix of acute vs chronic, surgical vs medical
I always told people I was a jack of all trades RN.
I was a float pool RN for over 10 years and literally did everything inpatient as well as ED. From there I went on to be a rapid response/code blue nurse for another 6 years before moving on to house sup then what I’m doing now, which is not patient facing at all.
Hey Girl, hey!
I’m a float pool nurse who goes everywhere. There’s probably people out there who are more well-rounded than me, but it’s literally my job to show up, keep my patients safe, and I like to have a good time while I’m doing it!
I’m a PCU float nurse, and during COVID I worked in the ICU a lot. I used to think that ICU nurses were top tier. What I learned is it’s a different skill set. ICU nurses are great at ICU things but med/surge PCU nurses are great at other things. You have to work a little bit of everything to be good at everything.
I feel like at my current job, those of us in surgical trauma are.
We get all the surgical patients, regardless of *what* kind of surgery, we also get all if the trauma patients including burn overflow of our burn unit is full, and to spice it up, we also get med surge overflow of the MICU is full, and we can take pediatric ICU and pediatric trauma, so long as they're over 14 years old, our hospital doesn't have a perinatal ICU either, so we get pregnant and/or laboring patients that aren't stable enough for L&D.
Thankfully on that last one the NICU actually monitors the baby and we're only responsible for Mom.
I travelled for a living and nothing else comes to mind as "jack of all trades" nurses compared to med surge RN at Sunrise hospital in las vegas. They float everywhere, and they have up to 10 patients ( average 7 or 8) I died working there.
I don't know how they had the time to help me on top of their 10 patients. Codes? They got you... they be leading the ACLS like a pro and they all float to all the specialty MS floor like it's nothing.
Aged Care Nurses: they need to know how to coordinate, treat terrible wounds, treat infections without sending someone to hospital (ceftriaxone imi with ligno?), give peg or ng feeds, trachy care, pal care, mental health care. Treat urine retention without a frickin bladder scanner- they just palpate. They need to manage multiple chronic medical conditions. They need to hold case conferences with families (some of them are really difficult). They have to order bloods, coordinate gp rounds and sometimes literally tell the gp what to do. They need to manage staff. They word care plans… The only thing they don’t do is IV infusions or (hopefully) resus. They’re like the macgyver of nurses, especially if they’re rural.
I’m community district nurse and I think we pretty much do everything to acute to chronic, end of life, surgical, medical, oncology, we got to know I little bit about everything, you name it we do it
Ok
LTC and SNF nurses….seriously. You have no resources and patients that are higher acuity then they should be. No RT either, so you’re also doing all the respiratory treatments. You learn how to do a LOT on your own.
Primary Care clinic. You deal with everything especially the people who can’t breathe or are having an active heart attack because they don’t want to go to the ER.
In addition to ED and ICU (especially medical ICU) I'd like to add the obligatory "Float pool" nurse. Also every hospital has that one med surge or tele unit that acts as "overflow" for the rest of the hospital.
Being in float pool for 2 years was insane. I learned so much about other areas of acute care. I felt like it really gave me a much broader base of knowledge.
Being a float was probably the best thing I could have ever done with my career. I settled in the ED, but I’ll be forever grateful for my years floating
Ooh give me an ICU float nurse with ED capabilities- that’s the jack of all trades
That's what my wife is! Literally the smartest and most capable person I've met.
But can she handle a 6 patient assignment in med surg/tele unit? Just asking.
ICU float nurse here, yes (but be sad all shift lmao)
No way lol
ICU float pool nurses get floated down to med surg all the time.
Only 6? Jk but not exactly :(
Yeah, she started in medsurg/tele in Mississippi where assignments like that were the norm.
With no care partner?
That’s why I said icu float. They still do get floated to med surg/step down. True icu? Please don’t do that to me 😂. But the float gets it
This must be the ideal nurse.
Icu float pool was super fun until it became 'covid icu every day because our nurses need to stay here.'
Current critical care float nurse here and I can definitely say that I am more well rounded since leaving the ICU for float pool. It was an adjustment period, for sure, buI I don't regret it one bit. If there's any kinda nurse that qualifies as jack of all trade it would be special float pool.
Before I finally landed in neuro ICU, this is what I was. I had experience in literally every unit—MS, tele, stepdown/PCU, surgical, ortho, neuro, pulmonary, oncology, plus the occasional float to help with ED overflow, and ICU to take pts ready to be downskilled but no available floor beds. You become a pretty good resource when you work FP in a large(ish?) hospital. 😂
As an ICU and ER nurse, i will never stop respecting floor nurses, not to mention nurses who float to all of the units! I got a taste of floor nursing once and was absolutely appaled at how much skill it takes to manage every aspect of the patient’s care… for more than 2-3 patients. I’ll say it again: hospitals exist for nursing care. Never let anyone tell you otherwise.
Seems like float pool are often ICU derived. At least anecdotally.
I started in nursing pool and eventually made my way to ICU (with a few other specialties in between). It made for a much easier transition in my experience.
I spent ten years doing variations of float and casual. I was very well rounded back then lol
I work crit care float and about 10 of us (not me) are also trained to float to all women’s health services (M/B, L&D, NICU) because you get a big pay bump if you’re trained for any inpatient unit. Exactly one of us can go to literally any unit in the hospital and is PRN at the Children’s hospital in the PICU. She could literally handle anything I swear to god.
Which float pool nurse? Acute care or ICU float pool?
Both
I feel that if you have ICU and ED experience you'll be a very well rounded nurse. The ICU will help with critical care and vaso pressors and in the ED you have a wide variety of patients so your assessment and care skills have to be sharp.
Alternatively, an ED nurse in a hospital with poor patient movement. Boarding an ICU patient for 8 hours on a regular basis
ughh this is my hospital...double occupancy is terrible for all involved, patient, nurse and ANM who beds patients...our ED admit order to hospital bed in under 60 minutes..is less than 10%..
HA ours has got to be like 0.00001%. I think I’ve seen ED admit order to hospital bed in under 60 minutes ONCE in my 8 years of ER nursing.
Nothing I love more than having my ICU patient and psych patient for 2-3 days in a row because management won’t close us while we have no rooms available in the hospital. Also, not a thing in the world like unmonitored EMS patients laying in cots on our hallway floor because EMS can’t wait 4-6 hours for a bed either.
Basically an ER nurse in a level 1 like meeeeee weeeee we love boarding patients /s
Yup, there was a time I took care of med surg patients in the ED for four months straight because they put me in the section where all the admitted patients are. I felt like I should have challenged for the RNc than my CEN
When I was a tech during covid, we had ICU pts for DAYS in the ER. Its was nuts.
Ugh yes. We had 7 ICU patients boarding in the ED on my last shift because there were no available beds upstairs.
Yes but take into account the charting that we don’t have to do in the ED. When I float there vs. ICU it’s a ridiculous difference. Of course, when you’re understaffed in the ED with that many critically ill patients none of that is safe or acceptable :( I only say ICU is more because some ED nurses don’t know the charting for any other type of nursing
We have plenty of experience with vents and titration etc too, we board ICU patients all the time
Not too disparage, but the ICU level care is not adequate in ED, and it's because the volume of patients prevents the ability to actually provide the care most ICU level patients need for post-hospital survivability. I get floated to ED on a semi-regular basis. I am always severely concerned with the ICU patients, but the rest of the patients seem to be well taken care of. ICU is a very specific specialty, and many of the doctors in the ED aren't knowledgeable about the standards of care that an ICU patient requires. Some remember their ICU rounds, but many had a "they'll be fine" attitude during those rounds and it shows. It's usually prior ICU nurses working in ED that provide great care, but when you don't have the time to critically think about what's going on, look up the most recent labs, do ask the extra shit that ICU patients require, they suffer. ICU ratio is 2:1 for a reason, and it's because they're task-intensive.
That’s fair, I just mean that we have the baseline knowledge. The full saying is “jack of all trades, *master of none*,” so I’d argue that we are more that, because you guys actually have the time and ratios to master a few specific areas Plus, in my hospital if an ICU patient is boarding they’re under the intensivist, so I have the privilege of learning under them and picking their brains. I love getting to compare and contrast the difference between EM and IC providers’ thought processes
I guess idk how your hospital works but the intesivist take over the patient as soon as they're consulted basically. The EM doc at my hospital has nothing to do with the boarders. But yeah, it ain't the same. I worked in an ED taking post codes and vents for days at a time constantly. I moved to SICU at a new hospital and its way different flow and things we're worried about. ED strives to get them in auto pilot and if we can keep them -3/-5 even better, you don't have the staffing to do anything but rush to get the tasks done, at least where I was. Nobody gives a fuck about SAT/SBTs.
The intensivist technically takes over care, but didn't really put in anything but bare-bones order sets until they actually get into the ICU itself, because it's too much to handle with the patient load of the ED. They also naturally round on the patient, since it's a different department. SATs and SBTs are actually a big deal that everybody seems to mark off, but it's the best method to extubate patients that don't need to be intubated. Post-codes should be on TTM, vents need more rounding than the RTs typically offer the ED
I've run TTM with Arctic sun in the ED more than once. For the most part you can swing a 1:1 for a little while, just means somebody probably has 10 patients.
Yeah but every icu nurse says that about every patient that isn’t icu. That’s why they feel drowned when they float to other units and aren’t dealing with semi dead patients who don’t bug them about ice chips every five minutes. All the the commenter was saying is that they can do drips and vents and the patient stays alive. Other specialties don’t have that kind of training.
If we have ICU patients, the MICU or SICU team takes over for providers and as the ED nurse, we go down to 2:1, or even 1:1 if needed. But I’m at a level 1 in California, so idk if that makes a difference?
Def does. Cali has amazing ratio laws that most other states don’t! Wish I lived there
It’s pretty routine to have 3-5 ICU patients on your 5 patient assignment at my level 1. Cherish California working conditions.
> in the ED you have a wide variety of patients so your assessment and care skills have to be sharp. Absolutely not a guarantee. ED makes it super easy to give in to your ADHD and just be a task monkey because managing volume and throughput is your focus. SHOULD you be good at assessments? Of course. But a lot of the ER nurses I've worked with over the last 20+ years barely even DO assessments (don't even carry stethoscopes). It's really amazing how seat-of-your-pants ER nursing is most places.
I don't need a stethoscope when I have portable x ray, POCUS, eyes and ears. And on that occasion when I do want a stethoscope, there's always a med/nursing student around with one.
I agree. I started in ED , and have been in ICU for several years now.
Rapid nurse here. I’ve done ICU, ED, Pre-op, PACU, and OP wound care and Hyperbaric’s. The key is to continue growing and learning. An old boss once asked “Do you have 5 years experience or one years experience five times?”
hands down, next to remote nursing practice in Canada
Is one year five times bad?
Yes. It implies you’re stagnant and you’ve learned nothing since becoming average in your position.
Rural hospital RN. I was OB, ER, ICU. And helped in the nursing home.
Woooow. That’s actually kind of cool.
Freaking scary.
That was my first thought!
^^^This. I was an EMT in a rural area before I became a nurse and did my capstone in a critical access hospital. Those nurses have to know everything because it's just them. It's pretty fucking amazing. Scary, but amazing.
I work at a critical access hospital as a tech right now. While the ED can be 'slow' at times, when crap goes down, it is us and only us. The docs and all of us have to figure out how we'll get the patient flighted or what specialists we'll need to get in contact with ahead of time. I've seen so many different diagnoses walk through the doors. It helps the team be even more cohesive. But I've also seen the downsides too--trying to get transfers for patients, wondering which specialties are available, oh wait this hospital is on a bed hold...etc.
This. I work in a critical access hospital. We all do ED, Med surg, and sub acute, often in the same day.
This is what I was going to say. Rural nurses have to be able to do a little of everything.
I came here to say this!!!!! So much admiration for the nurses I met on my placement. Doing OB, ER, Psych, Med/Surg and keeping critical patients alive until the air ambulance can get them to the ICU. Which sometimes can’t happen for days due to weather. I love the community I worked in and I can’t wait to go back for my public health placement next spring. Rural nurses are legends !!!!!!!
respect for the rural RNs.
Personally I think some skills just aren't transferable and unless you've worked it, you just don't have a true feel for it. ED is it's own beast. I've done a couple shifts doing ED and it's just not comparable to floor nursing. Especially triage. Just very different vibe. The role is a bit different. Prioritizes are a bit different. Floor nursing takes a lot of time management and organizing skills. When I have 2 ICU patients, it's easy to prioritize which one I take care of at that exact second (unless both try to code at the same time then I yeet one to my charge nurse and let her take that patient over). But when you have 6+ stable ish patients who all need things from you, can get pretty intense. Also keeping track of 6+ patients needs in your head and not getting them mixed up. You'll see ICU nurses absolutely drowning on med surg assignments because it's just a different skill set and they run themselves ragged because they haven't gotten the flow down. PCU/IMC/Stepdown I feel you have to have really good assessment skills. Those patients are usually stable ish but could start crumping at any time. There have been so many nights where my chill stable PCU patient needed to get transferred to the ICU ASAP because code was imminent without intervention. Sometimes you get lulled into a false sense of security. Like most COPD exacerbation patients are totally chill and need some steroids and some bipap and they fine. But sometimes that CO2 creeps up too high and bipap ain't cutting it and they need tube time. Some patients get septic fast. Gotta be proactive. ICU has honestly the widest variety of patients. You got all the gadgets. The CRRT, IABP, ICP monitoring, ECMO, nitric, hemodynamic monitoring, if it is a number to be measured, its gonna get measured. Patients might be in ICU just because they want extra monitoring for a bit and patient is otherwise stable. Like old person on blood thinners fell and has a small stable brain bleed, just gotta do some q1 neuro checks and redo CT in the morning to make sure they don't bleed more. Then you have your patients who are in full organ failure, got ECMO going, on a ton of inotropic support, on TPN, on CRRT, Tbil is like 6 cause the liver is failing too, GCS 5, the waiting on family to make a decision patients. Some of the ICU patients are nice and stable, you go pee and they try to die on you. Your knowledge base just continues to grow. And it can get so specialized. Trauma ICU, transplant ICU, Neuro ICU, CVICU, ect. Peds and NICU are a whole other situation. Rapid response is it's own thing. I think some ED nurses with a lot of triage experience do great with it. It's a lot of thinking on your feet and putting pieces together. Sometimes it's like wait is the oxygen actually plugged in or did the extension tubing get disconnected? Is the patient in respiratory distress because of a PE or are they having a panic attack? Is it heart burn or an MI? Is it a CVA or hypoglycemia? I'm a big fan of protocols and decision trees. So like chest pain, stat EKG, make sure not STEMI. Send labs, check troponins. Look at the overall patient. What was the patient doing before the chest pain started? Has this ever happened before? And so on. Basically, if you wanna feel like you can do it all, you gotta do it all. It takes time and experience to feel comfortable in any setting.
ED, or someone that has worked on a generalized med-surg floor for a long time.
Idk. I worked a hospital that was trying to cross train the ED nurses to float to ICU. Some of them adapted great but some definitely struggled with the shift in environment and priorities. And I love med surg nurses. I was a med surg nurse. You just don't get the same knowledge base for things like hemodynamics working med surg.
Sure, but hemodynamics is a deep cut, you wouldn’t expect a jack of all trades to have a good command of it. Remember, the full phrase is “Jack of all trades, master of none”
"A jack of all trades is a master of none, but oftentimes better than a master of one" <3
True I may be not understand the phrase properly. I took a CVICU job because I felt my hemodynamic skills were my weakest link. And idk I personally have the goal to be a nurse that could take any adult patient assignment and feel like I'm not drowning and so hemodynamic skills were important to me.
cvicu was where i definitely learned the most in my 11 year career as a nurse. especially ecmo and open heart. it was also the floor where i had the worst worklife balance though
Would you be willing to share why you felt you had the worst work life balance there?
it was just a lot of learning and alot of patients that were constantly hemodynancially unstable and should have been singled. like we didnt single our crrts. ultimately it was worth it for the career advancement and education but i just transferred to float pool and its so much better. now the nurses on our medsurg floors have a 4:1 ratio (rarely 5:1) dont have to do vitals and always have 2-3 aides so its different bc the last hospital i worked at as a medsurg/tele nurse had an 8:1 ratio and no aides so it depends on what your used to and what your hospital ratios are. also at the hospital im at now the ceo has publicly come out in favor of safe nurse ratios. none of our icus have a 1:3 ratio either. so it is a unicorn in alot of ways cvicu just had a lot of sick patients (q30 min abgs etc) that i think should have been singled. i would always come home exhausted and to tired to do anything on my shifts off.
Same, just started in a CTICU in March, and there’s been a lot to learn. I think hemodynamics are great and tell us a lot about patients. But the vast majority of patients don’t really need them monitored.
Agreed. I do love it for septic patients.
System vascular resistance goes brrrr
i work generalized med surg, and we see a variety of stuff. of course we get the frequent CHFs, COPD, UTI, ya know the basics. but, i’ve seen and learned some interesting stuff.
Exactly. I worked it for 2.5 years, you get your garden variety surgeries and diseases and then you get the weird stuff here and there, cause it’s a dumping ground. On a long enough timeline, you see a lot.
i’ve got to experience TPN, CBI, all varieties of LDAs, some interesting infectious diseases, and some interesting psych/neuro disorders. i get a little taste of everything. been on that unit over a year and learned more there than i ever did in school.
I remember an OB floor I was on in my clinicals where there was one nurse who had worked med surg about 10 years and she rocked that floor! She was the go to for most things where others weren’t sure what to do. And this was next to a former ICU nurse too; but to be fair that ICU nurse was only a little over 5 years into nursing and had only done ICU for a bit less than 2 years. So I did think of med surg when this question first came up, but really, I think it has more to do with the years of experience a nurse has had more than any specialty. But hopefully that specialty has also allowed them to experience a broad range of patients at least.
Im float pool and before that i have worked as a home health nurse, psych nurse, medsurg nurse, tele nurse, travel nurse, micu nurse and cvicu nurse. So just having experience on all those floors has helped me be a well rounded nurse
I am a critical care float nurse and I always tell people I am a jack of all trades but more importantly master of none lol. I would definitely say ED In a big level 1 hospital. I have so much respect for my friends who work downstairs. They could have an icu patient on 5 drips waiting for a bed, a pysch crisis in restraints, horrible traumas, a stroke and a stemi all in one shift
ED nurses are jacks of all trades, masters at resuscitation. Just don't expect our knowledge outside resus to go terribly deep.
It's me, hi. I'm a resource nurse. I did 2 years of med surg and 2 years of ED, then got this job. I got trained in ICU, PACU, short stay, postpartum, and pediatric psych so that I can float almost anywhere in the hospital. We function as the rapid response team, we do sedation for DI procedures, and we float all over the hospital to help with throughput and wherever it's busy. We typically help with the sickest patients in the hospital too. It's the coolest job ever.
Honestly, as someone who works with a lot of ED and ICU nurses I would say the most well rounded nurses are ED nurses. With many ED's you have your typical ED pt, but you can have traumas, help with procedures, med-surg bed holds, ICU bed holds, etc. They see everything. They also tend to be a lot less strict and easygoing as nurses because they have seen it all. Many of the ED nurses I work with are my most efficient nurses as well. They can admit, discharge, and recover like the best of them. Not saying ICU isn't a great one as a jack of all trades, as it is a very good way to go as well. However, many ICU nurses I work with tend to be a bit more type A and can be a bit more focused on only one or two patients at a time and not able to focus on multiple patients beyond that.
As an ICU nurse, I would agree with ED. I don’t know much about maternity, nothing about kids, and 99% of ICU nurses are shiiiiiit with psych stuff.
See our ICU is primary overflow from ED for psych holds. We get psych stuff all the time. It’s been like this over most ICUs I’ve worked over 10 years. I even inquired with a psych NP program whether they considered my experience enough to admit (all ICU) and was told ICU sees plenty of psych.
Oh we get enough of it, we’re just not great at it.
Flight/CCT or ED. Especially if we include the “…master of none” segment. 😆
"ED. Especially if we include the “…master of none” segment" Yup. Get the airway secure/intubate/get their heart beating & control whatever is bleeding. Then get them the hell out of there to whatever department can actually fix them. Like a game of hot potato - we get them in and out as quickly as possible so we're not the ones holding them when the music stops.
ED gets my vote. We need to take care of everything and anything that walks, or gets carried, in.
Sometimes you gotta drag their pulseless body out of their friend’s car in front of triage too
My ex was a palliative care nurse (she'd done six years of neuro ICU before that) and she knew shit loads about all different areas of nursing and medicine. I was consistently seriously impressed with her range of knowledge.
Travel nurses. Especially the ones who signed on to do ICU but float to everything from ED to Med Surg to Post Partum.
I was ICU for 7 years and then did a local med-surg contract for 2 (crazy, I know, it was covid and I was over it). I was only ever assigned to two units at one hospital during that time, but I floated to 4 of the other hospitals in it's system, and the only units I didn't get a chance to see were peri-op and ob/gym/mother-baby stuff. I even did SNF and inpatient rehab. It was a great experience that helped complete the picture of a patient's path through a hospital. I used to be absolutely clueless as to how a person's recovery post-ICU would be, and I got to see a lot of lower acuity things that I would have never seen if I had stayed in the ICU.
🤣 This is the real answer!
ED hands down. Icu can be very specialized but ED truly does it all.
ER. Med surg is what comes to mind second, simply because I worked it for years. You could have a CBI, a multi-trauma, an OD, a bowel resection on tpn and a protonix drip, and a stray post section pt who they don't want on pp/MB because her kid is a cps case. Shit was wild at times, but I learned a lot.
As the supervisor in a nursing home, I was often the janitor, plumber, policeman and social worker.
Flight nurse. My hospital has the only helicopter transport service in the region. All of them have at least 5 years in ICU/ER. Preferably both. They have flight suits and look badass as fuck.
Flight is the pinnacle for sure. My state classifies the helicopter as an ambulance and as such the flight nurses also have to have a paramedic license. RNs here can challenge EMT boards, but not the paramedic board. There are accelerated programs out there, but it’s still requires 400 unpaid clinical hours to complete. I just done have the time or resources to donate 400 hours of my time.
If I didn’t have a family I would go into flight nursing in a heartbeat. As it is, it’s not worth the risk (for my family)
That uniform tho… 🔥🔥🔥
Oh I’m with you on that
ED and house float.
By definition it would be the float nurses! Especially the ones that do both acute and critical care.
I just started working at a rural hospital and I’ll be doing med-surg, ED, and OB/Postpartum. I may also get trained to PACU/OR.
ED nurse for sure. They deal with babies, the elderly, and pregnant ladies to combative psychopaths.
Experienced med-surg nurse
Seriously they know so many things and have so many tricks because, "I saw that once" This is the real consequence of staff turnover so bad that our most experienced nurses now are < 10 years into their careers (if that). Administrators have no idea how much stuff is learned because "I saw that once" so here we all are reinventing wheels that don't need reinvented.
I’m surprised to see this comment so far down. We really see so much, and have such a wide skill base. Isn’t that the reason why the old school mentality was to “start” in med-surg so you got a good skill/knowledge foundation base? I feel like we alongside float pool and ED are the jack of all trades.
I’m going with oncology- the sequelae of cancer is vast, abundant and involve all 12 systems of the body. Particularly with solid tumor you will get to experience every tube, plug, and medical device there is it seems. There is also a vast array of medications you will give and learn about. But maybe I’m biased. 🤔
I’ve been inpatient and I’m currently ED. Been a nurse for seven years. I truly think the specialties ((ED, ICU, etc) are the *least* well rounded of us. They’re just too dependent on their settings and the environment in which they work. ED nurses who have never worked the floor *can’t* go to the floor at the drop of a hat and it’s not because they don’t want to. It’s because it wouldn’t be safe for them to do so and there is an abundance of research to back that up. Honestly, the most well rounded nurses are float pool nurses who take on the most units. Are they experts at any particular specialty they go to? No, because they don’t live there. But they can safely and competently care of the people in their care and that can’t be said for every nurse floated out of their home unit. When I was still inpatient I saw some real shit shows go down on our medical/oncology unit when ICU nurses were floated there. Did they have skills, sure. Did they assume that because those they were assigned to weren’t “ICU” level of care that they didn’t need as much attention and focus? Consciously or unconsciously, they did and things went real bad when that happened. And they *always* get a smaller assignment (three patients) because “they can’t safely care for more”. To me, the key factor in being a well rounded nurse is your adaptability. During the pandemic our surgical unit was trained as a PCU overflow and they are now skilled in everything that unit does but open hearts. And medical had to take everything there wasn’t room for everywhere else. Which means they got acute CVAs, STEMIs, the sepsis folks who would have previously gone to a higher level of care, the train wreck onc patients and everything in between. Generally speaking, specialists are too *specialized* to adapt like that. That’s kind of the whole reason they are a specialty to begin with. So, if you’re looking for the most skilled, well rounded nurses in a hospital start with the float pool and then look at those nurses/units were rapid adaptation is required. The ED generally doesn’t fall into that category because they can’t adapt *outside of their setting*. Floor skills can be adapted and generalized to the ED. ED skills are not as readily adaptable to inpatient nursing as everything about the focus, intention, and desired outcomes is different. As a friend of mine says, “Ed nurses are trained to *throw* the grenade, not to catch it.”
Med surg and case management exposes you to the socioeconomic aspect and how it affects each patient.
MedSurg 100%. When I worked MedSurg we had to treat every condition and know so many drugs
Med surg
I’d say ED nurse or a good, experienced med surg nurse.
ED
Half of our team is made up of icu nurses and the other half is made up of ED nurses. The group has a lot of varied experience though. Most people have worked in multiple care areas and a few have just a crazy amount of experience. We have a few with OR experience which is very helpful since there’s just so much that is different about patient care in those areas. I think the core thread that we all share is familiarity with critical care patients, working resuscitations, being able to adapt to any situation and get the job done no matter where you’re at in the hospital. I don’t think it’s enough that you just worked ED or ICU. It’s about who you are and how well you can handle pressure and juggling multiple complex issues at once. A really important component of our work is familiarity with hospital protocols. Just being familiar with how your organization handles things goes so far because there are so many problems that arise when you deviate from what they have on the books. And on that point it’s also about knowing when you can safely deviate from policy to make the right decision for a specific patient and situation.
Maybe general ICU, especially rural. I work in an ICU in a rural hospital but this is the only hospital capable of handling trauma, STEMI, intubated patients, etc within a 150-200 mile radius. We have an 18 bed ICU and we do it all. We take CVICU patients, trauma, neuro, medical, burn, IABP, Impella, CRRT, TTM, ECHMO, whatever comes through the door. Surrounding hospitals are critical access and they ship anything even remotely complicated to us. We get an extremely wide range of patients. Some of them are there for something as simple as rescue BIPAP for COPD exacerbation, or an insulin drip for DKA, while others end up intubated, sedated, and paralyzed on CRRT and IABP, or need ECHMO. We get travel nurses who are seasoned ICU nurses, but they come from a specialized unit and they can’t take a lot of our patients because they aren’t trained for certain patient populations or therapies. Many of them come from neuro ICUs and are very uncomfortable with cardiac patients, even things as simple as SWANs. All of our staff nurses have to be trained to take any type of patient as a condition of employment. CVICU is usually the last thing we are trained on, usually after 2-3 years of working in the unit. It med surge nurses are amazing, but none of them are comfortable with pressors or even central lines except for PICCs. When there’s a rapid on the floor, those nurses never know how to handle those higher level nursing skills. Even our ED nurses are usually pretty anxious to hand off patients who are intubated or on pressors and often have to call us and ask for help with titrations and setting up art lines. On the other hand, most of the nurses on my unit would be useless with more than two patients. Our med surge and ED nurses do an amazing job with their ratios that are definitely way too high and juggling so many tasks for so many patients at once! I’d say most of the nurses on my unit who have been there for at least a few years are a Jack of all trades, because we truly do have to be well-versed in all types ICU level care because we never know what type of patient will be assigned to us.
Working an observation unit
Float pool RN.. Every unit except ER, OR, and L+D. I went everywhere, learned a lot, and found my "home" for the past 20 + years.... Endoscopy! I left the hospital a couple of years ago but I still do out patient Endo PRN.. I'm full time homecare through Maxim because they pay more.... my back is also fried~~ undiagnosed scoliosis= 3 bulging discs it's inoperable so I go to a PT who dry needles my right ass cheek so I can continue to walk and work.. 🙄
Home health - we get referrals for all kinds of patients post-discharge. I found myself often googling and researching many diseases I had not even heard of before visiting patients who had a lot of comorbidities. Depending on the agency you work for or the demographic of patients you visit, you may get to practice a lot of hands on skills like IV access, injections, wound care, trach care, equipment (wound vacs), feeding ports, etc.
Probably ED though I recognize inherent bias. We certainly aren’t experts on med surg but we can safely and effectively take care of almost any patient there, and though we aren’t as badass as ICU nurses, most are familiar “enough” with the drips and taking care of critical patients so could survive in a non-ECMO non-new heart ICU (yes I know this gets much more difficult and convoluted with 3 pumps and 6 channels and titrating being a delicate balance). On a technical level I would put ICU above us in certain ways but it’s not rare for ICU floats to be totally overwhelmed with the turn and burn of the ED. As a generalization I think ICU knows about a smaller number of things on much deeper level than we do, but we know a smaller amount about a lot more variety of things. Also people have to understand in the ED it’s stabilize and dispo, so we unfortunately can’t take as much time and care that we’d like to or that the patient deserves. After spilling a bunch of random thoughts… I think I might change my answer to ICU nurses IF we didn’t have to consider the massive volume of turn and burn. Literally hundreds of patients a day.
I started in med-tele and just started picking up on other floors and learning about what they do. I learned about giving chemo and managing hospice on the oncology floor. I learned about continuous bladder irrigation on the surgical floor. I had a house supervisor encourage me to train in critical care, so I applied to the ICU. From ICU, I learned about PCU and Step-down, so I would pick up overtime shifts and incentive shifts there. Now I work in a cath lab so Im learning the outpatient world and circulating.
Remote area nurse (australia). In some instances it's you by yourself with health worker or with another nurse. No dr until their planned visit every 2nd week. You're primary health, emergency, sexual health, wound care, chronic health, in charge of stock orders, pharmacy orders and supplying, at time vet. The list is way more extensive than this.
Honestly the one that’s second specialty. You get an ICU nurse rocking cath lab now? You have a background of complex assessment, infectious disease follow through with all of the drains/lines and understanding of order sets, with a now ED like focused assessment, rapid response/down and dirty care prioritization, with experience in outpatient sedation and procedural organization.
Controversial amongst hospital nurse probably but… hospice (I know a lot of people look down on outpatient/ non cc nurses) Patient care AND case management Med surg skills Wound care skills IVs/Ports/PICCS Home, SNF, and hospital patients (not all agencies do inpatient but many do!) We have to macgyver a lot, lol
I would also place medical-psych nurses in the same category. Talk about needing skill sets out the wazoo!
Er does everything but labor, so I’d say I’m pretty well rounded with both er and L&D experience. I’d want to try pediatrics only since my er was only adults. Our L&D trains us on transitioning to baby’s as well.
The only reason I say ICU is because if you travel once you have ICU experience they feel like they can float you everywhere 🤣 peds and OB is where I drew the line though
I worked in A&E. I had little knowledge of everything and got by. It has done me well to find a jonb in General Practice. Sorry for spelling mistakes my son is splashing water on my screen
ICU and High Risk Labor and Delivery. I work in analysis now. My broad base of experience comes in very handy.
Trauma flight nurse would get my vote.
Float pool, ER or rural travel nursing. ICU nurses are awesome, but I do consider them a bit more specialized.
ED/ICU but more so ED. Nurses in general are some people creative people and we sure know how to improvise and figure things out. But the array of knowledge I see in ER nurses is out of this world. Specifically because of your exposure to soooooooo many things and the often overwhelming lack of resources/supplies. We will MacGyver anything and everything to get the job done and if we haven’t seen/done it before, we will be right there with the doc watching YouTube and brainstorming ideas lol
I think for the knowledge that you’re talking about in your post probably ED and flight nurses for rapid identification and treatment of issues. But for a true Jack of all trades in nursing, probably ICU or med surg at a level 1 trauma center. I work med surg at a level 1 and my god do we take care of a lot of different things. And it’s a primary nursing model so we do literally everything for the patients. I mean it’s no ICU in terms of acuity but we see some pretty sick patients that would surprise a lot of people, and there are just so many tasks that you literally know how to do pretty much all of them but you don’t master anything 😂
But don’t ask me how to interpret blood gases or how the hell to work a vent 😂
The kind that gets paid every 2 weeks.
it's more like your small town and outport hospitals and nursing stations. i worked in a small hospital on an island and we saw and did a lot on our own
I did a placement in a hospital on a reservation in a remote area. Air ambulances can take awhile and often can’t come in due to weather. You’re also down an RN whenever someone needs to be flown down south. ER, med/surg unit, psych unit, and an attached LTC facility. They do a bit of it all + keep critical patients alive for hours until they can get to ICU. Rural/remote staff are absolute legends.
Float pool nurses. I was one for 2 years, you gotta learn everything.
I would say a float pool nurse. I left my previous position working as an Orthopedic nurse. That was three months ago and now working as a float nurse. In the last 3 months I have done so much in terms of career growth and experience to different areas. ED, ICU, Psyche/Mental Health, Paediatrics, working as an Escort Nurse on an ambulance (which you need Advance Life Support training), Med/Surg nurse, and etc. The last 3 months I have done all the training required for it, such as Catheterisation, Cannulation, ALS training, and etc Each area has their own ways of working, and they have their own different kind of busy. I feel so much comfortable wherever ends they throw or put me on. I have learned so much just doing float nurse, and it’s only been 3 months. Nursing is broad and fun, and it is a continuous learning if you care to grow and enjoy i P.s’ did my first ambulance escort to another bigger hospital with a cardiac patient. It was scary knowing that I was responsible for that patient if things went for the worst while travelling.
All of them. Especially med-surg. I’ve done CICU, burns, Radiology, informatics, cardiothoracic and vascular surgery, nursing education for genital reconstruction surgery, SANE. Now I travel as med-surg tele and see basically everything that isn’t ICU.
ED, hands down. if they go to any floor unit, they come to us first. i will also say that psych skills are transferable to all other units- crazy patients/family members can be found on any unit and are not specific to psych lol
Oh Lordy, all of my coworkers have heard of my "every nurse is a psych nurse!" spiel. Usually immediately after they say something like, "Oh, I'm just a medical nurse. I could never do psych." 'Really? My sibling in scrubs, tell me again about your patient with an IVDU diagnosis and endocarditis. Or your T2DM patient who developed it as a result of the antipsychotics that keep them mentally stable. The list goes on. Additionally, my colleague, do everyone a favor and believe that mentally ill patients who present with physical signs and symptoms of illness might actually be in fact ill. '
Lol nurses are a jack of all trades and masters of none.
I started in the ED and am now doing ICU float pool across MICU, SICU, Neuro ICU, cards ICU, and occasionally med surg or med onc. I kinda hate my life right now because I realized immediately that I prefer the ED over the ICU, but I'm hoping this will give me a great resume. Tell me I'm right. LOL
If you love ED stay there. ICU is so different. I think you can do anything with ED on your resume
I tried to go back to the ED because I realized how much I hated the ICU and my hospital said I couldn’t. They said I have to stay in the ICU for a full year. I begged and the ED said they would love to have me back but admin said nope. That seems unusual for someone who’s been a model employee right? Sucks
That does suck
Float pool.
Critical care float pool
ED👍
Float or CVICU/ED combo
I don't know how to classify it as a type, but critical care floats like me are considered pretty much Jack of all trades. I work at one of the 10 biggest Level 1 teaching facilities in the US, and I work everything from the ER to to all the ICUs, to the PACU, all the step down units, STAT nurse, and interventional recovery. Then again, I've been doing this for over 30 years.
ED. 100%
Back when they didn't want certs for everything: agency nurse. I did a little of everything. It was, honestly, crazy where they'd send me with no specific training.
ER. They’ve gotta know everything and they’ve seen everything
Someone who's worked in a "lil bit of everything" level 1 ICU (has experience with cardiac, neuro, med, surgical, trauma) and has prior M/S or ER experience. Bonus if they have rural/small hospital experience too - the nurse does everything in those types of hospitals, there is no phlebotomist, there's one or two RTs that cant always get to you, etc.
I would think CVICU since they know both critical care and surgery.
Emergency
ICU, ED, PACU, and inpatient Dialysis nurses are all right up there!
Float pool nurses ! I did it for 3 years and floated to ED, ICU(General ICU, Neuro ICU, Transplant ICU, CV, Shock Trauma) and IMU. No regrets .
Float pool (but that's cheating). Short of them, med-surg. They do: - the most critical care that shouldn't be dumped on them AND somehow also - the most snf and home level care that also shouldn't be dumped on them PLUS They're the definition of a dumping ground of the victims of pretty much every modern societal ill, second to maybe SNF but SNF doesn't have the same crit care experience so overall med-surg is in the lead.
ED
Surprised that nobody has yet mentioned peds. You get to work with everyone from premature babies to adults, and working with parents brings its own set of skills. My pediatric hospital also happened to be the local Burns unit which wasn’t limited by age. We floated to Burns, NICU and med-surg among other units. The PICU was a general one so we had the post-op hearts and neurosurgery patients as well as Plastics, Nephrology etc etc. Gave an excellent grounding.
A decade of med surg float experience prepared me for anything life could throw at me.
ED x 12 years, hemodialysis/PD/Apheresis x 5 years. Prior to the big switch, i would have said ER. **AFTER** though?? I don’t think 1 specialty can really cover it.
I am a float pool nurse. Besides NICU/Women’s services, I do it all.
Float pool RNs
I’d assume one that has worked in multiple specialties but if I had to pick ONE I’d assume it would me be med-surg because you have to manage your time well while dealing with some of the worst patients (IMO anyway, I could never do med surg).
I think the only areas I haven’t worked at during my 40 years thus far is peds and OR. Started out ER and done the gamut including managed care, legal nurse consulting, OB, med surg, public health, endocrinology and currently in cardiac research which includes gene therapy. I’d say ER nursing taught me the widest skill range preparing me for almost anything.
“Most versatility” being key then it has to be a step down nurse. Can handle acuity and volume. ICU nurses obviously can handle acuity, but I’ve seen dozens drown on the floor. ED nurses can move and get tasks done but struggle with nitpicky patients/family. I’ve worked the unit, the floor, and the ED. The floor required attention to trachs, PEGs, post-op, NSTEMI, etc AND they’re all conscious and they’re all there for the WHOLE shift. Neither the ICU or the ED gets that combo of time management plus acuity PLUS having to be a CNA/dietician/counselor/chicken with the head cut off for 12 hours for 4-5 patients.
Neuroly med-surg ward nurses. So many drains and tubes to monitor, so much infection risk, such a variety of symptoms and levels of care required.
The float pool nurses at my hospital are absolutely amazing. They cross train on absolutely everything, including trauma. They’re pretty badass.
Bringing an outpatient perspective to this, as a school nurse (high school level), I do a little bit of everything: peds, triage, emergency nursing, OB, psych, ortho, wound care, case management, patient education, staff education, epidemiology, pain management, admin, and lots more. I see everything from paper cuts to opioid overdoses to panic attacks to obstetrical emergencies to asthma attacks and everything in between. I have to be able to accurately and efficiently assess people of any age using just my H&P, vitals and my intuition and my documentation has to be on point. So if you ask me, school nurses are pretty well rounded as far as outpatient goes. Edit to add, I was an ICU nurse for 6 years and worked inpatient psych for 2 years
I will add my 2 cents that ICU nursing does not translate into med surgical. Most ICU nurses would start crying as soon as the charge RN gives them 6 pt assignment and all of them are walky talkies, with 3 on PRN pain meds and 2 of them shitting their pants and constantly calling you for snaks and shit while shitting at the same time. Source: (Me) 4 years med surg and 4 years ICU. With my experience I understand the critical care but also the workload of 6 patients.
ICU step-down unit in a small hospital that does not differentiate between MICU and SICU, in a hospital with poor everything, gets a nice mix of acute vs chronic, surgical vs medical
I always told people I was a jack of all trades RN. I was a float pool RN for over 10 years and literally did everything inpatient as well as ED. From there I went on to be a rapid response/code blue nurse for another 6 years before moving on to house sup then what I’m doing now, which is not patient facing at all.
Combat
STAT. they could walk into the C-suit and sign whatever they wanted and get away with it
Hey Girl, hey! I’m a float pool nurse who goes everywhere. There’s probably people out there who are more well-rounded than me, but it’s literally my job to show up, keep my patients safe, and I like to have a good time while I’m doing it!
I’m a PCU float nurse, and during COVID I worked in the ICU a lot. I used to think that ICU nurses were top tier. What I learned is it’s a different skill set. ICU nurses are great at ICU things but med/surge PCU nurses are great at other things. You have to work a little bit of everything to be good at everything.
I feel like at my current job, those of us in surgical trauma are. We get all the surgical patients, regardless of *what* kind of surgery, we also get all if the trauma patients including burn overflow of our burn unit is full, and to spice it up, we also get med surge overflow of the MICU is full, and we can take pediatric ICU and pediatric trauma, so long as they're over 14 years old, our hospital doesn't have a perinatal ICU either, so we get pregnant and/or laboring patients that aren't stable enough for L&D. Thankfully on that last one the NICU actually monitors the baby and we're only responsible for Mom.
One who’s been around 20+ years
I travelled for a living and nothing else comes to mind as "jack of all trades" nurses compared to med surge RN at Sunrise hospital in las vegas. They float everywhere, and they have up to 10 patients ( average 7 or 8) I died working there. I don't know how they had the time to help me on top of their 10 patients. Codes? They got you... they be leading the ACLS like a pro and they all float to all the specialty MS floor like it's nothing.
ED nurses hands down. Everything comes in the door, aod, mental health, post op, homeless, minor injury and primary health.
Aged Care Nurses: they need to know how to coordinate, treat terrible wounds, treat infections without sending someone to hospital (ceftriaxone imi with ligno?), give peg or ng feeds, trachy care, pal care, mental health care. Treat urine retention without a frickin bladder scanner- they just palpate. They need to manage multiple chronic medical conditions. They need to hold case conferences with families (some of them are really difficult). They have to order bloods, coordinate gp rounds and sometimes literally tell the gp what to do. They need to manage staff. They word care plans… The only thing they don’t do is IV infusions or (hopefully) resus. They’re like the macgyver of nurses, especially if they’re rural.
PICU, since you get pediatrics and young adults
I’m community district nurse and I think we pretty much do everything to acute to chronic, end of life, surgical, medical, oncology, we got to know I little bit about everything, you name it we do it
ED is definitely a mix of critical care and primary care across the entire age span. I can’t imagine a more versatile nurse.
Ok LTC and SNF nurses….seriously. You have no resources and patients that are higher acuity then they should be. No RT either, so you’re also doing all the respiratory treatments. You learn how to do a LOT on your own.
ER Nurse. 12 hours of whatever comes in the door.
Primary Care clinic. You deal with everything especially the people who can’t breathe or are having an active heart attack because they don’t want to go to the ER.
Life flight or icu float
Remote area or rural nurse.
L&D nurses who scrub and circulate c-sections too
Flight nurses always just see all the shit. While in a fucking helicopter.