How do you decide which speciality you should try? Debating between OR, CVICU, and ER. Any advice is appreciated. Currently in Med surge and not loving it

I was selected for an ICU specialty right out of nursing school. 8 years later I have been a critical care float and worked in all 3 of those units. ER is fast paced, turn and burn unless there are no beds. CVICU is intense and you're expected to know an incredible amount. Most people are not super when it comes to painful surgeries. CV Doctors are my personal least favorite kind. Then you have OR. A lot of support, clear cut roles, can be a bit boring and cold but quite manageable. It boils down to what type of patient care you want, I loved speaking with people and families the first few years of nursing. After COVID ICU nursing OR or procedural nursing is a break. If you have the opportunity to become a cath lab nurse, do it. Of all it is my favorite, the right amount of critical care and patient care.

Ask the Lord to lead you and then trust He will.

It’s easier to train an ICU nurse in the ER than it is to train and ER nurse to the ICU. That being said, you have to know SO MUCH about your patient in the ICU and so much other stuff in general. It’s hard to let go of that to keep up pace in the ER. I’ve done both. The psych holds in the ER are probably what made me leave entirely. It was… hard to keep my compassion. I prefer total cares and vented patients any day. You get a lot of autonomy in ICU and ER, but I’m thinking Cath Lab is where I want to go next if I stay in a hospital. The burnout of bedside is real.

It’s up to you. They’re all completely different. I started in med-surge as a new grad too. I am in Cath lab now but I had to go to ICU first. To be honest, I loved ICU and would go back if I ever were to go back to bedside. How are you when you handle stress? I always use ER and ICU as examples. In ER it’s “complete chaos” as in you don’t know what you’ll get. They’re ratio’s are more flexible for a shift. ICU is “controlled chaos”. You know they’re very sick and you stick to one to two patients the whole shift. Same with cath lab and OR. Cath lab is like ER in a sense where you won’t know what can happen next (incoming STEMI will throw off the whole day’s schedule and you’ll be playing catch up). OR is similar to ICU where it’s controlled and you know that that’ll be your assignment the whole day. Yes certain procedures can go longer than expected but it’ll stay the same.

Be mindful that OR does have a “on call” schedule too. It’s different from being flexed. Being on call for the weekend can either be quiet and rarely if ever come in or you’re there all weekend.

Hi there,
I understand and kudos to you for wanting more. I was in same position 25 years ago and decided to go into a SICU at the largest trauma center in the Pacific. Wow what a great, but hard experience. I still remember the experiences ingrained clearly that were exceptional educational opportunities. I did SICU/MICU/neuro trauma ICU for 3 years and then Cardiac care for 1 year. Subsequently after that went into ED and found that to be an easy transition.
I recommend doing ICU first to get your assessments down and learn about the various medications and critical care protocols. Then when or if you get tired of the ICU transition to ED. Hope that helps and best of luck!!

I would work in ICU, then I will work OT (over time) in ER. Your vase experience in Medical surgical should be a plus in both area. I am from the old school. I believe a medical surgical background is the basic foundation of any nursing specialty. i started my career in medical-surgical, with that background I was able to take on the challenges of ICU, PACU, special procedure, stroke rehab, urology, spinal cord, LTC, and primary care. The only reason I did not work in pediatric and OB I was employed by the Department of Veterans Affair.
I presently work as a care manger in primary and my vase knowledge, which was base on a medical-surgical background has prepared me to excelled in any area (with minimum orientation) of nursing.

I did OR for many years. I started at a facility that allowed us to do both the scrub and circulating roles. I loved it for many reasons. I liked that the patients came in with a problem, and we almost always improved their life. It was an instant gratification feeling.

One way to try and figure it out is buy seeing if you can do some shadow shifts in each area. Each area has pros and cons. Or just try an area. If it’s not right try the next.

IF I WAS TO GO BACK AND DO WHAT YOU ARE WANTING TO DO... I WOULD SUGGEST GOING TO THE ER. THEY WILL ORIENT YOU... AND GUIDE YOU, I WOULD HOPE..... SINCE YOU WOULD BE NEW AT IT. YOU WOULD GET A VARIETY OF ALL AGES AND CONDITIONS AND LEARN QUICKLY HOW TO DEAL WITH ANY PROBLEM THAT COMES IN.I LEARNED QUICKLY AND WILL REMEMBER EACH CASE THAT I HAD ,WITH WHAT THE PATIENTS HAD..... AND WHAT WE DID FOR THEM.. BECAUSE YOU HAVE A FACE TO PUT WITH THE DIAGNOSIS... AND I DONT THINK YOU WILL FORGET IT...IT IS A GREAT WAY TO GET "YOUR FEET WET"AND ITS FAST PACED.. AND YOU HAVE TO LEARN TO BE CALM AND REASSURE EACH PATIENT THAT YOU ARE THERE TO HELP THEM AND WE WILL TAKE CARE OF EVERYONE!!!

I currently work ER and ICU. Sometimes you are the bug and other times you are the windshield. Keep that saying in mind, it's helpful.
I find that the ED is a treat and street mentality. Sometimes you don't know what happens to the patient and that can be a great thing. In the ICU, you will be with this patient for your entire shift and if you schedule your days together, then it can be prolonged throughout the week.

Both areas are fast paced learning curves. Both areas teach you beyond what you learned in school. Most docs don't mind giving rationales for interventions. So it's an endless learning well.
Whatever you pick, you don't have to stay there. That's what is so great about being a nurse. Every specialty has flexibility.

Or nurse for 43 years . If you s choose or nursing you have to love it or you will Die .

I would shadow a day in each area. You need to see what actually goes on before you can decide. I was in EMS before nursing school and went to the ER. Ended up being discouraged and bullied out. Took a periop class figure ing if I like it, I can go to the OR but if not at least it’s CEU’s. I loved it and so I went! I dipped out to try ICU for a year but came back to the OR. It’s not for everyone because it’s not traditional nursing.

Hi I thought maybe I could help. I have worked in the ER and the operating room. I have not worked in ICU but worked closely with nurses who did. If you don't mind stress and exceedingly high volume fast pace then try the ER. It can be really interesting. Just keep in mind that many days, or nights especially weekends, you may not sit down your entire shift. I worked 16 years in the OR, the last four of those as a night shift trauma charge nurse. I absolutely loved working in the OR and would recommend it to anyone who wants to try it. It can be very stressful especially trauma. You must be open to working with strong personalities and surgeons who can be temperamental. And I think I'm out of space but good luck.

I spent my whole career in OR. First I was an OR nurse and then aCRNA.

Does your facility have a shadowing program? This works by coming in on your day of and following a nurse in that specialty. It is always best to have some hands-on knowledge before making that choice. Good luck in your nursing career.

I say, get your hands wet in trauma, CVICU, or a trauma center ED and stay put there for at least a good 2 to 3 years. After that you can go anywhere and do anything. That’s the best experience you could ever get. Just my thoughts.

Only you know that answer. I know what I like. I forced myself to try the ER and hated every minute of it. I couldn’t control or influence the situation. I finally got into the ICU and love it. Challenging and lots of action. I have shadowed in the OR, not interested. I would be bored out of my skull.

Pt come to emergency only for first aid than patient shift for OR ,patient in OR stay only 5 to 10 hours ,but in cvicu patient stay more time that's fully recover your patient and than move to ward so cvicu is along care

Here is the beauty of being a nurse... you can do them all. No one says you have to stay in one place or one specialty. Personally I'd start with CVICU or ER and OR when you've had enough patient contact. Working in ICU and ER will open lots of doors both in and out of the hospital. OR is it's own beast with very specific skill sets. ICU and ER have high burn out rates and can be very stressful to work in but also extremely gratifying. The thing is this career can take you places you didn't know you wanted to go... don't be afraid to learn there is so much out there for you to experience as a nurse!

Depends on the facility. All units are not created equal. A CVICU in a level 1 trauma center is significantly different than a CVICU in a trauma level nothing hospital. I saw the worst of the worst in a trauma 1. Great experience and learned a lot. Now I am a travel nurse and the skills and experience I gained have made me a formidable applicant. 80% of the time I get offers on my first choice of contracts. A CVICU background opens many doors. You can pretty much get any job in the hospital. Best thing I did as a new grad.

Specialties pay more. You have to have extra clinical knowledge and responsibility as you will be making mostly independent decisions. Your assessment skills have to be top notch. You have to make sure you have your own liability insurance as your liability will be higher for the specialties. Do not depend solely on the hospital malpractice coverage. They will protect the hospital not the nurses

The ER is super exciting. It is also super dangerous, especially with all the fentanyl overdoses GSW and MVA's. (If you know those abbreviations, you are on your way to be an ER nurse!). Be prepared to see mentally ill patients who are also in medial crisis. Many patients come into the ER armed with tasers or shivs. Sometimes the HP don't thoroughly search the patients. I believe the policy of all ER's now is that every nurse and MD have to know how to do rape kits, also, be aware of human trafficking.

In my state, the only thing the OR nurses do is record the operation and assist if the patient crashes. OR techs are the ones that help the surgeons.

ICU, again, needs high clinical knowledge and skill.

If you are okay with these choices, then pick one. Go into it with your eyes open.

I would reflect on what you like and don't like about Med/Surg. Will any of the options you're looking at have those qualities/issues?
You could also ask if you could shadow a fellow nurse in the departments you are thinking of switching to so you can experience it firsthand and ask questions.

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I think the best way to make a choice in specialty is to chose what you truly enjoy to do. That's the only way you don't get bored.

If you like being on call constantly, choose OR. If you like running for 12 straight hours with constant turnover of rooms, choose ER. Havent worked CVICU but imagine it might be more manageable . Just a guess though. I imagine they run like crazy at times too.

Ask to shadow in any area of interest. Thankfully the nursing profession is supportive of peers in this way 🙂.

Did one year of med surg and then went and spend most of my career in the ED. Left to do pre op pacu and same day. Not nearly as rewarding. Just moved to the OR and loving it ( but I haven’t started call yet). I say go the ER if you are in your 20’s or 30’s. You gain the experience of a lifetime as long as the unit is supported with good management. Every job has its challenges. The only downfall of the OR is you don’t have as much opportunity to interact with patients.

I say

OR will improve your anatomy knowledge. ICU will help you with critical thinking and prioritizing needs. ER will help you with multitasking and speed - juggling so that all the balls stay in the air.

Cratical care unte (Icu}

I went to tge or from graduation in 1975. Never regretted it. Try things till you find your spot!

Iam also select icu

Each unit has its own requirements and I agree with those that say to "shadow" and see for yourself is this what you really want. Good Luck.

I would strongly recommend shadowing in those areas. Each are very different and you should get a feel for what you would enjoy.