Where Do RNs Work?

RNs have the unique ability to basically choose the type of workplace which best suites his or her ideal environment, usually this happens through trial and error and years of experience.

The RN can work in an environment with pretty curtains and a nice waiting room to a rough-and- tumble county hospital whose primary patient populations are inmates and homeless people. He or she may prefer clean and fresh patients who come from home and have a minor elective procedure or a not-so-fresh patient who was found unconscious in the street and is now barely hanging on for dear life.

Hospitals

• Emergency Roomarguably the most fast-paced and dynamic department a RN could choose to work, a day in the ER is never the same twice. Patient populations can be very different depending on the location and size of the hospital
• Intensive Care Unitthis department requires perfection, attention to detail, and a strong sense of self to tolerate some of the emotional highs and lows the RN will experience. Large hospitals will have more than one type of ICU:
  • Neurological ICU for patients with a traumatic brain injury of some variation
  • Cardiac ICU for patients who have had cardiac surgery or cardiac catheterization procedure, or post-myocardial infarction, etc
  • Medical ICU for patients with sepsis, withdrawal from a substance, stroke, MI, active gastrointestinal bleeding, etc
  • Trauma ICU for patients who have sustained injuries due to a motor vehicle crash, fall, attempted homicide, attempted suicide, drowning, etc
  • Burn ICU for patients with a large surface area of burn injury, the RN manages wounds, treats sepsis, and maintains the patient’s airway, among other responsibilities
  • Pediatric ICU for children or adolescents with life-threatening injuries or diseases, the RN sees miraculous recoveries as well as heartbreaking loss of children
  • Neonatal ICU for infants with life-threatening injuries or diseases, like the Pediatric ICU, the RN will experience dramatic highs and lows and requires a strong emotional core to prevent burnout
• Floor patients are admitted to the floor for monitoring and treatment of a stable diagnosis which could deterioration to unstable and require transfer to a higher level of care, such as the intensive care unit. RNs on the floor must be amazing at assessment and rapidly respond to an emergent situation. Floor patient care can be difficult due to high ratios, short staffing including having enough certified nursing assistants, and the fact that, many floor patients are not on telemetry monitoring
• Medical-Surgicalis for patients who have had surgery and are stable or have a stable medical diagnosis which may get worse, this unit has a good mix of patients and is often preferred by new RN graduates for it’s broad array of experiences
• Orthopaedicsis for patients who have sustained a bone fracture and/or need surgery to repair or replace a bone or joint. Common diagnoses for this population is Total Knee or Hip Arthroplasty. The RN helps to rehabilitate and teach this patient about new mobility standards, etc, which must happen for the patient to transfer to home
• Oncologyis for patients who have some form of cancer, many are receiving chemotherapy and/or radiation or preparing for a bone marrow transplant, which can require a very long hospital admission. RNs on this unit will experience many emotional highs and lows, so it requires a RN with a strong emotional core.
• Telemetryis for patients with a new or previous diagnosis of a cardiac dysrhythmia, cardiac complication, or have undergone a cardiac surgery. Some telemetry patients are being treated for a different condition but require monitoring of their heart because of a preexisting condition. A telemetry technician is assigned to monitor the EKG’s and notify the RN of an abnormality. RNs on this unit must be quick-thinking and understand appropriate cardiac interventions.
• Mother/Baby requires the RN to take care of newborns and post-delivery mothers. This unit is fast-paced and requires quick-thinking and strong assessment skills to monitor for hemorrhage and deterioration of either mom or baby. This nursing role requires the RN to care for 2 patients as a set.
• PsychiatricUnit patients are admitted for mental illness and disease, either temporary or permanent. RNs will be able to explore a wide range of skills relating to mental behavioral health.
• Operating RoomRNs will care for patients who require surgery, there are 3 areas of the operating room available to RNs
  • Pre-OP, or before surgery, involves the RN obtaining a medical and social history, documenting personal belongings, and preparing the patient for surgery
  • Peri-OP, or during surgery, involves the RN assisting or circulating the operating room while the patient is under anesthesia
  • Post-Op, or after surgery/recovery room, involves the RN recovering the patient from anesthesia and ensuring the patient’s airway and hemodynamics are monitored appropriately while intervening as necessary
• Labor and DeliveryRNs assist in delivering babies and everything that comes before and goes after this process. RNs in this area will be working in a fast-paced environment with very high stakes as the birthing process can rapidly escalate to an emergency or surgery. Especially good assessment skills and recognition to a developing crisis is required.
• Cardiac Catheterization LaboratoryRNs assist the cardiac surgeon with cardiac catheterization procedures, including cardiac stent placement, intra-aortic balloon pump (IABP) placement, etc. Patients during the procedure are under anesthesia and require intensive monitoring. This patient population has often just experienced a myocardial infarction and was transferred emergently to repair the blocked vessel.
• RadiologyRNs perform CT and MRI scans, and X-rays. RN’s often inject angiography dye or administer barium for specialized exams.
• Interventional Radiology (IR) the RN in this department assists the physician with procedures such as central line placement, nasojejeunal tube placement, PEG tube placement into the stomach, colostomy insertion, etc. The RN is required to set-up the IR room similar to how an operating room is prepared.
• Wound CareDepartment the Wound Care RN is specially trained in caring for wounds of various types, colors, and causes. Bedside nurses consult this RN for complex wound care and recommendations as well as Wound Vac initiation and management. RNs in this department should enjoy wound care and are rewarded by the improvement of wounds it’s contribution to overall patient health.
• Rapid Response Team is comprised of specialized RNs who are experienced and competent in rapid patient assessment and intervention for the deteriorating patient. A Rapid Response, or RRT, is called on the overhead loudspeaker at hospitals by non-critical care nurses who have determined a patient is deteriorating and needs immediate assistance. This is done when the patient is still breathing and has a heartbeat, so it is not a Code Blue. RRTs will sometimes become a Code Blue if the patient continues to deteriorate and the RRT team needs additional assistance.