An investigation of clinical unit choices by graduating baccalaureate nursing students

Although there is a general shortage of nurses throughout U.S. hospitals, there are certain areas, such as general medical and surgical units, where this shortage is most acute. The purposes of this study were to investigate clinical unit choices of graduating baccalaureate nursing students and to identify factors that influence these decisions. Seven semistructured focus groups were conducted, consisting of 55 senior baccalaureate students from two colleges. Most participants were 21-22 years old. There were 50 women and 5 men. Approximately half the sample had nursing experience prior to college, and two thirds completed a nurse extern program. Following graduation, approximately one third of participants planned to work in pediatrics and half of those in pediatric critical care. Of the remaining two thirds who picked an adult population, half chose critical care. Specific units were chosen based on the atmosphere, staff, nurse manager, and externship experience on that unit. Critical care was chosen over general medical or surgical units because of the nurse-patient ratio, independence, "making a big difference," acuity, and pace. Floor nursing was perceived as boring but too busy and stressful and, for many, only a stepping stone to other units. The contradictory perceptions about medical and surgical units appear to influence the choice between critical care and these units.