Frankie and NICU Nurse, I don't mean that the time on med/surg is just for organization and delegation. It gives the new grad the exposure to multiple situations such as contolled chaos and chaos. When there is a low census the nurses from the 'specialty areas" refuse to take even 4 patients and thus are not any help as the regular staff usually ends up doing most of the care and don't tell me they don't. The other is well, I mght get called back. Well, when that happens the rest of us will deal with it. Some of those things are necessary. Having one or two patients is ideal however the reality is that there are far more med/surg patients than there are 'specialty unit' patients. The majority of a hospitals income is the med/surg units. If all the new grads go to specialty units who is suppose to staff the floors that are already far to understaffed.
When I first started 20 years ago, and where I last worked the orientation was not limited to 6 weeks. It was geared to the grad and his/her preceptor. A contract was established that had room for changes. I have also found much hostility with specialty unit nurses when it comes to med/surg. Even tele floors have a great majority of med/surg and the monitoring is precautionary usually because of past history or that the doc doesn't want a patient on a particular floor. Our tele floor doesn't want to take more than 4 patients on evenings. That is unrealistic when the med/surg units are up to 10 each. The med/surg floors are ususally the heavier floors physically. It doesn't hurt to want to have someone who can assist.
Many new grads come out of school and have little experience on doing some basic procedures. These need to be accomplished first before monitoring a Swan Ganz or a specialized drip that they have only heard of. I know if I was admitted to a specialty unit I would want someone experienced in that area but also someone who would also be familiar with other disease processes that are not ususally seen in such a situation.
Studies have shown that those who go into specialty areas do have a calling but many do it because of a lessen work load and a higher salary. I am not denying they deserve the higher salary. But what about the resentment that seems to happen when the med/surg units need techs and the unit nurses vote them out because they don't use them because of the one on one or one on two.
I have floated to SICU and ICU and it seems funny that when a med/surg nurse goes there thay they certainly get the patients that have less intrusive care but I have had more of a patient load there as I have been told "you're use to it" Maybe we should base salary on the physical work.
In one class a nurse said her tech understood that it was a sacrifice for her to assist in changing an incontinent patient. What would she do if she didn't have a tech. She would have to do it alone.
A typical night on an 8 to 10 patient team usually had a couple of diabetics, most in chronic CHF, or other respiratory illness, peritoneal dialysis to be done twice on one patient. and transfusing two. Of those 4 were in various types of isolation. Unit nurses also refuse to take isolation rooms. Gee, I thought that there was isolation in the units.
I also monitor beds at the same time. I can do EKGs and report the findings to the physician for treatment. The same is happening with doctors. Soon there will be according to the latest studies few general surgeons. Most surgeons are "specializing" in such areas of Plastic or Cosmetic so that they can have a 9 to 5 day and spend time with their families in the evening and weekends. The reasons that are also stated are that they don't have to go through the training that requires them to spend years literally taking call all hours of the day and night and weekends.
So, maybe not a year but six months of exposure. This can be lengthened or shortened as needed. If a facility take the time to hire a nurse they need to make a long term investment and be certain that the nurse is prepared to do his/her job description. I would rather get some of the kinks worked out so to speak and have a more well rounded nurse.
If nurses are specializing immediately out of their nursing programs
than there will be a closing of beds since there isn't adequate staff or the facility will keep it open with the already strained staff until something happens that may be detrimental to a patient or the end of a nurse's career. Hospitals are going to abandon the nurse at the drop of a hat so that they will not be responsible for any monetary settlement.
I am sorry that you have heard the med/surg requirement so much but I cherish those experiences and hope that they have made me a more competent nurse so that my patient's outcome is not drastically altered because of a lack of knowledge.
As they say we are all entitled to our opiniion