I am about to begin my last year of my ADN program and am torn as to where I want to work when I graduate. Right now I am torn between Peds and Critical Care. I feel like I would not know enough; although, I think that is going to be true for the first six months to a year anywhere I work. Did anyone specialize right out of school? if so, do you regret not working in a general area first? Pros and cons would be appreciated! Also, how long of an orientation is ideal? All feedback is very much appreicated! Thanks a lot!

Started in NICU, have been there my whole career and no regrets.

I'm starting in a med/surg floor in about 2 weeks, fresh out of school. I chose that because I wanted to solidify a lot of my skills early on before specializing. But, I'll pass on some of what one of my preceptors said to me recently...she said it doesn't really matter where you start. Anywhere you go you will get an orientation, and every skill you perform is usually described in the policy and procedure manuals on the floor. Anyone can learn a task...sure if you go on a med/surg floor you're going to get more experience putting in catheters and giving IV meds than maybe a general pediatric floor, but really, every floor is unique, even between med/surg floors. She said it doesn't take that long to get used to a floor, and every floor is different, so no matter where you start, you'll get used to it, whether it be med/surg or critical care...you'll get used to the skills you are used to performing. Talking to her actually made me a lot less nervous about starting out all around. lol

One thing recruiters have said to me is it's easier to move from a med/surg floor into a more specialized one than from a specialized floor to another specialized floor...but they might just be trying to get more people in to med/surg because everyone always wants to specialize.

I think really the choice is just individual and up to what you want to do...nursing has so many options to offer and just because you choose to start out in one doesn't mean you're stuck there forever

Go where your heart tells you to go. There is no perfect, "one right answer" for everyone. If you really want to be a peds nurse, a little time in adult med/surg will not be very useful to you. Many people find it hard to become a "beginner" again when they switch from adults to peds. (I keep the recruitment/retention stats for a children's hospital and am in staff development, so I know that for a fact.) Other people find it not so difficult -- but they seem to be in the minority. So, I would suggest that if you want peds, go peds from the beginning.

However, if you are planning on a career in adult ICU, then the adult med/surg experience would be much more relevant. Soem ICU's hire a lot of new grads and have the support systems in place to give them a good orientation and help them through their first year. Other ICU's do not -- and it really helps the nurse to have some general care experience before going to those particular ICU's.

llg