best start in nursing

V SPN · Mar 3, 2001

To the veterans-

The conventional wisdom on this board, with my instructors, and others seems to be that the best place for a new grad to start out is on the Med-Surg floor.

I don't understand this. It seems to me that you would need more experience to work Med-Surg than a specialty.

To wit: as a Med-Surg nurse I would have 6 to 10 patients, each with their own issues, this one a NG tube, that one a chest drain, etc. each with their own chart and meds. The other floor nurses have their own charges, so back-up is limited, and the Doctor is on the other end of the phone.

As an OR nurse, RR nurse, or other lower ratio nurse/patient position, I would be sitting on top of the patient, watching them with both eyesballs wide open, as would the Doctor next to me, and perhaps a number of other medical specialists. Yes, additional training and skills would be required, but it seems a more focused and straightforward environment.

What am I missing here, could someone give me a clue? Thankx. V-

sonnie · Mar 4, 2001

Yes it's true that you may only have 1 or 2 patients in the settings you described, and yes you can sit there wide eyed and stare at them. What do you learn? You learn 1 or 2 major systems, and how to take care of the problems of those systems. What you don't learn are skills like time management and priority of care. Medical-Surgical nursing is a great way to see the world of nursing. You get a variety of disease processes to help you understand each system. You learn what to worry about and what can wait to be worried about. You get a very good education in lab values and various procedures in short you get hands on nursing. New grads are desperately trying to figure out where they fit in the web of nursing and med-surg gives them a good idea of what will be expected of them on the units. I would rather have a nurse who started out on med-surg with maybe less critical patients move on to the sicker patients on the units. The m/s nurse will have a better understanding of why this patient is as sick as they are because he/she has seen the lesser degree and knows the difference.

sonnie · Mar 4, 2001

Yes it's true that you may only have 1 or 2 patients in the settings you described, and yes you can sit there wide eyed and stare at them. What do you learn? You learn 1 or 2 major systems, and how to take care of the problems of those systems. What you don't learn are skills like time management and priority of care. Medical-Surgical nursing is a great way to see the world of nursing. You get a variety of disease processes to help you understand each system. You learn what to worry about and what can wait to be worried about. You get a very good education in lab values and various procedures in short you get hands on nursing. New grads are desperately trying to figure out where they fit in the web of nursing and med-surg gives them a good idea of what will be expected of them on the units. I would rather have a nurse who started out on med-surg with maybe less critical patients move on to the sicker patients on the units. The m/s nurse will have a better understanding of why this patient is as sick as they are because he/she has seen the lesser degree and knows the difference.

TracyRN · Mar 4, 2001

Med-surg is the make or break of acute care. If you can make it on med-surg for at least a year without going nuts, you can head into pretty much any specialty unit with confidence. School gives you just enough knowledge to be dangerous. Its the real life experience that makes that license mean more than the paper its printed on. If the only knowledge you get is what you learn in a specialty area, what happens when you burn out in that one area? You have to start all over from scratch somewhere new. If you have a strong med-surg base, minimum 1 year, you have honed assessment skills for everyone from 18 to 100, all body systems, about all major diagnoses, and become comfortable in your nursing skin.

In this day of nursing shortage you can certainly skip med-surg. But be very careful about the specialty you choose: you won't have the mobility that the med-surg-experienced nurse has earned.

TracyRN · Mar 4, 2001

Med-surg is the make or break of acute care. If you can make it on med-surg for at least a year without going nuts, you can head into pretty much any specialty unit with confidence. School gives you just enough knowledge to be dangerous. Its the real life experience that makes that license mean more than the paper its printed on. If the only knowledge you get is what you learn in a specialty area, what happens when you burn out in that one area? You have to start all over from scratch somewhere new. If you have a strong med-surg base, minimum 1 year, you have honed assessment skills for everyone from 18 to 100, all body systems, about all major diagnoses, and become comfortable in your nursing skin.

In this day of nursing shortage you can certainly skip med-surg. But be very careful about the specialty you choose: you won't have the mobility that the med-surg-experienced nurse has earned.

lexffs · Mar 4, 2001

THE LEARNING EXPERIENCES PROVIDED IN THE MED SURG SETTING WILL HELP YOU THROUGHOUT YOUR CAREER IN NURSING.

lexffs · Mar 4, 2001

THE LEARNING EXPERIENCES PROVIDED IN THE MED SURG SETTING WILL HELP YOU THROUGHOUT YOUR CAREER IN NURSING.

3651bht · Mar 4, 2001

Hi V SPN,

Think of Med-Surg as a foundation to a house. If you have a solid foundation you will have a solid house. Those individual systems all mesh together. A PACU nurse needs to think about an open-heart patient's kidneys. What if they fail because of a blood clot? Would she know what to look for? A med-surg nurse would. I work both med-surg and out-patient hemodialysis. I use my med-surg experience alot. Imagine the day an experienced (CNN) hemo nurse asked me to listen to a patient's lungs. Know why? Becuase she wasn't sure if the patient needed further dialysis and she hadn't listened to lungs for 5 years ( since her school days). I listened to the lungs and charted lungs crystal clear to auscultation. I was rewarded later that day when the CXR proved me right. Don't think you can take the easy road because you can't. Get all the knowledge you can you'll be glad you did....... TTFN Some things worth doing are worth doing right....

[This message has been edited by 3651bht (edited March 04, 2001).]

3651bht · Mar 4, 2001

Hi V SPN,

Think of Med-Surg as a foundation to a house. If you have a solid foundation you will have a solid house. Those individual systems all mesh together. A PACU nurse needs to think about an open-heart patient's kidneys. What if they fail because of a blood clot? Would she know what to look for? A med-surg nurse would. I work both med-surg and out-patient hemodialysis. I use my med-surg experience alot. Imagine the day an experienced (CNN) hemo nurse asked me to listen to a patient's lungs. Know why? Becuase she wasn't sure if the patient needed further dialysis and she hadn't listened to lungs for 5 years ( since her school days). I listened to the lungs and charted lungs crystal clear to auscultation. I was rewarded later that day when the CXR proved me right. Don't think you can take the easy road because you can't. Get all the knowledge you can you'll be glad you did....... TTFN Some things worth doing are worth doing right....

[This message has been edited by 3651bht (edited March 04, 2001).]

cmggriff · Mar 4, 2001

VSPN,

All of the above replies are accurate and correct. The one thing that I have found to cause the most problems with new grads and Critical care is the equipment.

There is still so much to learn about pt assessment when we graduate. If an RN goes from school to the ICU, they often become too dependent on the machinary for assessment of the patient. But when I trained RN's who had worked med/surg, they always looked at the patient first. And they used the machines to confirm their hands on assessments. I still don't like working the "floors". But I could never get that essential experience as fast any other way.

cmggriff · Mar 4, 2001

VSPN,

All of the above replies are accurate and correct. The one thing that I have found to cause the most problems with new grads and Critical care is the equipment.

There is still so much to learn about pt assessment when we graduate. If an RN goes from school to the ICU, they often become too dependent on the machinary for assessment of the patient. But when I trained RN's who had worked med/surg, they always looked at the patient first. And they used the machines to confirm their hands on assessments. I still don't like working the "floors". But I could never get that essential experience as fast any other way.