Med-surg First

  1. remember in the old days when everyone had to do med-surg first before moving into specialty areas. i was just wondering how everyone else felt about this. i work med-surg and also post partum. seems like many of the new grads who go straight to pp instead of doing med-surg are lacking some very important basic skills. i.e., ng tubes (yes, we do get these sometimes in pp), scd's, blood sugars on Mom's and what they mean, iv skills, time management skills. ok, so it is very obvious what i think about this subject, what do you think.....
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  2. 15 Comments

  3. by   Sleepyeyes
    i've worked LTC and MS/Tele, but if you put me on an OB or Pede unit (nonono, you can't make me float!! :chuckle )

    I'm sure you'd see the same problem--I wouldn't have a clue. To me, they're just different specialties with different skill needs.
  4. by   cokie
    i'm not talking about specialty areas. in general, i see it as a trend that hospitals hire new grads for specialty areas, with no med surg experience. i'm just not sure that this is such a great idea. i wonder what would happen if a pp patient started to throw a pe, would the person be able to recognize it.....just a thought....
  5. by   Arkansas
    Hey Cokie

    I'm about to graduate in May. This subject is one that I had planned asking everyone here at allnurses about. Most my instructors agree with you in that working Med/Surg first gives the best foundation in every nurse. I'm not really excited about going straight to med/surg, but if it would make me the best nurse that I can be, I think that's what I'll do. How long would you reccomend I stay with the floor before moving on to wherever else I desire to work (i.e. Surgery, ICU, ER)?

    Arkansas
  6. by   CCL"Babe"
    My hospital used to have a policy that for critical care areas you had to have a year med/surg. When I graduated there was a shortage so that rule flew out the window. I wanted ER and had worked there as a tech. I got hired to telemetry, I'm glad now that I didn't go straight to the ED. I have never worked med/surg in the 20 years I have been in nursing. Tele was a good start for me. I've seen RNs jump into specialties like ER and ICU, but I think that's generally not a good idea. Some new nurses are able to handle the jump, but not many.
  7. by   Darlene K.
    I think MS is the place to start. It gives you a good foundation to build on.
  8. by   Ortho_RN
    But cokie.. Most of those skills that you mention... New grads are lacking anyways.... Most things just come from experiance on the floor...

    I think new grads should go wherever they want to go... Obviously if the hospitals or these specialty units didn't think new grads could handle these areas, they wouldn't put them in it... Most give great Orientations 6 or more weeks, but somethings you will just have to experiance first hand while you are working..
  9. by   cokie
    i think 6 months to a year is a good start. this way you are able to get your time management skills down, see and have a chance to practice most skills. the hospital where i work in med-surg (i also work pp) used to let new grads go straight to er, icu, ob...now the new policy is 6 months of med-surg, before specialty areas. i realize that after spending almost all of nursing school in med-surg, most new grads don't want to work ms. i understand this...my goal was pp, but i took a med-surg job because that was all that was offered at the time. now i am glad that i did. it makes me appreciate the specialty all the more. plus, i am the person that they turn to for iv starts, scd's, ng tubes, k pads,...i have had some bad experiences in following people, some experienced and some new grads, that didn't remember the basic skills of nursing...i.e, checking ng placement q shift. i walked into pp and here was my patient with an ng tube and one look at the suction canister told me that it was not in the stomach. if that was the first one i had seen i would have thought that all was well...have many other experiences and i have only been on pp for a number of months.
  10. by   sjoe
    A year of med-surg is what I always recommend to people coming out of nursing school.
  11. by   SmilingBluEyes
    I did not do the requisite med-surg year out of school. Like said above,ALL grad nurses are bigger liablities than assets to their new employers and I learned things FAST. I also floated to med-surg and ICU when OB was slow, and did pick up a lot of skills those places. I only speak for myself here but, I was NOT going to burn out in med-surg my first year out of school, no way, no HOW. Despite not spending that year in med-surg first, I am a darn good OB/GYN/Newborn nurse, 6 years later, if I do say so myself. Just open yourself up to all learning possibilities, find a good mentor (or several, if you are lucky), ask lots of questions, don't be lazy, and be a sponge and you will make out fine. I did.
  12. by   cactus wren
    I did 3 months on a M/S floor, on my Gn while waiting for NCLEX results...And was forever grateful when I got my "real" license , and moved to ICU, and have been there ever since.....


    Now as a card carrying'old fart", am glad...don`t think my poor feet would stand 12 hours up and down long halls...and for sure, i don`t have the skills required for M/S nursing...you need to be much more organized to care for 8-10 patients, than I do with my 2-3....My hats are off for the M/S nurses...but I think I`ll stay where I am...
  13. by   KailuaNurse
    I was hired into a PICU residency program. The idea is to work in Med/Surg for a year then move up to the PICU. I also did my senior practicum in the PICU that I will be moving up to. I am about six months into my new job, and I think that doing Med/Surg nursing has been very benefical. I have been able to improve on my nursing skills and assessments and learn time management. I agree that new grads should do at least a year of med/Surg. It will help to make you a better nurse in the long run.
  14. by   fergus51
    I went almost streight into OB and have never regretted it. I may not have been fab at NG tubes, but neither are the seasoned maternity nurses because it's been ages since they did med surg anyways. I had to explain what digoxin was to one of my colleagues the other day. I think she worked med surg sometime around the ice age Med surg where I got my first job was an absolute hell hole and if I had to stay there longer than I did (about 3 months) I am sure I would've quit or been sued.

    Our current unit manager actually prefers to take the new grads instead of the ones who do 6 months in med surg (thouhg with the shortage she'll take anyone). She says the reasons are that it isn't fair to the med-surg units to use them for 6 months and then leave. It's also less stressful to just have one orientation in one area in one year than to be moving about. And she says she can groom them better if they haven't picked up any bad habits.

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