Putting in a year.

Nurses General Nursing

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  1. Should I put in a year on the Med-Surg floor as a new nurse?

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I'm on my last home stretch to get an ADN RN, and all of my instructors and local administrators are telling me I need to "Put in my year on the Medical Surgical floor. Does anyone have any thoughts on how beneficial putting a year in actually is for your career and your skill set?

I'm currently 5 months into my year on a Tele/MS floor. I would like to be in the ER and had the chance to as a new grad but I knew as a former LPN for several years before my RN, that a solid foundation in fundamentals would do me well in the end. I didn't get that in my first year as an LPN and it took me some time to become "good" as a result.

Let's be real though, MS/Tele is rough as they say which is why less new nurses actually want to do it. I don't stop in 12 hours, have 5 patients every shift, and its constant discharges/admissions. I actually just started to not dislike it because up until this point its been just trying to keep my head above water. I'm not a cryer but I cried in my car 3x during my 8 week orientation, its just so much coming at ya at one time. Many days I thought there is no way I'm coming back next shift.

BUT I have seen a lot already. I have been shoved out of my comfort zone, even more so when I float. I'm learning prioritization and utilization. And most important of all, I have learned how to get a handle on feeling like a tidal wave is coming at me and instead of internally spazzing, I'm finding my stride. I still have a lot I need to learn but I see the benefit of being on a MS/Tele floor already, much to my surprise.

Will I eventually love MS? No lol but I do see the benefit of a year in it. I've taken care of everything from CHF, sepsis, withdrawal, cancer, pancreatitis, post op, chest tubes, NG tubes, TPN, central lines, MI, stroke, and all kinds of drips. And that's just in 5 months.

I don't think its essential per say but very beneficial.

Specializes in CMSRN, hospice.

Depends on what you want to do, I think, but I'm glad I got my year, though I had already been a nurse for a minute. It really teaches you about a variety of diagnoses, and there is nothing like that firsthand experience where you can see what's happening and why certain treatments are effective. It is also a huge confidence booster to realize that you've survived the gauntlet, although there are definitely times when it doesn't feel worth it. Ultimately it won't break your career if you don't do a year on the floor, but it can't hurt (too bad, lol) and can be very beneficial in the long run.

I'm on my last home stretch to get an ADN RN, and all of my instructors and local administrators are telling me I need to "Put in my year on the Medical Surgical floor. Does anyone have any thoughts on how beneficial putting a year in actually is for your career and your skill set?

That depends entirely on your long-term goals.

Specializes in public health, women's health, reproductive health.

I agree it depends on your career goals. About 7 months on the floor is what it took for me to get into what I really wanted to do as a nurse. I'm not sure that it was working as a floor nurse that did it for me but rather the connection I made while working there. I had no intention of working in a hospital in acute care for any longer than necessary and I would not go back unless there was absolutely no other way to feed a starving baby. That being said, I did learn a lot there, not only in nursing skills but about myself as a nurse and as a person. I do not think everyone needs to work a year in acute care. It highly depends on the direction you want to take your nursing career.

From what I've seen and heard, it's more the putting in the year that matters (in some type of acute care setting helps a lot too...not necessarily just med surg). If you leave before a year is up, you're showing future employees that you may be a potential job hopper.

You'll hear lots of opinions on the whole starting out on med/surg thing, and you should weigh each opinion carefully because both sides have strong arguments. The reason so many believe starting in MS is a better idea is because you'll see a lot, learn a lot in general, and the acuity isn't so high that you'll be more overwhelmed than a new nurse usually is. One reason that others may say you don't need to start in MS is becauae, depending on your area and the job market, you'll still have no problem finding a job and you might be happier doing what you want to do from the beginning.

Ive has friends start in OB and ICU and then transfer to tele and ER respectively and they didn't seem to have a problem doing so.

So in general, there isn't necessarily a right or wrong answer in my humble opinion.

I'm currently 5 months into my year on a Tele/MS floor. I would like to be in the ER and had the chance to as a new grad but I knew as a former LPN for several years before my RN, that a solid foundation in fundamentals would do me well in the end. I didn't get that in my first year as an LPN and it took me some time to become "good" as a result.

Let's be real though, MS/Tele is rough as they say which is why less new nurses actually want to do it. I don't stop in 12 hours, have 5 patients every shift, and its constant discharges/admissions. I actually just started to not dislike it because up until this point its been just trying to keep my head above water. I'm not a cryer but I cried in my car 3x during my 8 week orientation, its just so much coming at ya at one time. Many days I thought there is no way I'm coming back next shift.

BUT I have seen a lot already. I have been shoved out of my comfort zone, even more so when I float. I'm learning prioritization and utilization. And most important of all, I have learned how to get a handle on feeling like a tidal wave is coming at me and instead of internally spazzing, I'm finding my stride. I still have a lot I need to learn but I see the benefit of being on a MS/Tele floor already, much to my surprise.

Will I eventually love MS? No lol but I do see the benefit of a year in it. I've taken care of everything from CHF, sepsis, withdrawal, cancer, pancreatitis, post op, chest tubes, NG tubes, TPN, central lines, MI, stroke, and all kinds of drips. And that's just in 5 months.

I don't think its essential per say but very beneficial.

I could have written this exact same thing! Just last week is when I finally realized that I don't dread going into work and actually like some of my patients! Before then I would try to get in and out of the room as fast as possible because I felt so overwhelmed about how much I had to do. Now that time management is down, I have more time to actually get to know my patients. I've also gotten to the point where I'm catching things related to the patient's health and know what to do in a rapid reaponse (without freakin out), so that feels good. I'm starting to feel like an asset.

So that is another thing OP. There's no better place to learn time management than those general floors.

The "putting in a year" mindset is a large part of why so many hospitals are increasingly reluctant to hire new grads. Hospitals spend a lot of time and money orienting new grads, and it takes at least a year, more like two, for new grads to start becoming an asset to the organization rather than a financial liability. When people leave after one year, the hospitals are just taking a loss on having hired that person. (Of course, moving elsewhere within the same organization isn't as bad for the employer, although it's still a problem for that med-surg unit.)

I don't know what your goals are but this is just my general opinion/personal preference...

I don't identify with/understand the mindset of wondering "what's the minimum I can do" or "what's the most I'll have to do" in order to get on to something else in nursing. If one's goals involve acute care, then having that time to progress from novice to expert (or at least highly competent and working with some semblance of a degree of comfort) seems incredibly important. Maybe it's the personality differences of human beings, but I would hate the idea of doing something only long enough to be able qualify to fling myself at something else and go right along through life without the idea of allowing time to become really good at what I do. Time in that first acute care position (assuming it's an overall healthy situation) is, to me, utterly foundational. Everything else you wish to do is built upon that foundation. The time to think about moving on is after one has become reliably competent and comfortable in the role, performs it very well, and is a go-to resource for others because of knowledge, skill, and wisdom.

So, I have to come down on the side that would say that a year is bare minimum. I'm not even entirely sure it's good to talk about it in terms of "how long must I..." Become good at what you do. Become excellent.

The answer to you question depends on what skill set you want to have. But if your goals are clincally-oriented/involve direct patient work OR any role that affects those who do direct patient work, then yes, I think it would be a very, very good idea and I think you should view "a year" as not a goal to reach but a minimum. The reaon to stay at least a year isn't to help your employer recoup their "investment" in you or to avoid looking like a job-hopper, but to give yourself an excellent nursing foundation.

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