Specialization after Graduation???

  1. Hello everyone!

    I am posting this question and poll for a group nursing project. We are just a few months away from graduating and this information would be very helpful for us. You participation is greatly appreciated!

    Question: What are your thoughts about a nurse going straight into a specialized nursing field after graduation? Please give examples of successes or failures with regards to this type of transition.
    •  
  2. Poll: Should a new grad specialize right after graduation?

    • YES

      65.00% 26
    • NO

      35.00% 14
    40 Votes
  3. 31 Comments

  4. by   SmilingBluEyes
    I went directly into OB after graduation. NO problem transitioning other than being a green nurse; which every new grad IS.

    another thing I believe: ALL areas are "specialties" not just the ones we recognize, and that would include med-surg nursing.

    So any area you choose after school will challenge you. It will frustrate you. You will learn. Med-surg is a good place to start to lay a foundation for other areas, but dont' make the mistake of thinking it is not a speciality. IT IS!!!!!!!!!!!!!!!!!
  5. by   nekhismom
    I agree with Deb. Med Surg is a specialty.

    I think the cookie cutter approach of everyone specializing or not is not applicable. Because no matter what you do, it is specialized in some degree. So, yes, all new grads specialize in something. If you were asking if new grads shouldn't go into areas like OB, L&D, ICU, OR, etc, that answer depends on each person. Everyone has to do what is best for him/her. Some people NEED the time on med/surg to develop confidence or to develop skills to progress to intensive care areas. Others have a passion or desire to work in areas other than adult care, or simply HATED their med/surg experiences. Those who hated med/surg should probably not work on a m/s floor after graduation. But it just depends on the individual.
  6. by   fergus51
    I specialized as a new grad and have no regrets. I have oriented both new grads and med-surg nurses and haven't seen a big difference. It's very individual.
  7. by   Tweety
    I agree, it's o.k. to go into a specialty right away, especially if one is sure of the area they want to go into.

    I wasn't sure what area I wanted to go into so I choose med-surg. Been in med-surg or slight variations ever since.
  8. by   BarbPick
    I always use my Cousin Susan in all of my examples of mistakes, , well just some of them.
    Anyway, she went straight into Mother/Baby for 18 year, did not float much and her job was phased out. She was under the impression she was a nurse who could do anything. She found out later that you do not handle sick people on Mother /Baby. I don't mean ugly situations, but in Mother /Baby 90% of the patients are routine and bascially well.
    She was so sorry she did not do at least 6 months on an adult Med Surg unit in the begining. She was so lost, she had to go take a nurse refresher course just to function.
    I believe it is most important to know how to take care of sick people first.
  9. by   SmilingBluEyes
    I don't think I will be anyone's example of a "mistake" here in saying: I am in no fear of being phased out as a nurse who can provide care for Obstetric, PP, newborns and GYN patients. I do take care of "sick" people in OB quite often, as well as GYN, so I think Barb can't speak for all who specialize after graduation. I just can hardly believe there was nothing for a Mother/Baby nurse to go to after her job was lost. What about labor/delivery? What about GYN ? Mother/baby nurses do have surgical experience with csection recovery. I am sorry, it's so hard to believe: There ARE things she could have done.

    And like I said, I think all areas are specialties on one level or another. How highly specialized, well that varies. But there is room for us all; unless we suddenly stop having babies in the country. Or unless women quit having hysterectomies and/or pelvic repair work done. Yes, med/surg experience cannot hurt in any area, but I don't think going there is FOR everyone. It wasn't for me.
    Last edit by SmilingBluEyes on Feb 15, '04
  10. by   fergus51
    I also have to point out that nurses who have 6 months of experience 20 years ago aren't current anyways. I had one nurse ask me what DIE-G0-XIN was (digoxin). She had done her time on med-surg in the 60s.....
  11. by   gypsyatheart
    It used to be the standard that you had to complete 6mos to 1yr doing Med-Surg, which is a specialty unto itself, to "learn" how to be a nurse. This is no longer true. I knew exactly what I wanted to do when I graduated and I went directly into my chosen area....if I had been forced to spend a yr on med-surg,...I just don't know...
    Now, new grads are coming into all "specialty" areas. Some don't like it, and, yeah, they transfer to a different area, and learn all about that. That's one of the beauties of this profession, there are so many options!
  12. by   BarbPick
    This is not 40 years ago, as you are comparing to a nurse in the 60's. This is recognizing when a patient becomes ill very quickly. I will not get into an arguement.
    It amazes me how quickly some are to use someone name in their reply, when they disagree as if to dress them down for having their own opinion. Making it so personal when it is something to just discuss. I have sent these posts to the moderators. This was written by Ted after I sent the posts.

    No wonder Ted the moderator had to post this:

    Is is a full moon outside? Are we all just in a cranky mood?

    Or maybe it's just me. Maybe I unreasonably wish that we can have debates and discussions that do not spiral down to mud slinging.

    Honestly! I don't care what you choose to discuss or debate. But I do care how you respond to one another. I know that not every post can be perfect example of polite debate. But, GEEZE FOLKS, there's been more debate about each other than on the topics at hand.

    Here's a few suggestions (Note: JUST suggestions, not rules!):

    1) If the debate starts to get heated, count to ten before posting.

    2) If the debate gets too heated, avoid addressing each other by name. Instead, just write more in general terms. . . again focused on the topic. (Honesty time: I actually hate it when people address me by name during a recognized debate. It is a pet-peeve of mine!)

    3) Stick to the topic at hand. (Am I beginning to sound redundant?)

    4) Write to those as you would like to be written to. (Does that make sense?)

    5) Do NOT debate like "they" do on television. What's usually seen on those "Point/Counterpoint" type debates is entertainment, NOT constructive discussion/debate! We're better than that, folks!!

    Feel free to add any Constructive advise on respectful debating. I'm sure many of us have taken debate classes (or something along those lines). Share your knowledge. What have been your postive experiences in a healthy, respectful debate?? Share!

    Finally, this is a "Current Events" forum. Any type of current events can be posted here (just as long as it's kept in the PG-13 realm.) In other words, it's "O. K." to post topic that's not necessarily political. No one is going to discourage the type of topics posted here. But variety is the spice to life. There's a whole world of current events happening out there. Some interesting. Some not so interesting. But all fair game for this forum!

    With only my deepest respect to you all!

    Ted

    P. S. Again, if you see a post or member who is violating a TOS, report that post or member to the moderators/administrators.
  13. by   mspringer
    Quote from BarbPick
    This is not 40 years ago, as you are comparing to a nurse in the 60's. This is recognizing when a patient becomes ill very quickly. I will not get into an arguement.
    It amazes me how quickly some are to use someone name in their reply, when they disagree as if to dress them down for having their own opinion. Making it so personal when it is something to just discuss. I have sent these posts to the moderators. This was written by Ted after I sent the posts.

    No wonder Ted the moderator had to post this:

    Is is a full moon outside? Are we all just in a cranky mood?

    Or maybe it's just me. Maybe I unreasonably wish that we can have debates and discussions that do not spiral down to mud slinging.

    Honestly! I don't care what you choose to discuss or debate. But I do care how you respond to one another. I know that not every post can be perfect example of polite debate. But, GEEZE FOLKS, there's been more debate about each other than on the topics at hand.

    Here's a few suggestions (Note: JUST suggestions, not rules!):

    1) If the debate starts to get heated, count to ten before posting.

    2) If the debate gets too heated, avoid addressing each other by name. Instead, just write more in general terms. . . again focused on the topic. (Honesty time: I actually hate it when people address me by name during a recognized debate. It is a pet-peeve of mine!)

    3) Stick to the topic at hand. (Am I beginning to sound redundant?)

    4) Write to those as you would like to be written to. (Does that make sense?)

    5) Do NOT debate like "they" do on television. What's usually seen on those "Point/Counterpoint" type debates is entertainment, NOT constructive discussion/debate! We're better than that, folks!!

    Feel free to add any Constructive advise on respectful debating. I'm sure many of us have taken debate classes (or something along those lines). Share your knowledge. What have been your postive experiences in a healthy, respectful debate?? Share!

    Finally, this is a "Current Events" forum. Any type of current events can be posted here (just as long as it's kept in the PG-13 realm.) In other words, it's "O. K." to post topic that's not necessarily political. No one is going to discourage the type of topics posted here. But variety is the spice to life. There's a whole world of current events happening out there. Some interesting. Some not so interesting. But all fair game for this forum!

    With only my deepest respect to you all!

    Ted

    P. S. Again, if you see a post or member who is violating a TOS, report that post or member to the moderators/administrators.
    Barb,

    Can you give me some insight into our topic at hand. You spent a lot of time reminding users of bulletin board rules, but neglected my topic for the most part. Any insight would be useful! This is for a project....not just chit chat.

    Thanks,

    Marc
  14. by   BarbPick
    Quote from mspringer
    Barb,

    Can you give me some insight into our topic at hand. You spent a lot of time reminding users of bulletin board rules, but neglected my topic for the most part. Any insight would be useful! This is for a project....not just chit chat.

    Thanks,

    Marc
    I made my comments. follow the thread. Called out by name for giving my opinion like there is just one way. I do not believe in going to a specialty without learning how to organize time, learing how to tell when someone any age becomes ill .
    I have been practicing for 28 years and hold an advanced degree. My insight was given early in the thread.
    I guess you missed it. I will cut and paste it.

    BarbPick vbmenu_register("postmenu_670486", true);
    Registered User



    Join Date: Sep 2003
    Location: South East Florida
    Posts: 1,055


    I disagree
    I always use my Cousin Susan in all of my examples of mistakes, , well just some of them.
    Anyway, she went straight into Mother/Baby for 18 year, did not float much and her job was phased out. She was under the impression she was a nurse who could do anything. She found out later that you do not handle sick people on Mother /Baby. I don't mean ugly situations, but in Mother /Baby 90% of the patients are routine and bascially well.
    She was so sorry she did not do at least 6 months on an adult Med Surg unit in the begining. She was so lost, she had to go take a nurse refresher course just to function.
    I believe it is most important to know how to take care of sick people first.
  15. by   gwenith
    Marc This is an Aussie example so I don't know how much use it is to you.

    I have recently worked two different ICU's within this city -

    ICU A - routinely employs new graduates - up to 25 at a time as "warm bodies". The staff of this ICU never "float" (we say pool - guess both terms are about being in deep water) Few will work agency or outside of thier own unit and those that do have a poor reputation for being very intolerant of different methods and approaches to practice. The practice in this unit is very prescribed i.e. eye care is done second hourly regardless of the patients ability to blink and the condition of the eyes.( they will even do 2nd hourly care on patients who are post -op high dependency "baby-sit type patients) The staff on the whole are very insular and have major knowledge deficits i.e. they did not know about bladder scanners or alcohol withdrawal assessment because they had never used them within that unit.

    ICU B Smaller and mixed ICU/CCU staff with rare exceptions must be 12 months post-grad (does not matter where). Staff float/pool reasonably regularly. Patient care is individually tailored to requirements i.e, if the patient is more comfortable sleeping in a recliner chair then they are allowed to. It must be THE most proactive unit I have ever had the pleasure of working in as far as showering ICU patients. Staff go out of thier way to do "special" things such as taking a long term vent (e.g. Guillian Barre) outside.

    If you are familiar with Benners theories (Novice to Expert) what can be seen happening is that ICU A due to the large number of junior staff with a narrower focus of experience and the tendency to promote (preferrentially) those staff teh overall expertise of the unit declined. Instead of operating at an expert level they are now operating at the level of "competant"

    ICU B due to the wider experience of the staff are operating at expert level.

    If you need me to elaborate please post and I will try to do so

close