May Graduates: Med-Surg or Specialty area?

  1. I've heard both sides of the issue concerning whether or not new grads should work med-surg for at least 6 mos. to 1 year before going to a specialty area. I am not opposed to working on a med-surg unit, however, it wasn't my first choice. Luckily, the hospital was more concerned about putting me somewhere that I would be happy vs. sticking me somewhere I didn't really want to go. I just wanted to know where everybody is going, why you chose your respective units, and what's your take on the issue. Congrats to all!!!
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  2. 13 Comments

  3. by   EDValerieRN
    I am starting soon, and I went directly into the ED. I did this because Emergency nursing had me hooked the first time I tried it, and I know I don't want to be anywhere else. My hospital also has a great orientation and preceptorship. I don't know if I would have jumped in so soon if they didn't.

    Med-surg isn't for me. I was on a m/s unit as a CNA and Nurse Intern, and I liked the ED much better. M/S isn't easier or harder than other areas, just really different. I noticed that in my facility, staffing in the M/S units was always a mess, but this probably has to do with the management.

    Follow your heart, and start out where you feel like you should. If you go somewhere and are unhappy... it may cause burnout of nursing as a whole, and not just a particular unit. M/S is a specialty in itself... and I thought it was much tougher than ED, just because of the staffing issues, having to worry about delegation to LPN and CNAs, and having so many more patients... plus I would rather take care of my patients for a short time while they are critical and then ship them off. It keeps me interested I guess.

    Good luck in whatever you decide.
  4. by   Spidey's mom
    :yeahthat: Definitely go where your heart is.

    steph
  5. by   raynefall
    I, personally, would rather go into a specialty and bypass med surg all together but I will bite the bullet and work in it for at least 6 months. I believe that it will be better for me in the long run, if I get that med surg experience. I'm interested in working in ER, NICU, Neuro, Forensic, ICU, TICU, and doing travel nursing. I've thought ahead on my future nursing career plans and I decided it would be best for me to work on a medical surgical floor first to get that foundation and then move on.
  6. by   LadyT618
    I'll be starting in a Critical Care unit (CTU or CCU) for my first job. No interest in Meg-Surg for the same reasons (staffing issues). Always had a love for the heart and how it works (and doesn't work sometimes!)
  7. by   Aneroo
    I too will be in the ER after I pass my boards. I've wanted to be an ER nurse since I was 13...it only makes sense. Besides, to me, it's the best place to get experience with everything. What a better place to get good skills and get awesome assessment skills. I have a 14-16 week orientation, so I will have a lot of time for training. -Andrea
  8. by   HappyNurse2005
    I'll be starting in a Cardiac Surgery PCU. The orientation is 12-14 weeks. I am not interested in med surg, it just wasn't what captured my interest. My eventual goal is L&D or NICU or PICU, adn I think the PCU experience would be a better preparer. Plus the unit environment seems great.
  9. by   grinnurse
    I originally had decided to go into Oncology which was a night shift 50 miles from my house (one way) b/c the hospital that I wanted to stay at only had night shifts of varying nights off and on. Well, when I told them that I couldn't work that shift they were sad that I wouldn't be coming back to them (I had worked for them 4 years in a tech position). But then, a couple of weeks ago, they had a day nurse that was wanting to go to nights so they ended up being able to offer the new day shift and I took it!! So I will be starting in M/S instead. Although it's not exactly what I wanted to do, I too feel that it will be better in the long run and open up many more doors in the future. I eventually want to go into ER, Oncology, and when I am a little older Home Health. All of these departments really prefer a years worth of M/S.

    Alot of how I came to my decisions were based on the needs of my children and how much time I would have to be away from them. They haven't had me for close to 2 years with NS and all and wanted to have a schedule were I could spend more time with them.

    Follow your heart though if you can. Good Luck
  10. by   MandyInMS
    I guess if you are unsure of exactly where your heart lies, med surg is a great place to start..you learn so much about sooo many diff areas/conditions...but you you have your sites set on a particular specialty goooo forrr ittttt with proper orientation shouldn't be a problem...but make sure you have an extended orientation period if you're a new grad..don't let 'um "throw you to the wolves" .......best wishes
  11. by   LilRedRN1973
    I was worried about not doing my "time" in Med-Surg until these last few weeks of my final practicum on a med-surg floor. The skills needed on this floor (medical and nephrology) is MUCH, MUCH different than those needed in ICU. I've been precepting in the ICU as an Apprentice Nurse for almost a year now and I'm truly amazed at the difference in organization between the two floors/units. My organization method DOES NOT work up on Med-Surg and I'm lost. I've had to really put what I've learned in the ICU out of my mind in order to have any sanity during my practicum.

    I'm one of those who enjoys a structured regimen. I like having assessments every 2 hours and having to chart every 2 hours. I get thrown when I can't get all my assessements done by 8:30 up on Med-Neph as I can down in the ICU. I like the really, really sick people....I love titrating drips.....I love seeing someone who wasn't expected to live the night get well enough to transfer out of our unit up onto the floor....I love seeing someone extubated successfully....I love seeing a former patient return, walking on their own to say thanks.....I really like the entire atmosphere of the ICU.

    I think it would be worse for me to have worked a med-surg floor, then transfer down the ICU because I truly would have to "unlearn" a lot of things. That being said, I am really amazed at the floor nurses and tell them daily how unbelievable I think they are. Their assessments skills are top notch, they are patient and friendly with all the patients up on the floor (even those days when they have 7-8 patients!!!), and work their asses off. I really admire them and can't believe how "beat up" I feel when coming home from those 12 hour practicums. The days do go by really fast (faster than mine do when doing my ICU shifts) and it's over before I know it.

    I was concerned, but after spending four 12-hours shifts (and 2 more to go) in a med-surg environment, I really believe that personality has a lot to do with where a person should end up. I LOVE my unit and plan on being there many more years. I start my 3 week orientation (yes, 3 WEEKS) on June 6 and then God willing, once I pass my boards, will be on my own by the first week of July.

    Melanie = )
    May 24 Graduation!!!!
  12. by   CarVsTree
    [QUOTE=RNnTraining1973]I start my 3 week orientation (yes, 3 WEEKS) on June 6 and then God willing, once I pass my boards, will be on my own by the first week of July. /QUOTE]

    3 weeks!!! I'm sorry but that is not a reasonable orientation for ICU. You've been interning there. Is that a tech job or have you actually been practicing nursing under an RN. I've never heard of an ICU preceptorship of 3 weeks. Heck, med-surg internships at my hospital are 8 weeks. 3 weeks sounds very unsafe.
  13. by   Aneroo
    WHOA! I too agree. I don't how long you've worked there as a tech or intern, in an ICU you need a heck of a lot more than three week orientation. Demand it! You don't need to be on your own in three weeks...it's unsafe. If you chose to do so, get some awesome malpractice insurance. -Andrea
  14. by   LilRedRN1973
    Sorry....I failed to mention that I've been working as an Apprentice Nurse since June of last year. So almost a year of functioning in the capacity of an RN, working under an RN. I do all assessments, charting, calling docs, taking orders, giving meds (except IV meds), trach care, and anything else the RN is responsible for. I worked full time (3 days a week) through summer and then cut back to 2 days last semester and this semester, one day per week.

    I feel comfortable yet still have that little bit of fear that I think is healthy to have in a critical care environment. I am the first person to ask all those "stupid questions" and have been told by my preceptor that asking those types of questions are what make me a good nurse, not a stupid nurse. My co-workers are EXTREMELY supportive of all the new grads and other RN's there and I will be working nocs where it's a bit slower paced, allowing me more time to get my thoughts together.

    I still am a bit scared at only have 3 weeks, but other RN's have told me that having been precepting there for almost a year, I will probably be fine. I feel sorry for two of my classmates who just started their Apprentice Nurse positions at the end of January. They've only been there a few months and are only going to get 5 weeks of orientation. I'm really glad I started when I did. I actually began working in the ICU in December of 2003, right after my first semester of school was over. I started as an Apprentice Nurse I/Critical Care Tech, which gave me a lot of exposure to the ICU environment, familiarized me with staff, physicians, location of equipment, protocols, etc. So once I start in June of this year, I will have been in this department for 1 1/2 years.

    I could still use a longer preceptorship (as anyone could), but I'll see how I feel once I'm done and they are ready to set me on my own. They do assign patients for you in the first few months.

    Melanie = )

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