New grad needs some honest advice

amarilla, RN · Dec 28, 2010

I'm a fellow new grad 6 months in on a surgical floor. First thing - congrats on graduating and passing NCLEX! Second: congrats on multiple job offers/interests! :yeah: It's a refreshing change to hear about people getting jobs and feeling excited to get started.

My opinion, for what it's worth: I too like med-surg, and this is why I accepted a position on a busy general surgery floor over two others, (cardiac and hospice.) I wanted the skills I felt this type of floor would provide, particularly the time-management, exposure to a range of patient conditions, and clinical skills; at the six month mark, I can say that I've learned so much and am grateful for the job and what it's taught me. I think you're wondering about the same, and with a good floor and team, I think you will also find yourself learning and developing rapidly with this type of environment. I can say that I actually feel like a nurse, which is something I didn't expect until at least a year.

That being said, I found your post particularly interesting because I also wanted to go to the OR after graduation. Our OR unfortunately wasn't hiring, and jobs for newcomers, (unless you've been a scrub or tech there), are scarce here. I've rotated to shadow there since beginning on my floor and know that I would still like to work there, so I'm currently trying to get a foot in the door to be considered in the future.

You've said that you miss the patient contact and worry that you will be stuck in the OR if you start there. I'm inclined to agree with you, honestly, that it may not be right for you. OR skills are specialty skills and not the same ones you will be using on the floor should you choose to transfer; you'll need to find your feet in an altogether different way, which is always anxiety-producing, IMO. The OR nurses I know love the OR and want only to work there. It's a feeling I've found common to most OR staff.

If you really want to be bedside and don't plan on the OR being your end-all-be-all, I suggest that you chase a job which gives you the foundation you seem to want. You can always make a change later, after all, but you'll never have the opportunity to orient as a brand new nurse again. Take advantage!

Best of luck!

I<3H2O, BSN, RN · Jan 5, 2011

I think you can never go wrong with med surg. You will learn skills there that you can take with you for the rest of your career. Think about in 3 years when you want to go work in a different area. They will think you have 3 years exp. as a nurse. You will be required to juggle things that you haven't done since nursing school and you will most likely feel like a failure.

BluegrassRN · Jan 5, 2011

If you want to do OR, do OR. There are plenty of opportunities for patient contact in various areas of the OR (pre-op, PACU, etc). You have the job there already. Do your orientation and put in your 6 months. After you've been there a while, you can make a better judgement regarding whether OR nursing is right for you, if there is another aspect of surgical nursing you would prefer, or if you need to make a move out onto the floor.

If you do decide to leave the OR entirely after 6 months, well, you have your foot in the door. You can internally transfer to an area that is a better fit, and not loose your seniority or your accrued benefits.

classicdame, MSN, EdD · Jan 6, 2011

the nurses in our OR are great preceptors. They are careful not to let new people get in over their head. You will not be working alone ever. I say give the OR a try and transfer when the company's policies allow if you are not happy. Good luck

carluvscats · Jan 7, 2011

I'll give you my story: took a pediatric home health job after graduation (no hospital jobs available) where I had one fairly stable client all the time (no bouncing from home to home), started feeling like I was a bit "too comfortable", so after one year of that, resigned was hired for the OR. In school we had very little OR exposure, so I really had no idea what a circulator did. Wow, was I in for a shock. It's true what they say about the OR, either you love it or you hate it. I was not cut out for the job or the atmosphere; I really missed hands-on care and felt like I was losing everything I learned in nursing school. It's just a completely different skill set in the OR. Thank God my manager was understanding; she saw that I had made an honest effort at trying OR nursing; I put in a for a transfer and nine months after starting the OR, I made my way onto a medical floor.

I have done 8 weeks of orientation and have been on my own for about 5 weeks now. It has been a game of trying to put ALL the puzzle pieces back together that were only partially together in the first place, courtesy of nursing school, some 2+ years ago. Very frustrating at times and very disconcerting almost all the time. I depend heavily on my co-workers, quadruple check almost everything and live in constant fear of harming or killing someone (I know, pretty normal they say!).

The great thing is that I finally feel like I'm getting a good foundation that neither home health nor OR could provide.

So you probably will guess that I'm going to encourage you to go with med-surg first; get some experience and confidence and then transfer out. Even if you don't stick with med-surg, I can't help but think you would be a better OR nurse having spent time learning and growing in med-surg.

Best of luck to you as you decide!

Ilovethe80s · Jan 8, 2011

Thank you so much for responding! I have actually lost sleep trying to figure out which path to follow. In the end, I think I will go to Med-Surg so I can work my way up to ICU. I talked to the OR manager, who I have great rapport with, yesterday and I expressed my concerns to her. I was amazed and relieved at how supportive she was. I told her that I love that OR, but since being there I've developed an interest in anesthesia and she told me "If you were my daughter, I would tell you to pursue anesthesia." She told me I was always welcome there if I ever wanted to apply in the future and that she just wanted me to do what would be best for me. I was so afraid she might be upset b/c they've been holding a position for me....but she wasn't.

Also, I admire you for being honest with yourself and your manager that the OR wasn't the place for you. It really isn't a job any nurse can do...it's very specialized and completely different from floor nursing (IMHO). Thanks again for your response...I really appreciate it :)

Bea1128 · Jan 9, 2011

Thank you all for your input. I too am a new grad. I had the opportunity to do an externship in the CVICU my last semester of nursing school. I absolutely loved it and know that's where I want to end up, eventually. I was hoping for an internship in the CVICU, but because of budget constraints, the hospital has decided not to do internships. They did, however, offer me a job in med-surg/oncology with a preceptor for up to 12 weeks. After reading everyone's post, I feel this is the right thing to do. I know med-surg will be very beneficial for not only skills experience but also time management. I'm very excited to get started and learn everything I can. Thanks!

carluvscats · Jan 9, 2011

Colleen1978, glad you have sorted things out, and that you had an understanding OR manager who probably gave you some great advice. Sometimes I think anesthesia is really where it's at. :) At my hospital, the CRNAs seem to be the happiest, most intelligent well-rounded nurses around, with incredibly diverse backgrounds, tougher-than-steel nerves and better than average schedules. Happiness might have to do with the six figure salaries, haha.

Anyway, I'm happy you seem to be at peace now. May you enjoy every step of your journey, no matter where you end up. :)