Help choosing my precepted unit

[FutureDNP2021, ASN, RN]

Once I graduate my BSN, I have the opportunity to enter a 2 month state funded, new-grad preceptor program. Wherever I choose, they give me an interview at the end for full-time employment. I want a challenging preceptor in a acute unit, but I do not feel safe to start my first full-time job in an acute unit as a new-grad. I am able to choose from any acute specialty unit at any hospital of my choice. Id think that a higher acuity unit like Trauma, ED, Critical Care would provide the best exposure for my long-term career. I feel that the 2 months between licensing and my first actual job is a great opportunity to get some challenging precepted training, in an acute unit. Precepting in med-surg does not feel worth my investment of 2 months of working there for free. I want to make the most of the experience, but I also do not want to waste the included unit interview opportunity at the end of the preceptorship either. Id feel more comfortable to follow other nurses advice and start my very 1st job in a Med-surg floor for my first couple years, until I gain my bearings. So should I chose a preceptorship in a highly acute unit like Trauma or ED to experience my long-term career goals, even though I know my first job will be lower acuity unit? Or should I just skip the preceptorship & once Im licensed just get focused on the first step in my career path's 2 year, full-time working in med-surg phase? ~ THX ~

[HouTx, BSN, MSN, EdD]

Based on my (plenty one) years as an educator working with new grads during their transition to practice, the HARDEST skill to master is time management.... learning how to prioritize and deal with all of the "stuff" coming at you during a shift. This takes a while. Going through a 2-month experience in a high-intensity area won't translate very well to a MedSurg area. The contrast is greatest in ED, which is based upon episodic care - it's very different from an inpatient unit. ICU's generally have a 2:1 pt/nurse ratio - it's a completely different ballgame in MedSurg, where you'll probably have at least twice as many patients.

From a practical standpoint, you may want to find out how they will arrange your 'real job' orientation after the preceptorship. Will you get another 6 weeks or so before you're expected to function independently? If so, it may all work out OK. But if you're expected to hit the ground running in that new job because you have had the benefit of the preceptorship, it may not turn out well because you won't have enough time to get used to a completely different setting.

Wishing you the absolute best of luck on launching your career.

[llg, PhD, RN]

Go where you plan to work. Not only will that help you be successful in your first job ... you won't be wasting another unit's investment in you. Those other units (trauma, ED, etc.) can't afford to be investing in you if you have no intention of working there right away. They need to be using their scarce resources investing people who are actually interested in working for them soon.

The preceptorship sounds like a great opportunity to establish a solid foundation that will help you get your career off to a good start. Don't waste it by squandering it on a "sight-seeing trip" that may not help you much.

[Here.I.Stand, BSN, RN]

What is this about "Precepting in med-surg does not feel worth my investment of 2 months of working there for free?"

You're not going to be paid for this internship?

If I understand correctly, my advice is to skip it entirely. Don't work for free...ESPECIALLY if you aren't guaranteed a position. Heck I wouldn't even want a paid internship if it meant my job hunt was just beginning.

Look for new grad programs where you are hired FIRST, then begin precepting.

As for your question, I agree with the above that med-surg is a great place to start, if you plan to work med-surg. (Although I have to point out, it *is* an acute unit.) Really 2 months of an internship followed by 2 years in med-surg means you have 2 years' med-surg experience....same as if you started med-surg right out of school.

If trauma interests you, you could also look into working the surgical floor in a level 1 or 2 trauma center. Where do you think trauma patients go after they're done in the ED? ICU or floor, depending on acuity. It's acute care, not critical, similar to med-surg -- just a different population.