Age Old Med-surg Experience Question

prmenrs, RN · Sep 28, 2003

Supposedly, it is to hone your clinical and organizational skills, and then move on if desired.

However, when a student wants NICU or Peds, honing all those Med-surg skills means it will take longer to UNlearn them when the graduate gets to where s/he REALLY want to be. IMHO, that's a big mistake, because premies, babies, and children are NOT adults, they have immature organ systems, they evidence disease in different and more subtle ways, they 'process' medications differently, and they often have very different social and developmental issues. NICUs and PEDs want them as new grads, and often have extensive orientation and mentoring programs. Way to go!

I'd be willing to bet that the practice originated in hospital Schools of Nursing trying to staff MedSurg floors w/new grads. When there was less variety in Nursing, it might have been a good thing. Now, with increased specialization, I think you could evaluate where the student thinks s/he ultimately wants to be. If they want to do adult ICU, a year in M/S won't hurt.

Long Term Care Columnist / Guide · Sep 28, 2003

I don't know about the research, but as a hospital RN I can't help believing that med/surg is the best all-around experience one can get. Not only do you see a little bit of everything, you see a LOT of chronic diseases, which are by far the most common health problem affecting people of all ages, and you learn how to help patients manage them. You also gain invaluable time-management and multi-tasking skills which will serve you well throughout your career.

But that's just my opinion.

Tim-GNP · Nov 1, 2003

I think that the 'one year of med/surg experience' myth was applicable 30 years ago when nursing was less developed than it is today.

I think those of us who work in specialty areas can all agree that there is a specific knowledge base that exists specific to the area of nursing we work in.

I encourage my senior students to go right to the area they want to work. If they hated med/surg but loved pediatrics... why make the agony of med/surg continue for them???

In my humble opinion...

Vsummer1 · Nov 1, 2003

Originally posted by Tim-GNP
I think that the 'one year of med/surg experience' myth was applicable 30 years ago when nursing was less developed than it is today.

I think those of us who work in specialty areas can all agree that there is a specific knowledge base that exists specific to the area of nursing we work in.

I encourage my senior students to go right to the area they want to work. If they hated med/surg but loved pediatrics... why make the agony of med/surg continue for them???

In my humble opinion...

I had my peds eval today. My instructor said basically the same thing as you do. I asked if she thought I might "fit" the peds unit, since I really didn't like Med/surg. She said she thought I would do well there, but I might want to consider going straight to NICU. I took that as a compliment!

Todd SPN · Nov 1, 2003

Originally posted by profjanmc
As a nurse educator of new graduate students, I am often asked "Why should I do a year of med-surg after graduation?" I have no evidence (research) to support my answer. Any ideas/research articles about it? Thanks

I'm curious, what is your answer? I went to school to specifically work LTC and that is what I am doing. One of my classmates wants to be a flight nurse (she was shift commander and EMT at a firestation) and she is now working ER, another classmate wanted to only work in clinics and that is what she is doing, 2 wanted L&D and that is what they are doing.

profjanmc · Nov 1, 2003

Well my reply is basically, do what you love and it will serve you well, if you love something, you are more likely to stick with it through thick and thin, but I have no evidence to prove it works out for them. In this era of "evidence based" practice, I have only opinion to offer, that's where my dissertation steps in....Wish me luck!

psychomachia · Nov 2, 2003

profjanmc writes: "I have no evidence (research) to support my answer."

ME: That's because there is NO evidence to support the "age-old" myth of what constitutes experience in nursing, just as there is no evidence to support the myth of "what makes a better nurse, an ADN or BSN?"

And if your unsure, just look up the definition of anecdotal evidence...

Everyone has a right to find out what area of nursing they want to work in without yesterday's rules being held over their head. And in this day and age, to tell someone they have to go do a year of med-surg before doing what they really want is not only outdated, but probably a good way to continue fueling the nursing shortage.

Do doctors have to practice a year as a GP before going into a specialty? NO. So why should nurses? Of course training has to be in place that consists of more than the "see one, do one, teach one" mentality with REAL internships/preceptorships/etc. that take new graduates and develop their skills for the areas they wish to work.

RN-PA, RN · Nov 2, 2003

Speaking as a med-surg nurse who's seen more than my share of nurses come to our floor to be "trained" and then leave for "greener pastures", I'd just as soon have nurses who WANT to work med-surg who will COMMIT to work there, not just use it as a stepping stone to other specialties. We have enough turnover as it is and trouble just retaining med-surg nurses (who actually WANT to work med-surg) due to the poor working conditions! :eek: :stone

indie · Nov 3, 2003

I'm with prmenrs and Tim: Encourage the student to apply to the specialty area of choice.

This is still considered a no-no in some backwoods, but I think there is a rationale for my view, if not evidence.

These days, many of our students finish training with an 'elective' or 'preceptered' experience in their area of choice now whether in a BSN or ADN program. And students, at least in my relatively recent classes, were often mature students either in age or life experience. They knew what 'worked' for them.

Our pediatric faculty often facilitated this sort of 'direct-to NICU/PACU/general peds/even Peds. OR transition and rarely did it not work out.

The only time I think about Med/Surg as vital background is the RN who either wishes to or will have to move/travel in future (e.g. (military spouse) or who is bright enough to foresee a long career ahead and has an understanding that it may take him/her to many diff. health care arenas.

Certainly I don't think I would have had the background to support the diverse career moves I have made without the basic Med.Surg., but I also came from a background which valued 'generic RN' up to a point. That almost no longer applies as specialties become such narrow expert nursing arenas.

bwt02 · Nov 29, 2003

I always advise my BSN students to go directly to their area of interest. In my personal opinion I would have rather been an accountant than a Med/Surg nurse. Forcing a new grad into the med/surg specialty has the potential of driving them away from nursing all together. The thought process of a Med/Surg nurse and a good critical care nurse is very different. Neither one would be able to handle the others job with ease.

chris_at_lucas_RN, RN · Nov 29, 2003

Funny thing, I was just on the phone with my mom last night. She retired a couple of years ago after FIFTY TWO YEARS as an RN (yea, Mom!) and she said, "just concentrate on getting the RN, get your two years of med surg, and then go do what you want to do."

I thought, TWO YEARS OF MED SURG? Yish!

This was the first I'd heard of it.

I bet with the need for us being everywhere, the "requirement" is no longer.

Thanks for this thread. I was just accepting it at face value.

Whew!