All Med-Surg units created equally?

[wendalin920, CNA]

Hi everyone,

I am currently in an ABSN and graduate next May. I've been thinking about where I would like to work after graduation and I'd like to be an ER Nurse. I understand that the ED is not always open to new grads so I'm thinking of doing Med-Surg first and then transferring. 

Do you think there's one type of Med-Surg that is better in preparing someone to work in the ED? Last semester, my clinical rotation was in Ortho-Trauma and this semester I'm in Oncology. Both are Med-Surg but handle different patients. Last semester was more shadowing as it was our first time in a clinical rotation and this semester I get to do more things. I see the differences between the patient injuries and reasons why they are in the hospital, but the patient ratio is different as well. In Ortho-Trauma, the nurses had about 6-7 patients and in Oncology there's 3-4 patients per nurse. 

I'm really liking Oncology and the patients are so appreciative. I've been thinking of applying to a Cancer Research Center as well as other general hospitals, but I'm also wondering if doing Oncology Med-Surg won't adequately prepare me for the ED later on. I've heard people talk about learning time management the first year, but is this really possible if I only have 3 patients? I know the tempo in an ED will be much different! 

Thanks for any advice!

[JBMmom, MSN, NP]

You're going to gain skills in any new position. And then some of those skills will transfer to anywhere you go, and you'll have to develop new skills to go with them. It's important to like what you're doing, so if you like oncology, don't discount that just because it may not as readily transfer to the ER.

For me the ER seems a whole different world that you can't really prepare for except in the ER. I did a semester of clinical there in my NP Program, and it made me realize that I would NOT have been a good ER nurse. My brain doesn't work that way. I have enjoyed med-surg, ICU, even long-term care, the ER with the mix of really sick/not all sick/ no idea why they're there, just isn't me. I'm glad there are people that like it because we need them, I know I'm not one of them.

Good luck with whatever you decide. Don't make too many decisions on down the road plans, because those can often change. 

[Nurse Beth, MSN]

I totally agree with JBMmom! You're bound to learn new skills in any job you take on. So, don't worry too much about it! It's okay to feel a little nervous about the ED, but remember, there's really no way to fully prepare for it. Just take it one step at a time and you'll do great!

[FiremedicMike, RN, EMT-P]

In my area, ED's are fairly open to new grads and generally have a good onboarding process.

My last experience with med-surg was in my final semester of nursing school, and just to chime in with the above sentiment, ED is it's own animal entirely.  It is blatantly apparent to me how different it is when we try to call report on patients.  It's a different speed, a different mentality, a decent mix of autonomy and collaboration directly with the physicians.  I could NEVER be a floor nurse and I respect those that can.