All preferences aside, what is the best "track" for a new nurse to learn?

Keri8680, BSN, RN · Nov 25, 2010

It probably depends on how much you really want to challenge yourself. I work on a stepdown floor, and can get a 4-6 patient assignment each shift. We see patients right from the CCU, on drips, etc. This was right for me at the start, now I feel I could be better prepared for a more acute floor such as an ICU or ED. I wouldn't have felt comfortable in the ED right after graduation, and was not interested in a med surg unit. I currently work on a cardiac/tele floor. My suggestion would be to start on a tele/step down unit, that's just from personal experience, I'm sure you'll get other responses and suggestions as well. Good luck, and happy turkey day!

kayern · Nov 25, 2010

My vote goes to Med/Surg. As a 20 year Med/Surg nurse I get to see it all, but best of all I get to see almost all of my patients leave to go home or rehab. I have a question for this board............I get the distinct impression that many of us do not value Med/Surg nursing. It is ABSOLUTELY a speciality. My nurses manage 7 patients, various/multliple drips that include tridil, cardizem, heparin, amiodarone, bumex(just to name a few), epidurals/PCA/CBIs, teach/education patients/families, etc. I challenge most critical care nurses to walk one shift in my nurses shoes...............I'm convinced they couldn't.

Thanks for letting me once again stand on my soapbox!

ashfost, BSN, RN · Nov 25, 2010

Im a new grad (May 2010). I took an ER Nurse Residency position at a Level I trauma center. As a new grad, any experience is going to get you going. A nurse is a nurse is a nurse. The angle of thinking may be different (critical thinking, etc) but putting in an NG tube or a foley is the same anywhere you go. The critical thinking and "gut instinct" comes with time in ANY area; CCU all the way to Med-Surg. My advice is to concentrate on getting the basics and learning how to THINK like a nurse first. To answer your original question, a new grad should start where their interest lies. You'll wake up a much happier person going to work on a floor that INTERESTS you rather than being there just to "get experience". I'd choose happiness over politics ANYDAY! Good Luck!

BettyBoop01 · Nov 25, 2010

If you know where you would like to end up, I would try to start there, like if you are interested in peds or L&D. I started in med surg and I feel like it is all over the place, total chaos. I feel like in med surg having 7 - 8 patients on my own right now (2 months in, had 6 weeks orientation) seems unsafe, I am still slower than an experienced nurse and feel thjat my patients get the bad end of the deal. I dont have time to pee! If the patient load was more manageable or if I had a tech to help, I might have a better opinion of med surg, but now i HATE it. I know that it is good experience and I am learning a lot, but I think being in something more specific where I could work on and learn one area might be better for me. We are all different, some people love the chaos of med surg, not me. I wish I was in something more specific, I am really interested in Dialysis. I feel obligated to fulfill a year of med surg, but I dont know if I will make it unless 1. I find a position with a more managable load or 2. I get better at handling this patient load that seems impossible right now. I know I dont want to stay in MS any longer than absolutely necessary to get into something else.

aerorunner80, ADN, BSN, MSN, APRN · Nov 25, 2010

I think it depends on what you want. There is no one right answer because we are all different people with different needs and learning styles. For me, the ICU environment worked like a charm because it fits my personality. For others it's med surg, nursing homes, SAC, etc.

susan janea · Nov 25, 2010

Happy Thanksgiving to all!

I was and am older when I went back to nursing school. So, as soon as I graduated I went directly to long term care, as I know that is what I like.

I could never do med-surg. That is difficult, although you learn a lot there.

I do not do as much "skills" as I need to keep up, but I can do it when necessary. I draw blood some, put in foley, but not often.

I do assess and do wound care and everyday "stuff" plus meds. and I love my residents. But, I do have 30 residents and it keeps me busy busy all day long. but, I love it.

Good luck, and just find what you enjoy and go there and stick with it. :)

PostOpPrincess, BSN, RN · Nov 25, 2010

A heavy duty med surg unit into a heavy duty ICU.

Very rough..but boy, oh boy, so glad I did it..later I was basically able to write a ticket to any department in nursing....

jpeters84 · Nov 25, 2010

kayern-I absolutely value med/surg nurses. I think they are the hardest workers and have the hardest assignments. Med/Surg nursing may not be as flashy or considered as "complex" as other specialties but I think its just as difficult if not more so. I just know that med/surg nursing is not for me. I am better focused on one to two patients. Whenever I am on the med-surg floor I feel like I run around like a chicken with my head cut-off, the patients seem less cooperative or appreciative of your help (some pts confuse the hospital for a hotel) and I just go home exhausted and not enjoying my day as much then when I'm working in ICU or in Peds, NICU. But I wanted to let you know that I respect med/surg nurses so much. To me they are the unsung heros of the hospital.

Alexsys · Nov 25, 2010

I think it depends on what you want. There is no one right answer because we are all different people with different needs and learning styles. For me, the ICU environment worked like a charm because it fits my personality. For others it's med surg, nursing homes, SAC, etc.

Same here. I went straight to ICU. I loved it. I kept hearing that I should do med/surg first, but after a few years, I found that I made the best choice for myself

RNDreamer · Nov 25, 2010

I vote for following your heart.

GM2RN · Nov 26, 2010

Im a new grad (May 2010). I took an ER Nurse Residency position at a Level I trauma center. As a new grad, any experience is going to get you going. A nurse is a nurse is a nurse. The angle of thinking may be different (critical thinking, etc) but putting in an NG tube or a foley is the same anywhere you go. The critical thinking and "gut instinct" comes with time in ANY area; CCU all the way to Med-Surg. My advice is to concentrate on getting the basics and learning how to THINK like a nurse first. To answer your original question, a new grad should start where their interest lies. You'll wake up a much happier person going to work on a floor that INTERESTS you rather than being there just to "get experience". I'd choose happiness over politics ANYDAY! Good Luck!

I kind of agree with this, except that new grads don't know what they don't know. That's not a knock on the inexperienced. Nursing school does little to prepare nurses for the real world of nursing, so there's just no way anyone can know what they are getting into on a particular unit until they are there.

One critical care NM told me that something like 3/4 or 4/5 new nurses don't make it in critical care and have to be reassigned or let go entirely. So if that's where the interest lies, there's a good chance that the new grad will not make it and then lose confidence for any other unit.

I didn't always believe that new nurses should start out in med/surg, but I do now. Yes, I know there are some who could handle starting in critical care, but it still wouldn't hurt any of them to put in a year or two on med/surg first, and it would give all new nurses the greatest chance of becoming the confident, skilled nurses they want to be.