Decisions Decisions...Med-Surg or Cardiac Step Down

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I need advice. I am a new grad. I have been working in a nursing home for the last few months. I am so grateful that I have been offered 2 different job opportunities. My conundrum is choosing the right job. Job #1 is in a community hospital on a med-surg telemetry floor (mostly medical). The hospital is an hour drive from my house. It is not a teaching hospital. Job #2 is in a metropolitan hospital in the cardiac surgery step down unit. The hospital is a teaching hospital and I would be part of the new grad program. However, this job would mean relocating (plane ride distance).

As a new grad, I have been reminded over and over again that med-surg is the starting line for all nurses. Is this a must? Will I miss out on valuable experience if I do not start in med-surg? Or will I gain more experience in the step down unit? I am interested in cardiac nursing, but what if I change my mind later in my nursing career - will I be locked into cardiac nursing? Which job offers the greatest opportunity?

Again, I am so grateful as I know how hard it is to get a job these days. Any advice is greatly appreciated. Thanks!

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Specializes in ER, progressive care.

You do not have to start out on a med-surg floor as a new grad. Med-surg floors are good for getting your skills down and for learning a lot, but you will also learn A LOT on a cardiac surgery/telemetry unit. Teaching hospitals tend to get sicker patients so you will see more things. Being a part of a new grad program sounds like it is an internship - that is a GREAT opportunity! It is so important for a new grad to have a good, thorough orientation. It can make or break your career. Personally, I would go for the cardiac surgery unit.

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If I were you, I would go for the new grad residency program!

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Specializes in MICU - CCRN, IR, Vascular Surgery.

I'd pick step down in a heartbeat. I graduated last year and got stuck starting on Med Surg, and cardiac is my dream job. You will learn a ton there!

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If relocation is not a major issue for you...

go for the step down position!

Your training and experience will include basic med-surg and you will also be learning the cardiac as a bonus.

No, you will not be "stuck" in Cardiac.. it is highly desirable skill you can take anywhere.

Good luck .

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Specializes in pediatrics, geriatric, developmentally d.

i would absolutely choose the step-down unit! If you want to work kin cardiac here is your chance! and its a teaching hospital! you have a wonderful opportunity here if you have no problem going on that plane ride i suggest you do it. you will learn so much and im sure they will teach you med-surg fundamentals. good luck on YOUR decision. keep us updated and congrats on the offers!

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Specializes in Peds Medical Floor.

If you can move, I'd take the new grad cardiac position! You are lucky to get such a chance!!!

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Specializes in Cardiac.

I graduated last June, started immediately working at a large teaching hospital (well large for my area), I work on a cardiac step-down unit and you will still get med-surg over flow TRUST ME! So with that said chose the step-down cardiac floor. I love it, some days are far more challenging than others but I wouldn't change it for anything. In this last year I've learned so much already. I want to eventually become a nurse practitioner for acute critical care and this is a great start. We get some med-surg patients, the down side to that is, they end up getting transferred off our floor when there is a cardiac patient that needs to be on our floor more, such as just had a heart cath, etc. I can do all drips, except insulin. It's so cool knowing only our floor and ICU do cardiac drips, like I said it's a challenge but I've learned so much. Good luck. :)

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I work as a Nurse Extern on a cardio step down unit and will transfer to full time RN after graduation (May 12, 2012!!). I have gained a ton of experience in the past 5 months. Even though it is the "cardio" unit you will see many other disease processes as well. If relocating is not a problem I would definitely do so. Think of it the way I was told when I got hired: You were chosen out of the hundreds of applicants so you obviously are special. Even though you have two offers I am sure the teaching hospital with the internship has a longer list of people that would love to take your place, don't let them! The great thing is once you have cardiac the possibilities are endless.

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Specializes in Thoracic Cardiovasc ICU Med-Surg.

Take the step down position. Afterwards you can transition to ICU with ease if that is your direction. But the acuity, and the specialty will really make you into a very good nurse with lots of career options.

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Thank you all for all of your input and advice!! I really appreciate it! :) I have been leaning towards the cardiac surgery step down unit position, and I'm so glad I posted because now I know it is the right decision. Woohoo! I was excited before, but now you guys got me really excited for this opportunity. Thanks again!

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Specializes in Cath Lab & Interventional Radiology.

I would agree with what the others stated; you should go for the cardiac step-down unit. I am a new grad (December 2011), and after a brief stint in a LTC facility, I landed a job on a cardiac progressive care unit. I started about three weeks ago, and I've already learned so much. I don't think you will regret your choice as there will be so many opportunities with this experience and skill set! GOOD LUCK to you!!

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