Do you recommend a year of med/surg in 2021?

[FolksBtrippin]

Had a conversation with a couple of retired nurses and a nursing student that got a little heated last night. 

Basically the retiree nurses were saying you must have 3 years of med surg before doing anything else as a nurse.

I said that was not the way it works anymore, that you need to find a facility that hosts new grads appropriately with a residency… and that this is happening in home care as well as the hospital on various types of units.

I pointed out that I went straight into psych and I’m competent. The retired nurses were saying that psych is a different animal and therefore doesn’t apply. As though I’m not an actual nurse.

The whole thing was frustrating and I think each feels the other is out of touch.

Please weigh in. 

[Closed Account 12345]

I don't recommend a year of Med-Surg for anyone, in any year, except nurses who would like to work in Med-Surg and gain that experience. 

Think about diabetes.  The way a diabetic is treated in a family practice clinic, labor and delivery, ER, ICU, and Med-Surg might vary. Each unit has different goals and a different patient focus.

It isn't necessarily a huge deal that the diabetic with a broken thumb in the ER has a 260 glucose; he's going home and lives that way.  In my experience, the glucose wouldn't be treated at the hospital. 

It isn't necessarily a huge deal that the non-compliant diabetic in Med-Surg has a glucose of 260 as he drinks a soda and tells you he has no plans to stop.  He will take some meds to lower his glucose, but there's no real sense of urgency. 

On the other hand, it would matter quite a bit if an OB patient or the post-ROSC ICU patient had a glucose of 260.

For this reason, I feel it's important for all nurses to be competent in their chosen practice areas- not in floor nursing. 

[Tweety, BSN, RN]

The facility I work for hires new grads directly to the ER, ICU and L&D.   We have a good orientation and support system.  Old school nurses do worry about the lack of critical thinking in stressful situation, but with good support people do well. 

If you have goals that don't include med-surg there is no reason you should be miserable for a year or longer.   

If you don't know what field you really want to get into or there are no openings in the field you want getting some med-surg experience is quite helpful.  Med-surg is a skill set quite valuable.  

[CeciBean, ASN, RN]

No, no, no, and no....unless you absolutely have no idea what you want to do, and most of us do when we graduate. (I made a big mistake and paid dearly for it, but that's another story.) I ended up where I probably should have been in the first place, ICU, and did well from there, eventually going on to home health where I honed my assessment and people skills and then on back to ICU and into a rewarding career in cardiac nursing.

In retrospect, here's what I really would have done, I think, all things being equal. You see, I wanted to be a midwife. I mean, really wanted to. However, at the time I graduated, midwives were having an awful time, getting beat down from every direction--the public, the OB/GYNs, even the educational establishment to a degree. The closest place I could get a CNM degree was an HBCU in a city 4 1/2 hours away, which would have meant leaving my family (3 school-age children) during the week. My late ex brought the hammer down on that, of course. Not only was I not doing that, I was not going to an HBCU for anything. So I chose another field which was a big mistake. I should have just gone on and done L&D at a hospital in a nearby city and bided my time until the kids got bigger, taken all the preliminary courses I needed, and busted out when they were older, because the CNM degree became available at a nearer institution later on. However, hindsight is always 20/20, is it not? And my other career enabled me to travel just as well. So my advice is, if you know what you want, GO FOR IT. If not, the Med/Surg year is an option, but keep your eyes wide open. You will likely find something else.

[SarahMaria, MSN, RN]

I have often been told that, "you're not a real nurse, you're a psych nurse."  It is offensive and condescending.  I completely disagree with needing ANY med-surg experience.  I also directly went into psych and am very happy and competent.