Do you think new grads should start on a med/surg floor or jump into specialty areas?

Dixielee, BSN, RN · Mar 15, 2005

This subject has been debated many times. I think if you do a search, you can get lots of feedback. Personally, I think you need a year or so or med surg before you jump into a specialty area. You gain organizational skills, assessment skills etc. that you will use whereever you go. I think you limit your options and abilities if you jump into a specialty first.

SmilingBluEyes · Mar 16, 2005

I think nurses should follow their hearts, and if that is not going into med-surg first, then so be it. Life is short.

grinnurse, RN · Mar 16, 2005

I have wondered this many times as I also graduate in May. I have been teetering back and forth with the thought. Many nurses (recent graduates) that I know have all felt that it was a good idea to start out on Med-Surge before specializing just because you never know what you will end up liking if the specialization turns out not to be what you imagined it would. Also, alot of the home health agencies, in Texas, require a certain amount of Med-Surge including Hospice agencies etc.....Even though I write these words, I still have no idea what I am going to do first. :uhoh3:

Good Luck

happy&healthy · Mar 16, 2005

I will be graduating in may and i was wondering how people felt about new grads getting right into specailty areas. Do you think they should work med/surg for awhile? Let me know what everyone thinks.

Hi Stacy,

"Med/Surg" for a year at least, will serve your developing skills well. I chose that too, and found it valuable - in the dozen different Specialties following, and gaining service experience in also.

*PICURN* · Mar 16, 2005

well if you know what specialty you want to get into, then do that.

if you are unsure, then maybe med-surg is the way to go.

for example, if i would have done med-surg (knowing i wanted PICU) the med-surg would have done absolutely NOTHING for me as a new nurse b/c pediatrics is totally different than adults. It may have helped my organizational skills and some techinical skills, but not much else. I would have been better off starting in the PICU right away (or a general peds floor).

If you KNOW what you want to specialize in, do that. Doing med-surg first may actually hinder you in the long run, because you may have to "un-learn" things they taught you in med-surg. I have heard a lot of ICU/ER/OB nurses say they prefer new grads over nurses w/one year of med surg b/c new grads have a "clean slate".

TMPaul · Mar 16, 2005

This subject has been debated many times. I think if you do a search, you can get lots of feedback. Personally, I think you need a year or so or med surg before you jump into a specialty area. You gain organizational skills, assessment skills etc. that you will use whereever you go. I think you limit your options and abilities if you jump into a specialty first.

I agree with Dixielee. :)

PC · Mar 23, 2005

I've seen it go both ways.

The better nurses by far are the ones with a wider range of experiences to draw on, not just the narrow experiences within a particular speciality.

There will AWAYS be time to specialize. I advocate doing med/surg first and get your general foundations firm, then specialize.

lee1 · Mar 25, 2005

I have seen many good ICU nurses who went directly into ICU after school. HOWEVER, this requires that the hospital is committed to this type of program as precptors must be available for a lengthy period of time that are willing and able. There also needs to be a CNS available to do the core ICU teaching which should occur over the first few weeks, followed by occasional lessons thereafter as the preceptee gets more advanced knowledge. The preceptee should follow the preceptors schedule. The preceptor should also not be overwhelmed by inappropriate assignments or ratios. It should start with the less acute ICU patient gradually moving to the most extreme, so the proper patient assignment is always taken in to account. From my experience it takes approx 1 year to become an ICU nurse. AND that nurse must be always reading, attending conferences on her own, etc. The formal preceptorship might be the first 3 months with no floating for the first 6 months.

Normally not more than 1 or at the most 2 new nurses can be incorporated into a ICU setting at a time depending on the size of your unit.

Littlewonder · Mar 25, 2005

I think this topic is so hotly debated mainly because many hospitals just don't orient well. If you have a hospital with a good preceptorship program, you should be fine to go into whatever specialty you want.

I did not go into Med-Surg first because I greatly disliked my Med-Surg clinicals. I went straight to ICU where I was preceptored by a very experienced nurse who taught me great prioritizing and orginizing skills. Now I work OB where I am faster than many of the nurses who worked Med-Surg for years. So much of it depends on your individual experience and the hospital where you start.