Do You Have To Work Med-surg??

AprilRNhere · May 3, 2008

Not necessarily. There are many threads that talk about this. It's easier to find a job on med/surg as a new grad..but not always mandantory. I was hired into CCU right out of school. It's been a great learning experience. Honestly though...I tend to agree with those that think you should do med/surg. I managed through it..but only because of great staff.

Only you and your employer can decide what you're capable of.

Trauma1RN · May 3, 2008

I totally agree with the above poster. I started as a new grad in a neuro/trauma SICU in January as a GN. I did have two years prior experience on a med surg floor as a aide and then a tech. Seems like all of the staff is telling me that I am doing great and are impressed with me so far. However, another one of the GN's I started with on my unit was let go last week because they were not picking it up according to the higer ups.

I think it depends on your personality and prior experience. There is no doubt that I am where I am supposed to be. I hope it works out for you.

RNsRWe, ASN, RN · May 3, 2008

Really depends on the area you wish to go into, and the facility that you're in. Some will not orient you to a particular unit until you've had experience in m/s first. Others might. An ICU in one hospital might take a new nurse and train for 6 months; another will expect you to have 2 yrs m/s experience and offer 2 months orientation. It varies.

Overall, if you want opinions, I'd say it's a good idea to GET that experience. Because even if you do go to another area you'd prefer first (they take you), there's a reasonable chance you'd want to LEAVE that area for something else, and then you are still faced with that "but where's your m/s experience"?

I had a classmate who wanted to go into OB. Two facilities would not take her on, but a third did. She stayed there for eight months, only to find that she didn't want OB after all (our desires really do change!). But she was kinda starting from scratch in that she DID want to go to ICU. Sorry, but without a minimum of a year (or better) in med-surg, no dice. So now she's working med-surg, but 8 months behind her classmates who ALSO want the same jobs she's eyeing!

Two other classmates have gone on to agency and home care. Without the med-surg experience, it wasn't an option.

Some will tell you to go for whatever specialty you want right out of the cage, that med-surg doesn't matter. And sometimes, if you find a facility that allows it and you feel you will get very good on-the-job training for that unit, and never want to LEAVE that unit, it's just fine. But others will say what I am saying, that if you want to have ALL the options open to you, get as much experience in as broad a range as you can.

For what it's worth, I really thought I'd HATE med-surg, as I HATED it in school, but just needed to "do my time", LOL....and now I really LOVE med-surg! I complain about the ratios all the time, but you know what? So does every unit at my facility!

*By the way: turn off the ALL CAPS as internet etiquette would dictate that SHOUTING is not a good mode of communication

locolorenzo22, BSN, RN · May 3, 2008

There are highs/lows: You get a lot of different cases on med/surg....and you get a LOT of different cases on med/surg. On med/surg, unless someone needs a specialized floor...you'll probably get most of the admits.....You will do a lot of things with some unstable patients that a lot of nurses don't do on other floors. I don't remember the last time I saw a NG tube on my ortho floor.....

I personally feel that ortho/neuro is generalized enough that I'm not worried when I get a "med/surg" type patient......I am (almost) a nurse, and I feel confident that when it comes time to do x, I can do x!

In any case, almost 1yr is the usual amount of time you "have" to stick it out somewhere....

Katie82, RN · May 3, 2008

Depends on your pre-RN experience. My daughter works as a unit clerk on a Labor & Delivery floor while attending nursing school. I have been advising her to do a year of med/surg for the experience. She is doing PCT training during summer break and will be working on a med/surg floor. Her Unit Manager is trying to convince her to work on her unit after graduation. I was opposed to that at first, but I think if she works for a year on med/surg as a PCT, that will give her the foundation she needs. It has been my experience over the past 25 years, that nurses who go directly to a Specialty floor after graduation are a little lacking in the fundimentals of nursing later on. I have worked in several different disciplines, and I can usually tell the specialty nurses from those who have worked in med/surg for even a short time. I would like to see an obligatory "internship" in med/surg, much the same as a medical student does. Would give new nurses a chance to get their feet wet and look around for an area they think would appeal to them. It certainly would cut down on the young nurses who are leaving the profession because of horrendous experiences they have as new grads on specialty floors. I have read more than one on this forum.

Tweety, BSN, RN · May 3, 2008

No. Most hospitals realize it's more productive and efficient to invest in new grads in the areas they are interested in.

llg, PhD, RN · May 3, 2008

A lot also depends on what area of nursing you are most interested in. Adult med/surg can be a really helpful foundation for some jobs (e.g adult ICU, case managerment, community health, etc.) -- but it is NOT very helpful for newborn nursery, neonatal ICU, peds, etc.

As others have said, it also depends on your particularly abilities and skill level.

Finally, it depends on the unit that interests you. Some units are used to hiring new grads and have the orientation programs and support systems in place to meet the extra learning needs that most new grads have. Other units (in the same specialty) may not hire new grads very much and simply not have the educational programs and support that new grads need and want readily available.

That's why there is no "universally true" answer to the basic question. There are lots of factors that coe into play and each situation has to be evaluated individually.

Ms Kylee · May 3, 2008

I hope not... I'm just a few weeks away from my year as a PCT on a Med Surg/Oncology floor and I HATE it... hate it in nursing school too. I can't decide on a specialty either... don't want critical care or ICU (lower patient ratios, but still not sure of my skills). Maybe Ortho since I love bones.... I dunno... I just know I don't want Med Surg.

SummerGarden, BSN, MSN, RN · May 3, 2008

I would like to see an obligatory "internship" in med/surg, much the same as a medical student does. Would give new nurses a chance to get their feet wet and look around for an area they think would appeal to them. It certainly would cut down on the young nurses who are leaving the profession because of horrendous experiences they have as new grads on specialty floors. I have read more than one on this forum.

This is a good point and my hospital seems to agree. They have implemented an orientation that is Med-Surg based for all New Grads even those whom will be working in specialties. I will probably start in a specialty as a New Grad, however I do agree from my school rotations that there is much to be learned to benefit me and my patients orienting in Med-Surg. :twocents:

Tweety, BSN, RN · May 3, 2008

Depends on your pre-RN experience. My daughter works as a unit clerk on a Labor & Delivery floor while attending nursing school. I have been advising her to do a year of med/surg for the experience. She is doing PCT training during summer break and will be working on a med/surg floor. Her Unit Manager is trying to convince her to work on her unit after graduation. I was opposed to that at first, but I think if she works for a year on med/surg as a PCT, that will give her the foundation she needs. It has been my experience over the past 25 years, that nurses who go directly to a Specialty floor after graduation are a little lacking in the fundimentals of nursing later on. I have worked in several different disciplines, and I can usually tell the specialty nurses from those who have worked in med/surg for even a short time. I would like to see an obligatory "internship" in med/surg, much the same as a medical student does. Would give new nurses a chance to get their feet wet and look around for an area they think would appeal to them. It certainly would cut down on the young nurses who are leaving the profession because of horrendous experiences they have as new grads on specialty floors. I have read more than one on this forum.

Bad idea in my opinion.

Med-surg floors are horrendous floors with high acuity and high patient ratios and nurses leave med surg in droves. Why would you want to subject people who aren't remotely interested in med-surg to torture themselves and those of us in med-surg with an "internship".

There's a reason med-surg has so many openings and it's not just because it's a launching ground for other specialities, it's because it's so hard. How can someone take care of so many patients and learn "fundamentals" when they are barely able to chart at the end of the day. "Fundamentals" can be learned anywhere. Critical care, even starts at the basics ABCs and other fundamentals personal care.

CraigBSN02 · May 4, 2008

If you wanted to be a policeman, how much sense would it be to be a firefighter for a year?

If you're a person who is certain that one specific specialty is what you want and have make it your career path thus far (eg: you want to be in ER, so you became a unit secretary, then a tech, then an EMT, etc), why would you waste your time to "serve time" on a M/S unit? While I agree you should have an appreciation for how other units operate, nursing needs to move past this punitive mentality of 'pay your dues' in order to work in a specialty. It depends on the person's experience and aptitude, frankly.

I am all for having new grads rotate thru ICU, M/S, OR, L&D, etc., but the mandatory M/S service should go the way of the cap.

-Craig J.

RN, BSN, and others.