ER or Medsurg first?

[Marette S.]

I am starting my senior year in the fall (just a few short days away). I have worked all summer in the VA ER in Lexington and LOVED it! I would like to keep doing this after i graduate but have heard over and over that i need to work medsurg before, for the practice in skills, etc. What do you think? Since i really dislike medsurg, would ICU be an ok subsitute? Also, what can i do to make myself more appealing so i can get a job at the VA?

[hypocaffeinemia, BSN, RN]

Med/surg is its own specialty these days. Why should you work in a specialty you have no interest in? Go straight to ER if that's what you want to do.

[SillyStudent, ASN, RN]

Mes/surg is its own specialty these days. Why should you work in a specialty you have no interest in? Go straight to ER if that's what you want to do.

:yeahthat:

[Roy Fokker, BSN, RN]

Mes/surg is its own specialty these days. Why should you work in a specialty you have no interest in? Go straight to ER if that's what you want to do.

I used to belong to the school of thought that said: "work a non-critical area of nursing before jumping into critical areas of nursing".

When I started working med-surg, it further served to reinforce that thought process i.e.: You need to be able to handle non-critical patients and learn to recognize patterns, become proficient in your assessment skills; before you work critical care.

I switched over to ER, and I can honestly say that my years in med-surg really helped me. Not only am I more "familiar" with the hospital environment in general [i'm sure there aren't too many of us here who think/feel that nursing school ever actually prepared them for real life nursing], I also have had a fair bit of experience with procedures - be it IV sticks or wound dressings. But the most important skill I learned was assessment: what do normal/obstructed bowels sound like, good heart/lung sounds etc. etc. Plus I had the bonus of being able to pass a multitude of meds in a relatively stable setting and watch/observe the outcome. Finally, I truly felt the whole 'continuum of care' experience - from admit to discharge.

That, among other things, are why I'd still recommend "med/surg before critical care"* - but I'm nearly not as vociferous as I used to be about it.

The reasons I'm not nearly as adamant about it than before are:

1. As a couple posters have already said - why work a speciality if you don't want to?

2. Many hospitals offer extended "orientations" for new grad nurses joining the ED. I'm skeptical of this approach, because I still think that new grads fresh from school lack the critical thinking aspect of nursing care.+ However, I've met some kick ass ED nurses who started out as ED nurses and are very good at what they do.

Don't get me wrong - I totally understand how ED is a completely different ball of wax (and it really is!) I just thought I'd share my , 'tis all. :)

cheers,

* : What I said above isn't a "put down". As a former med/surg/ortho/neuro/tele nurse, I've lived the dreams and dreaded the nightmares of floor nursing.

+ : I was a student not too long ago and I still remember the absolute rude awakening I received when I began working a 'real job'. Nursing school in NO WAY prepares you for the real world - in fact, my standing truth/joke is: "all I learned in nursing school was how little I actually know". This isn't meant to disparage students or frighten new grads - it's merely a signal flag saying "heads up!". Which is why I still think it's a good idea for new grads to work non-critical areas of nursing before signing up for critical areas.

[classicdame, MSN, EdD]

go to ER if possible, since that is what you like. If you ever change your mind you can learn that speciality as well.

[IngyRN]

Go to the ED. Most hospitals offer excellent new grad orientations. Med/Surg gives you a great base....but if you know for sure that you want to work in ED-go for it!!!

[HM2VikingRN, RN]

I tend to be from the school of thought that you should follow your passion......My top 3 choices were psych, ER, Extended Care (Rehab). I ended up being offered a position in psych. (ER was not an option for the VA).

I really like my psych job and my manager is very supportive of staff development. (She has given me the go ahead to get ACLS training and other certifications which will eventually let me pick up a per diem ER job.)