Experience in Med/Surg or not?

pagandeva2000, LPN · Nov 15, 2006

Having gone though a bit of med/surg--which I was not interested in at all, but knew it would be "good for me"--I say go with what interests you. True, I learned a great deal in my short stint in med/surg--and anyone who goes the "med/surg-first-route" will have an opportunity to learn and practice many different skills (much to their advantage)--I have found it has gotten harder and harder to work in a specialty I truly do not enjoy. Unless you have to, I don't see why *anyone* should tough out a year or two in a specialty they hate--be it med/surg or whatever.
So, if you end up enjoying med/surg or are able to tough it out for the benefit of your career, by all means do so. But I am no longer of the opinion that med/surg must always come first.

I appreciate hearing this perspective, because I really hated med-surg. I will probably do some overtime up there, if allowed, but somehow, I think that the Creator placed me where I need to be, and while I do feel a bit insecure not having med/surg experience, I have to realize that no matter what, I AM a NURSE.

Morgan314 · Nov 15, 2006

I went into med-surg right after graduation because there were no psychiatric facilities in the area where I lived. After a 4 week orientation, we were assigned a unit and were expected to function as an experienced nurse. Back in the early 80's, we had no preceptors. The other new nurses were graduates of the hospital's nursing program and had much more experience that I had as an ADN grad. In our ADN program, we got no hands-on experience with IV's. In clinicals, we were never assigned more than 2 patients, but from the first day on the med surg unit, I was assigned a hall with about 18 patients. They all had tons of meds and IV's with different drip rates (machines hadn't been invented yet, or if they did exist, this hospital didn't have them). It only took me 3 weeks of med surg to get all the experience I needed to prove that eventually I would be a successful psych nurse. I worked 5 years in long-term care until finally our local hospital opened a psych unit and I was able to work there. When our psych census was low, we nurses were pulled to other units, but this only helped us appreciate our psych unit even more. Med-surg experience is great if you can live through it.

augigi, CNS · Nov 15, 2006

True, it's hard as hell, the pace is insane, the ability to prioritize and organize is essential when you start (and you'll sharpen that skill tremendously as time goes by). Now, although I struggle with time management and the sheer quantity of Stuff You Must Know for assessments, etc, I'm SO glad I made this choice. I really feel that once I have this base, **IF** I decide to go somewhere else, I'll be so much more comfortable than if I hadn't done this work. But you know, I don't know I'm going anywhere anytime soon :)

This is the reason to do med/surg first - you get a variety of patients, with different complaints, and get a good basic understanding of pathophysiology, pre and post surgical care, prioritization and time management. These are the most important skills you can gain as a nurse.

However, after a graduate year which included 4 months on med/surg and 4 months on rehab, I went to ICU and never left. As everyone said, if there's good preceptors and a good orientation, and you have the right personality for it (quick learner, eager to learn) then you'll do fine.

miko014 · Nov 15, 2006

I think you should try med/surg and see what happens. You don't have to stay forever, but I have learned more from my med/surg pts than anybody else. I'm on an inpt medical oncology unit. We also have reserved beds for inpt hospice pts and palliative care pts. After all that, then we get the med surg overflow (and there is a LOT of it!). So any given day, I might have someone getting chemo, an acute hospice pt, a palliative care, a pancreatitis, and I dunno, someone whith a chest tube and a bili drain. I love the experience because it's so valuable for time management and organization, and PRIORITIZATION! Will I stay here forever? Probably not. But am I glad that I took this position over the cardiac floor? Yep! I would have loved to have worked for cardiac, but I am getting such a wide variety of experiences where I am that I wouldn't give it up for anything! I'd try it if you can. But remember: you may go into a specialty and end up hating that too. See what is available and what their requirements are, and, like tweety said, look at what is offered in orientation, and make the choice that you think is right for you. Like you said, you have lots of time, and you may change your mind several times. But, like someone else said (lol, I seem to be referring to a lot of other posts here), a lot of places won't take new grads. My hospital will not take anybody into OB without 2 years of previous experience. Food for thought!

rninme · Nov 15, 2006

First of all....medical/surgical nursing is a specialty....and it takes a special nurse to work there. Nursing school will give you an opportunity to look at the various specialty areas. You may change your mind about where you would like to work several times before you actually graduate!

Some hospitals require nursing exerience before hiring into speciality units, some offer extensive training programs for new grads. Some nurses search for their "niche", others know where they want to practice after graduation. It isn't a decision you need to make right now. Enjoy your clinical experiences, they are a great learning opportunity. Good luck to you in your studies!

Antikigirl, ASN, RN · Nov 15, 2006

Now I got out of school and found a job at a hospital I wanted to work for and did their med/surge grad program. I hated my job...not because of the tasks or learning experience..that was very valuable, but the politics of that hospital and the rude staff I had to contend with. I left...

I ended up (after a few jobs) working at an ALF for four years, and that med surge background really helped (if they were going to have an issue, typically they would be in a med surge for a while...at least I know what they would be going through and perhaps needs post hospital!). Very good experience but I had very little of it!

Well the ALF really stuck it to me and I left that...my only viable option, and one I loved...I went agency, and for me med/surge would be my backbone. I was nervous, but took on the challenge and was happy I remembered so much! Thankfully with that background, and working on things I remembered, I was offered a job with a hospital I adored (helped to work in one before choosing to stay!)...and now I am med surge ortho and loving it!

Because of my experience, I did find med surge to be benificial as something I could always rely on if I found myself needing a job...because you just never know. I am happy I at least gave it 6 months, but wished I had had more under my belt when I started agency...but being a go getter I was able to find a hospital willing to work with agency nurses...gained my skills back, and hired on (which is very lucky).

BTW..the idea of med surge made me feel very down and I didn't want to work it...but now with more experience out there in the real world...I like it again and find it is very valuable! To this day I am shocked I like it so much now!!!!!! LOL!

Focker, CRNA · Nov 15, 2006

I think Med-Surg is tremendously valuable. It lets you hone-in and more fully develop your nursing skills and definately enhances critical thinking. It provides you a wide variety of learning experiences and perhaps gives you a more specific insight into what you truly would like to specialize in as there is so much out there. It teaches you to prioritize, to organize, and to use your time most effectively.
It also gives you experience in seeing and utilizing all your resources. It teaches you how to become an effective advocate for patients, and a valuable team-member.

I don't see why this only applies to med-surg, you learn critical thinking, prioritization, time-management, etc. in ICUs and ERs as well. As a nursing student, I was told I needed to get experience in med-surg first too, and I didn't listen to it for a second. In fact, just today I told a soon to graduate nursing student, who was told the same thing, that that is BS and he should go into whatever specialty interests him. There is absolutely nothing wrong with med-surg, but to say that it is a pre-req for other units is just not fair to new nurses who are too naive to know better and would be happier somewhere else.

West_Coast_Ken, BSN, RN · Nov 15, 2006

First of all....medical/surgical nursing is a specialty....and it takes a special nurse to work there.
...
Some hospitals require nursing exerience before hiring into speciality units

So they require experience for other specialties but will take someone with no experience into the specialty called med/surg? That makes no sense.

I've decided I'm going directly into what I want if I can find a position, of course, etc. I learned a long time ago to go for what you want and to not dance around. Life is way too short.

West_Coast_Ken, BSN, RN · Nov 15, 2006

I don't see why this only applies to med-surg, you learn critical thinking, prioritization, time-management, etc. in ICUs and ERs as well.

No kidding! I smile to myself when I hear this comment. Who made the rule that only in med/surg can one learn critical thinking, prioritization and time management?

I'd hate to be in an area I didn't want to be in and was just using to go into something else as soon as I could. That's not fair to the med/surg RNs, the pts or me!

4tnerzwife · Nov 15, 2006

just wanted to share that I thought that I had it figured out my second year of the four year program that I am in. I wanted to work in a cath lab or in the ED. I also despised Peds and OB and dreaded the clinical and class. Guess what? I have an interview for a NICU position! Once I experienced the NICU, I knew that is where I belonged. So, you never know!

slou! · Nov 15, 2006

Don't worry about your specialty now - just do the clinicals and see what happens. However, just want to add that med-surg IS a specialty and 2. Nothings sadder than watching an OB nurse try to take care of a sick patient in OB who's never had any med-surg experience to fall back on. Bad things don't happen often in OB but when they do, its awful because two patients are involved. Its not the same when someone skips med-surg to go to critical care because patients come to critical care from all over the hospital with a variety of diagnoses and you will learn to respond quickly to resuscitative issues. In OB you rarely have to resuscitate somebody and that's why its appreciated when you have an OB nurse who's done it several times before and can respond quickly and appropriately.

Thanks! Yeah I am not worried about it at all yet, I am going to try to go through clinicals with an open mind so I don't try and like something I don't really like just because I wanted to do it before. Does that make sense? For example, I could end up hating OB but try and make myself like it because I liked it before clinicals. But I won't do that! And like I said I'm not worrying about it yet, I still have years; I was just curious.. That's another thing I heard, say you have a pregnant patient who has something wrong with her, whatever it may be, and you don't even know how to treat a normal (I mean not pregnant, not they pregnant people aren't normal!) patient with that same thing wrong with them, how would you handle that on top of them being pregnant? That is something I've heard before. But like I said I am really not worried about it now I was just wondering what some people have done.

slou! · Nov 15, 2006

No kidding! I smile to myself when I hear this comment. Who made the rule that only in med/surg can one learn critical thinking, prioritization and time management?
I'd hate to be in an area I didn't want to be in and was just using to go into something else as soon as I could. That's not fair to the med/surg RNs, the pts or me!

I'm sorry I didn't mean to offend anyone by this! I didn't mean it like that. I meant that a lot of times I have heard (and have had people told me) that you should gain experience in med-surg, and it might even be a requirement for certain jobs.

I also agree that med-surg IS a specialty, I don't think I clarified that in my original post! I respect all med-surg nurses so please don't get me wrong! I was just asking because I've seen a lot of posts on here of people going to med-surg then going somewhere else. I personally wouldn't like to be in an area I HATED and I see so many posts about new nurses in med-surg and they HATE it and want to leave nursing. I hope that I am never in that position, I hope if I do med-surg than I really want to do it! :)