To Specialize or Not to Specialize?

Nurses New Nurse

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I've been told many times that the first year of nursing is difficult and has a steep learning curse. I've heard its so much different than nursing school and can be challenging. I'm graduating in December and have always wanted to go straight into a specialty unit (ICU or ED). So many people have told me that it's important to get at least a years experience on a medical floor before going into a specialize department. I got a job offer for the ICU but am wondering if I am biting off more than I can chew? Is it really that important to get medical/surgical floor training before jumping into the more critical units?

Specializes in Public Health, TB.

Too many variables to tell. A lot will depend on your orientation plan, and preceptors. Best of luck to you.

Specializes in Pedi.

There's really only one way to find out if you're biting off more than you can chew. I had plenty of classmates that went right into ICU after graduation- in a critical care new grad program with a very long orientation, which probably made a difference. I disagree with the notion that "everyone" needs 1-2 years of med-surg experience. I've been a nurse for 11 years and I have 0 years of med-surg experience.

Specializes in Med nurse in med-surg., float, HH, and PDN.

I guess it's different nowadays, but instead of searching out a certain specialty, I decided to go to the biggest, 'scariest' hospital I knew, and apply there. (MGH/Boston). They chose the floor they would hire me to, which turned out to be immediate-post-op spinal-care and rehab, where the docs were developing the first Halo frames.

I occasionally got floated, and learned I did not EVER want to work a burn unit again; I'm very uneasy in Pediatrics; Neuro ICU taught me some very important things. But then, as a float, I was not 'in charge'. We did Team Nursing then and I had a senior shift-member for back-up if I needed it.

From then on, any hospital I worked at, I signed up for the float team. It kept me from getting bored or burned out with any patients, services, or staff members. I really liked the variety,

But, you can't be a Nervous Nellie. I saw so many previous grads and people from my own class who were 'afraid'. I didn't want to be one of them, so I just took a deep breath and took the leap, and never looked back.

In my 45+ years of experience as a nurse, when starting out I'd do what I knew and could do on my own, pitched in and helped others, and volunteered for new things as they came along. Little at a time I built my knowledge by being willing to work in differing situations.

Having to decide on a Specialty right away, and being afraid of imperfection will make it hard, IMHO. Not pushing a product here, but the words "Just do it!" are good advice.

I got a job offer for the ICU but am wondering if I am biting off more than I can chew? Is it really that important to get medical/surgical floor training before jumping into the more critical units?

It is NOT that important. Please don't listen to anyone who wants to tell your differently. If you got a job offer, go for it. I loved SICU right out of school because I could concentrate on my one or two patients, my close working association with the surgeons and house staff who were very willing to teach me.

I worked SICU, then ER, then OR. After 3 years of general OR, I specialized only in open heart surgery (adults and peds) for the next 8 years.

I have never worked med surg in a hospital.

Best of luck!

Specializes in CRNA.

I went straight to the ICU from school. Never looked back. Yes, It's a steep learning curve, and it took probably a year before I stopped dreading going to work, but I wouldn't have wanted it any other way.

Please... take this advice... go straight to ICU. Just don't be scared about stupid stuff that some new grads are scared/nervous about (like priming IV tubing). Practice, read, learn, study do whatever it takes. Bust your bottom breathing in ICU material that first year or however long it takes for you to start being confident and competent, and make it happen.

Thats what I plan on doing except I have ...almost 2 years experience. My only regret is that I didn't do this coming out of school. Some days I wish I had gone back to school, graduate and then start in ICU (yes I would subject myself to nursing school all over again bc some days the overwhelming feeling of it all is way too much). I didn't have a chance to get into ICU out of school. Idc what anyone says, the experience you're going to get on the floor is not enough to substitute the quality and amount of training you need for the ICU. THAT is what you really need, a lengthy, quality orientation in a supportive organization with resources and preceptors with a teaching heart.

Otherwise they can cheat you out of a proper orientation bc "you have some experience" and put you out on your own after only 8 weeks of floor training...

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