Future New Grad RN does not want to work Med-Surg!

[JuleG]

Hi there! 

I will be graduating from a BSN program this December and need some guidance. I have heard from many nurses, professors, and mentors that new grad RNs need to work Med-Surg for their first year to gain experience and learn to be a nurse. I have also heard from nurses I've spoken to that it doesn't matter, each unit is different and to go after your desired specialty. I want to pursue NICU nursing in a residency program but have zero nursing experience (CNA,PCT) on my resume. I have volunteering experience in a children's hospital and leadership positions, but my only work experience is within the customer service range. So my question is, would a NICU hire me or any OB unit? Should I just bite the bullet and work med-surg for the first year to gain that experience even though its not where I personally would enjoy going to work? 

Thanks so much!

[Rose_Queen, BSN, MSN, RN]

Apply for what you want in addition to other positions. You may not be able to get right into your desired specialty right out of school as many are very competitive. Nursing experience in a different specialty is better than no nursing experience and a gap from graduation. 

[JKL33]

This may well boil down more to who is willing to hire you rather than being about what nurses or instructors say is or isn't necessary or ideal.

Seek out the jobs you would like to have, but don't miss out on what's available in doing so. ?

[NICU Guy, BSN, RN]

On 9/9/2020 at 9:31 AM, JuleG said:

I have heard from many nurses, professors, and mentors that new grad RNs need to work Med-Surg for their first year to gain experience and learn to be a nurse.

This may be relevant to someone that wants to pursue adult nursing. NICU is a very specialized unit. A majority of what you learned in nursing school and would learn on an Adult Med/Surg floor does not apply to NICU.

A nurse residency teaches you the basics of what you need to be competent as a NICU nurse. While experience as a PCT in a NICU or having a Capstone in NICU during school would have been a benefit, it is not required.

If you have the ability, applying nationwide would help your chances getting a NICU residency. When I graduated, I applied to every posting on indeed.com  that did not require NICU experience.

[Scottb88]

To answer your question with the experience I HAVE HAD, Medical-Surgical nursing is likely one of the toughest sub-specialties of nursing. Even experienced nurses can find some (Not all, or even most) days very challenging and exhausting. This is because you deal with many different diagnoses, overflows, admission/discharge paperwork, and sometimes things you haven't seen yet. 

As a new grad nurse, I did an internship/contract into Pulmonary-Thoracic Intermediate Care. At the time, I found it stressful and very intense, even with only three patients because I was brand new. This was due to my lack of experience and confidence. This comes with time. Later I worked in Peri-Op while getting my MSN and have recently gone to back to doing some Med-Surg bedside.. Even with an APRN I found Med-Surg to be very demanding. Not knowledge or decision wise, but with time prioritization as you are expected if you have to, to take 5 patients around the clock.. You could start with 5, and end with 5 new. 

So... hospitals will do internships with new grad nurses into specialized units. Either way, the learning curve will be intense. Nursing school trains you on the basics, and its a lot to learn even at that. Here is the kicker: If you want to work a specialized unit and they train you, then by all means do it. Specialty units are great for new grads because you can be hyper-focused on one thing. The downside is that you don't get your butt kicked getting the experience on the med-surg dealing with stuff that veterans still get stressed/cry on their ride home about. 

At the end of the day, the most important thing will be liking/loving what you do. As you get better/faster/more experience, you will find that you will have the time/knowledge/documentation skills that allow you to make that connection with your patients or family members that makes nursing so awesome. At first, you will be learning the unit rules, medications, and likely struggling just to get the orders done, and find that it may be frustrating that you feel like you barely got anything done except the minimal orders. Stick with it though, because you will find your stride. 

In summary, if you know you want to do NICU and get a placement with adequate training, then definitely do it. Medical-Surgical nursing is very hard, and the expectation to hold your own in a variety of scenarios is high, but it does make you better as well. When I was a new grad, I did intermediate pulmonary care and thought it was hard. Now I do Med-Surg nursing and realize it was just my lack of confidence that was in my head. I hope the best for your journey, just realize that all you can do is your best, and with time the confidence will come and you will find your stride in whatever setting. Work at a hospital that allows you to transfer units if you don't like what you do. Never let yourself feel trapped in whatever setting you end up in, and always go out of your way to befriend other nurses in the hospital, this will open roads for you down the road, particularly if you want to transfer units. Nurses are in high demand more than ever. Don't fall into the trap of "I didn't sign up for this" in whatever you do. If you don't like your ultimate situation, then transfer within the hospital if you can. 

Best of luck

[northmississippi]

I know a nurse that went straight to nicu and is doing just fine. I"m sure there was a lot of training for it once she got there. Your success there probably depends on if you have someone who will really teach you and not go sit in a back room reading a book while you work the floor.