Getting a year of experience...

[PICU RNtoCRNA, BSN, RN]

I was curious to hear what many of you think about getting your first year on a general med or surgical floor. I have repeatedly heard from other students, nurses, and managers that I should plan on getting a year on a gen floor before I try to go anywhere else. Do you agree that this is necessary? Why or why not?

[Nature_walker, ASN, BSN, RN]

I started off in psych right out of school. That's what I was interested in and the unit I'm on was hiring. I think if there is an opening and you want to jump into something then go for it.

[C0SM0]

I heard the same crap all throughout nursing school. I can't even count the times I heard "You will start off on a med-surg floor to gain some confidence before moving onto something else." If that was true, I would have dropped out of nursing school. I did two years of clinicals on a med-surg floor and HATED every minute of it. Now, that's not to take away from those that do work med-surg. It's typically a busy unit with a decent learning curve, it's just not for everyone. I went to nursing school because I wanted to work in the OR and I was fortunate enough to get a job there right out of school. Many hospitals have residency programs where you'll work on many units and then get to apply for what you want at the end of it.

[NICU Guy, BSN, RN]

With a proper orientation period in a non-Med/Surg unit, I don't think that 1 yr of Med/Surg would better prepare you long term.

For example, two new grad classmates' goals are to work in Adult ICU. Nurse A takes a Med/Surg job for a year to learn to be a nurse and hone her skills. After a year, she transfers to an ICU. Nurse B starts the same day in ICU as Nurse A started on the Med/Surg unit. Nurse B had a 12 week residency in the ICU before being set on her own. After 2 yrs of being a nurse, which is going to be more confident in their skills: Nurse A who had 1 yr of Med/Surg experience then transferred to ICU or Nurse B who went through a ICU new grad residency and has 2 yrs experience in ICU?

I posed the 1 yr in Med/Surg question to my Med/Surg instructor before I graduated. He told me that you start out as a Novice in Med/Surg and work your way to Advanced Beginner by the end of the year. When you transfer to the ICU, you backtrack into the Novice level (not the very bottom of the level) and have to work your way back up to Advanced Beginner level. You are essentially taking longer to get to the Competent level in ICU by spending a year in Med/Surg.

As years go on and you are in the Proficient-Expert level, where you started as a new nurse becomes irrelevant.