Go right to the floor or to a specialty?

TazziRN, RN · Jul 7, 2007

I went directly into the ER, was there for 19 years. I am now starting a career in home health, and while I love it, I regret not having the base knowledge that medsurg gives you. I don't know what chronic conditions look like at maintenance because I only saw the exacerbations. I'm learning how to do wound care because in the ER we wrapped 'em and shipped 'em. Wound gel? What the heck is that?

I loved the ER and would not trade the experience for anything but I missed a lot going straight there.

MIA-RN1, RN · Jul 7, 2007

you have to follow your heart; you are working hard to become a nurse and you deserve to do what you want to do. There are no 'shoulds' because there are two sides to everything.

I graduated and went right to postpartum (mother/baby) Its been just over a year now and I will be moving on shortly to a surgical floor. I was too scared to start my career on that floor, and used mother/baby as a jumping off point. Yes I will have to 'relearn' some technical skills (IV starts anyone? lol) but I did what I had to do to feel comfortable in my new role. It was perfect for me. Others I know started right off in med surge. Some are happy, some aren't. It all depends on your own feelings. Just go with your gut and do what you feel pulled towards.

rnin02 · Jul 7, 2007

I started off working in telemetry and I am very glad about that in retrospect. I had wanted to start off working in NICU or nursery and there weren't any positions near me when I graduated so I wound up in tele. It really did help me get organized, practice some skills, sort of round things out a little, and I learned quite a bit at the same time. I think I benefitted a lot from it, I can compare myself to a coworker who started off in wellbaby nursery and is having an extremely difficult time orienting to postpartum (we are tranisitioning to mother-baby couplet care this fall, so everyone is getting cross trained)...she has had an extremely difficult time getting organized, relearning some skills, getting used to actually giving meds at a certain time, etc, etc. I don't want to say anyone has to start off in med/surg or any other one place, but I can see the benefit to starting off some where that will require you to be organized, become used to working with a variety of patients and use a variety of skills. I would think starting off in a speciality such as ICU, ER, etc would really prepare you to work anywhere later...but you also want to be happy in your position, that matters a lot!

HM2VikingRN, RN · Jul 7, 2007

I am graduating in 5 months. I am planning on seeking a position in an ICU or the ER. (One of my advisers told me that she thinks I would get bored in a straight medsurge role.) She thinks that my personality is a better fit for those areas.

allnurses Guide · Jul 7, 2007

I have to say that, even working in psych, I am so glad that I have my med/surge experience. Last night I caught a real problem with a patient's meds that could have been serious, that someone else may not have caught. This woman had a heart rate at 4pm of 48. Her heart rate the day before at the exact same time had been 42. This woman was getting Cardizem CD twice a day, as well as Toprol XL, twice a day, for history of hypertension. I remembered giving Cardizem to patients in the hospital whose heart rates were HIGH, way up in the mid 100's or even higher! Not only that, but after conversing with the doctor on call, we both realized that this patient was on meds that are only supposed to be given once a day!

Yes, I'm patting myself on the back. But I'm one of those people who tends to beat themselves down a lot, so I deserve it for once. :)

So bottom line, I personally recommend at least a year or two of med/surge, if not more. You work with SO many different patients and illnesses, and can learn SO many different things!

hbug · Jul 7, 2007

Thanks for all of your input, I still may have to flip a coin in the end, but I appreciate your advice.

Tweety, BSN, RN · Jul 7, 2007

There are many opinions on this. My opinion is that new grads should go to the specialties they are interested in. Why torture yourself on the floor. Why subject the unit to an endless revolving door of new grads who don't really want to be there.

If the program is supportive of new grads, the training is adequate, and the staff is supportive of having you there, then go for it.

RN Zeke · Jul 7, 2007

Go where your heart leads you and don't look back!!! Not everyone is cut out to be a floor nurse. There are too many options for those that don't have a calling to work the floor.

Jolie, BSN · Jul 7, 2007

Hi everyone! I am graduating in 26 days and I could use some opinions please. I know I SHOULD go to the floor and get my skills and organization down first. But, there is a large hospital in my area that loves to hire new grads into specialties so that they can train us to their liking. I'm just am afraid that I will go to the floor and regret it. Did anyone go to the floor, like I know is best, and regret not going directly where they may have wanted? Or vice vesra? Thanks.

I respectfully disagree with the statement that you, or anyone SHOULD go to the floor and get skills and organization down pat.

If med/surg floor nursing interests you, then go for it! If not, don't. Nursing is too hard of a job to begin in an area that you are not passionate about. And it is simply not true that med/surg is the ONLY area that is suitable for learning clinical skills, organization, prioritization, etc. Those skills can (and are) learned in ANY setting.

If you have an interest in a particular specialty, and can find an extensive orientation/internship at a reputable hospital, I suggest you go for it! I had no interest in med/surg, and went to the NICU as a new grad. I have never regretted it.

Good luck!

RNperdiem, RN · Jul 7, 2007

Take advantage of the times. In the past, hospitals would not hire new graduates into specialty area. Nurses began in LTC or med-surg on the least popular shifts because they had no choice. We took the jobs we settled for not the jobs we really wanted.

Go for what you really want.

Ivanna_Nurse, BSN, RN · Jul 7, 2007

I am into my third week of orientation in ICU. I was warned about not getting the med surg experience first, but now that I am there, I have noticed that the orientation criteria, materials and checklists are the same as med surg with a great big dollop of ICU spread nicely right on top. Ahhh. I do not regret that I chose a specialty. Good luck in deciding and Congrats on your upcoming graduation! ~Ivanna