How do I make the "right" choice??

HM2VikingRN, RN · Jan 11, 2009

Go where you want to go. There is absolutely nothing wrong with getting a broad based M/S experience.

(Frankly I think your classmte is in for a real humility check. arrogance will bite her in the kiester.)

catshowlady · Jan 11, 2009

I was a PCT on an intermediate care unit at a large hospital and knew I wanted critical care coming out of NS. I did get a job in ICU in a small city right out of NS.

However, they required that I put in six months on med/surg before coming into ICU. It was worth the time. I got familiar with the hospital & their charting system, and was able to get my feet wet as a new grad with pts that weren't critically ill. NS does not prepare you for the reality of nursing (in my opinion). So it was a good transition.

That said, med/surg can be tough. Ratios can be crazy - I did nights and was responsible for 7 pts if I had a tech or LPN in my care team, or 4 pts in primary care. It was really hard to keep up w/ 7 pts at first. Days can be especially chaotic w/ rounding, PT/OT, tests, etc. There was a lot of pt turnover, too, and admission/discharge paperwork is time-consuming.

Overall, I found the experience worthwhile. Exposure to a variety of pts and conditions may help you to decide if you want to specialize.

Just because something is a good fit for your classmate, does not make it a good fit for you. Satisfy your wants & needs, not hers. Trust yourself. :)

Zana2 · Jan 11, 2009

Talk to your mentors. They're the best to judge according to your performance. I was told pretty much straight away:'oh, you're an 'acute' one', and I looked blank at her..acute what?

Fast forward 3 years, and yes, I'm definitely 'acute', medical exhausts me and I cannot see the finality of it all, although I'm not showing it..it's just not me, which is fair enough. I know my limitations.

I have friends who i considered crazy to want to swap surgical for medical, but they thrive on medical.

Having said that..I'm about to start applying for jobs...I'll go for surgical first, but I'm good on medical too, i could give it 6 months..so the bottom line is i'd do anything to get my foot in the door. We're lucky enough to have a qualification so varied, it doesn't work in one place, try another.

StrwbryblndRN · Jan 11, 2009

When I graduated I only knew what I did not want. L&D, postpartum and peds.

I work med/surg and love the pt population. I like the elderly medical more than the post surgical. Call me crazy but I love the confused and overthetop pt's.

What I did find out over the course of 1.5 years is that I would love to do hospice. We get some hospice pt's and taking care of them works for me. Some can't stand it.

Also for me, I was not keen on asking others their opinion as to what I should do. It guided me to do what everyone thought would be the "thing to do". I had to have it come to me. It was a calling to become a nurse and I feel it is a calling for me to pursue hospice nursing. Not yet though, I am still having fun with my pt's. (Our ratio at night is no more than 1:6, no tech)

I have to admit I find the phrase "those that can do, those that can't do med/surg" horrible. If you can handle being a bedside nurse at all than that says alot. Good luck!

Katie82, RN · Jan 11, 2009

You should go where you will be happiest, but since you haven't had the opportunity to learn where that is, start with med/surg. My daughter is in her final year of nursing school, and I have given her the same advice. It will be both skill-building and knowledge-building. I have been an administrator, and am now a Case Manager and I could not have gotten either one of these jobs without a solid med/surg background. Recruiters are hesitant to hire nurses whose background is too specialized if they need someone with a broad base of knowledge. You don't have to stay there. But starting there, then transferring to an area that really interests you will mean more happiness and success in the long run. In its infancy, your career is not about acheiving instant status, but building a strong foundation.

M.YOUSEF · Jan 11, 2009

me .. the general surgery dep. is my choice . i thinh , the med\sur is right choice.

llg, PhD, RN · Jan 11, 2009

I agree with the others. There is nothing wrong with choosing a general med/surg unit. The patients there need good nursing care just as much as any patients do. They deserve to have good nurses working there who truly WANT to do that type of work.

However, your friend was right about one thing. Sometimes, med/surg units offer less extensive and less supportive orientations for new grads. It's as if they assume you already know a lot about med/surg because you studied it in school. Some of the specialty units offer more extensive/supportive orientation programs because they know that many of their new hires have not had much (if any) previous experience in that specialty.

So ... be sure you investigate the type of orientation you will get as a new grad along with the amount of support that will be available. For example, avoid choosing a unit on which the turnover is so high that you won't be able to get a consistent, experienced preceptor to guide you. Look for a good supportive work environment and feel good about starting your career in a job that will help a lot of people and give you a chance to further develop your general nursing skills. You may decide to stay there forever -- but if you don't, you will have established a great foundation of skills and knowledge to build upon.

sunray12 · Jan 11, 2009

I am feeling so out of it right now. I am in my last semester of ns and I still don't know where I should be trying to apply for an internship. One of my classmates asked me what dept did I want to work in after graduating and I said, maybe Med/Surg. She said, "I hope you are not SERIOUS or just STUPID! no one in their right mind would pick med/surg on purpose. You will be treated like crap". She goes on to say, "I'm going into the ER or ICU. You know the old saying, those that can do, those that can't do med/surg". What is so wrong with med/surg??? What's wrong with me?? Should I really be considering one of the other depts? Can anyone share how/when you decided and what dept you are in. Did you make the "right" choice and loving it, or do you have regrets and wish that you had gone in another direction.

She doesn't sound like she's going to make a good nurse herself. What's with all the (her) negativity? Its one thing if she doesn't want to do med/surge herself. No problem - with the variety of options available there's no reason why everyone should do med/surge. But there's also no reason for her to insult the legions of med/surge nurses who are in med/surge by choice and good at what they do.

Princess_M83 · Jan 11, 2009

If that is what you want to do, then do it. Do not let your classmates negativity hold you back from something that you may truly enjoy. Not everyone (including her) is cut out for Critical Care. I already work in Critical Care as the department coordinator doing staffing and scheduling and payroll and other things. I think I want Critical Care when I graduate but that does not mean I will be good at it, also doesn't mean that I wouldn't make a great med/surg nurse either. Just because someone chose med/surg as their area does not mean that they would not be a wonderful ICU or ER nurse with a little training and time.

cupid09 · Jan 11, 2009

Thanks everyone, I really appreciate all the responses. I'm sure that I will make the right decision and if not there is always a plan B. I am feeling much, much better after sleeping on it, and after reading your replies! If anyone else asks me what dept I want to go into, my reply will be...I'll know when I get there

NursKris82 · Jan 11, 2009

I just graduated and some of us know exactly where we want to go and others just know where we don't want to go. I want to go to a cardiac step down, but got an interview on a med-surg step down. I think it's going to be great. No matter where you start, there's lots to learn. Your friend sounds very prideful- she better get that off of her before she starts working on the floor. There's nothing nurses hate more than new grads who think they know it all!!