Interested in L&D/NICU, but should I start in Med-Surg?

beekee · May 27, 2020

You should start out with a job. They are hard to get. If offered both, take the L&D job. There’s no rule that says you must start in med/surg if you don’t want to.

Sour Lemon · May 27, 2020

41 minutes ago, beekee said:
You should start out with a job. They are hard to get. If offered both, take the L&D job. There’s no rule that says you must start in med/surg if you don’t want to.

Exactly. Don't torture yourself making a "decision" until there's one to make. Apply for everything and see who calls.

I like behavioral health, and think med/surg is a great foundation for it. L&D and NICU are so specialized that it would make more sense to go straight there- if you're sure that's what you want to do, and if you get an offer in either area right out of school.

Closed Account 12345 · May 27, 2020

Former L&D nurse here - Go to L&D or NICU right away, if you can. There'd be no significant benefit to working Med Surg first. HTN is treated differently in L&D and M/S. Diabetes is treated differently in L&D and M/S. Etc. Etc. If you're able to go directly into your chosen specialty, you'll learn how to handle medical problems as they apply to your specific patient population.

As others said though, it can be challenging for new grads in some areas to get hired into specialty areas. I'm guessing most students from your class who will head directly into specialties received offers to do so before graduating for residencies, internships, etc. It's not the end of the world if you end up in Med-Surg for a year.

**NICU Guy, BSN, RN** · May 27, 2020

5 hours ago, Sour Lemon said:
L&D and NICU are so specialized that it would make more sense to go straight there

1 hour ago, FacultyRN said:
Go to L&D or NICU right away, if you can. There'd be no significant benefit to working Med Surg first.

^^ I agree^^ A 70 yr old with comorbidities and a 30 week gestation infant are two totally different creatures. There is no benefit to get a year in Adult Med-Surg first.

toomuchbaloney · May 27, 2020

7 hours ago, anneliserichards94 said:
I just graduated from nursing school and am currently waiting to take the NCLEX. I have a passion for L&D/NICU and am wondering if I should start in Medical Surgical Nursing to get a good foundation. For those of you working in L&D/NICU did you start in Med Surg and if so, how do you think it benefited you versus those who did not start out in Med Surg?

Many moons ago I graduated nursing school and hired directly into the NICU. It was a wonderful platform. Instead of going from there to OB, I went to PICU, trauma and transport before high risk OB. I developed critical thinking, technical and professional skills that carried me through a very long and varied career. Having not worked one day on a hospital medical surgical unit, I have managed to competently, even expertly, care for patients across the age and and acuity spectrum. There are lots of us.

You can too. If NICU is what you want and you can get in...get in now.

OUxPhys, BSN, RN · May 29, 2020

Nah. Despite what you've been told you do not need to start in med/surg first. If you are offered a job in L&D or NICU take it. If you can't find an opening in either of those two areas take a M/S job.

HiddencatBSN, BSN · May 29, 2020

Agreed with everyone above- there’s certainly no harm in starting in adult med surg and if that’s where you’re able to get a job there’s a lot you can learn there- but that’s true if any unit, and any new specialty you go to is going to have a whole new set of pathophysiology, treatment protocols, organization and time management.

I started in a peds ed and went to peds med surg for a few years after a couple years experience in the peds ed- I felt like I was starting over again in so many ways and the flow and organization was completely and totally different. Over the years I’ve worked with many nurses who are transferring in to the specialty and how much orientation they need has more to do with how closely related their last field was than how much med surg experience they’ve had.