Is med-surg really the best place to start as a new grad?

Nurses General Nursing

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I will be a new graduate RN in a couple weeks and am interested in experienced nurses advice on where to start..? I have been told by many instructors that med-surg is the best place to start and I have enjoyed my clinicals on the floor, but I'm more interested in other areas. I appreciate your thoughts and time!

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here's the thing, i bet you 90% of all jobs out there are med-surg for a new grad. You kinda don't really have a choice to get into specialized area. you're more likely to get into an area you did your preceptorship in. but if you did your preceptorship in an area that isn't hiring, its harder to get into med-surg.

i'm a new grad out for a year, who didn't do my preceptorship in medsurg. now i find it hard to find a job in the specalized field i want (bc there are no jobs out there), and its hard for me to get a medsurg job either bc my preceptorship was something else.

frustrating. if i had to turn back the clock 1 year ago, i would probably have done my clinicals in med-surg, and applied only to medsurg jobs.

and yes you learn a lot more

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Specializes in critical care/tele/emergency.

Look at it in terms of building a foundation. If you start in Med-surg where a vast array of medical conditions are seen, you build a broader base of knowledge. Let's face it, some specialty areas are more interesting but you've got to make certain your foundations are solid

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i would say definitely!

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Specializes in Critical Care, Pediatric.

Hi there!

Congratulations on almost finishing! What a great accomplishment :)

I am going to disagree with the previous posters, with some conditions. If you live in a large metropolitan area, I think that you would be more than fine to start within a specialty. If the institution is a teaching hospital and capable of nurturing you as a new nurse, then a specialty is definitely doable. The other piece of the puzzle is your own comfort level and confidence as a person in general. I started in a sub-subspecialty right out of school (a pediatric cardiothoracic ICU) and have been fine. The "basics" or "fundamentals" of nursing you will find in any new nursing job, assuming it is the right environment. I would contend that you could easily start on an ortho/med-surg floor and not get taught the basics, or even get trained to have bad habits or wrong fundamentals. It's all about the employer and nursing culture of the unit.

My suggestion to you is not to limit yourself. Any direct patient care nursing job is going to give you a slew of fundamentals - you can't survive without them! If you know that you are a quick learner, flexible, and motivated then you'll do fine in a specialty. I wouldn't be able to work med-surg for more than 6 months because I need the stimulation, excitement, and constant learning that my specialty gives me.

I hope you find something perfect, and best of luck!!

-Alex

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Specializes in LTC/Behavioral/ Hospice.

I think you will find that opinions go both ways. There are nurses out there who firmly believe in Med-surg as the first place to work as a new nurse, and others who feel that it is just fine to enter a specialty field. I'm in the same boat as you, hopefully graduating soon and I'm going to check the specialties I'm interested in and talk to those that I hopefully will get an interview with and see what they think. If they are willing to hire me and give me the training I'll need, I'm going to go for it!

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Specializes in CRNA.
I will be a new graduate RN in a couple weeks and am interested in experienced nurses advice on where to start..? I have been told by many instructors that med-surg is the best place to start and I have enjoyed my clinicals on the floor, but I'm more interested in other areas. I appreciate your thoughts and time!

This is old nursing dogma that cannot truly encompass all new nursing grads. Think twice when people start force feeding that med/surg foundation hullabaloo down your gullet. The majority of the time they are regurgitating what someone has told them and through repetition have come to believe it themselves. Where you work should be based on: 1) your previous experience prior to being an RN 2) your near and long term career goals 3) most importantly....what makes you happy.

From having worked as a tech and EMT on various units in numerous hospitals before and during nursing sckrewl, there was no way in hell I could be happy working the grind of a Med/surg or Telemetry deck as a new grad RN. I found a job a few hundred miles away from where I lived with a good training program in the ED and life progressed to what it is today. All went well.

There are many jobs out there with decent orientation programs for nurses looking to do something other than the status quo recommended to you by nursing instructors, most of whom have not set foot in a hospital as a staff RN since Vanilla Ice was still "cool". Yes, new grads survive and function in specialty areas (Benner's theory is a load of crap). Maybe I am a bit biased, but I think the best place to see EVERYTHING "and learn a lot more" is to go down to the ED deck and work for a while.

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Specializes in Level 1, Level 2, Level 4 trauma and med.

YES! You will experience more in 1 yr on med surg than any othe floor. No brainer!!

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Specializes in NICU.

Depends on what you want to do ultimately. I started in NICU and wouldn't have it any other way. A year of med/surg wouldn't have done anything for me, besides the general time management/prioritization skills that every new grad has to learn, because my patient population is so specific and there's little to no crossover with adults in terms of diagnoses, meds, and interaction with patients.

Like Redcell suggested, my unit has a good orientation program with lots of great nurses for preceptors, so I was able to survive the steeper learning curve of ICU. Of course, if I were put on a med/surg floor with 7-8 patients, I'd drown, but then I have no plans to go back to adults any time soon.

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Look at the job market in your area.

In many cases jxRN is right, and med-surg floors are the ones hiring new grads these days.

My hospital HR website even lists the units that freely hire new grads(mostly med-surg), areas that hire new grads who have done an externship or are otherwise known(ICU) and areas that will not hire new grads at all(PACU).

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Specializes in CVICU.

IMO, the best place to start is the place you're most interested in ending up. If you think you want L&D, try to get a job in L&D. If you think you're an ICU nurse, try to start in ICU. ER is a great place to see everything, but you don't really get in depth with any one thing, you stabilize many different things and move the patient out for more in depth care. But, if you like to see a little of everything, maybe ER is for you.

I started in cardiac ICU and have never regretted it, even though my goal is to eventually get to L&D. However, I definitely think that Med/Surg would have soured me on the profession and I would have been angry and frustrated trying to transfer out. If you know Med/Surg is not for you, don't start there unless you can't get a job in your area of most interest. In a nutshell, don't do what someone else thinks is best for you. Do what YOU think is best for you.

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Specializes in ER.

Sorry not true. I started in ED and have flourished. I think you will learn the most in an ED, any ICU, or step-down unit. Do what makes you happy!

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