JUST CURIOUS! After completing a new graduate residency program, when can I request a transfer to a specialty unit?

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Specializes in M/S.

Hey guys!!! Im currently a novice nurse in a med surg Residency program in Boston. At one of the larger hospitals- my dream hospital tbh.

little background: I worked as an aide in a different hospital system praying for entry cause that hospital is the #1 hospital in the country (hint hint ) but getting in as a nurse was like pulling teeth! I ended up getting a job in a skilled nursing facility aka rehab aka DONT EVER DO THAT lol ( my assignment was always 10+ patients with lots of dressing, wound vacs, TPN, abx THE WORKSSSSS) and within 9 months of rigorous hunting I got the residency position in medsurg (not my favorite but grateful).

Anyways, the hospital I work at now is great. My residency program prepared enough for me to work on my own and utilize any resources if needed. Orientation was scheduled for 6-8 months but I was able to be on my own after 4 months (thank God for that wild experience prior). Despite getting off orientation early, I reeeeally feel ready. I still have a little nervousness going into work cause of course I’m responsible for the lives of others but also because my floor is a surgical telemetry floor; all my patients are fresh post op or fresh traumas from the ED needing surgery and things can go south pretty quick.

My dream is to be an OR or ICU God one day (I know two completely different parties but I’m young and I’m interested after shadowing). Itching to work my way up the ladder. I was wondering when the best time to make the switch once I feel ready. My hospital policy is 6 months after orientation but I know a year is preferred. Any suggestions? Any suggestions on what I can be doing in the meantime?

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

How long is the actual residency? Most don't just end because you are off of orientation.

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Specializes in Critical Care; Cardiac; Professional Development.

The "ladder" you speak of doesn't exist. If you wish to be in a different specialty, great. But thinking of it as a hierarchy where ER, OR, ICU, NICU and others are higher up than med-surg, rehab, LTACH or any other kind of nursing is a delusion. Do not foster this kind of thinking.

Only your employer will be able to tell you when you can change departments per their policy. As far as political wisdom, you should stay a year to two years where you are.

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Specializes in school nurse.

Two years would be good (as a minimum). In the meantime, polish your skills as much as possible and get as many applicable certifications as you can.

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Specializes in NICU, ICU, PICU, Academia.
2 hours ago, Nurse SMS said:

The "ladder" you speak of doesn't exist. If you wish to be in a different specialty, great. But thinking of it as a hierarchy where ER, OR, ICU, NICU and others are higher up than med-surg, rehab, LTACH or any other kind of nursing is a delusion. Do not foster this kind of thinking.

This X 1,000,000,000,000

The various specialties in nursing are different - not 'higher' or 'lower'. And that #1 ranking for the hospital?- Those ( like college rankings) are purchased and mean nothing.

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Specializes in Pediatrics, Pediatric Float, PICU, NICU.
9 hours ago, TtheIndecisiveRN said:

My dream is to be an OR or ICU God one day (I know two completely different parties but I’m young and I’m interested after shadowing).

OR or ICU God? ?

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Specializes in orthopedic/trauma, Informatics, diabetes.

I had a 6 month residency (I did ortho rehab at a facility and it was a great experience learning time management) in the specialty I wanted. After 4-5 months, I was trained to work in our sister unit which was plastics. I was not allowed to go from a CNI to a CNII until 1 year. I had a 2 year contract WITH the unit I was hired in.

ICU and OR are two very different specialties. At my hosp, it is another 6 month orientation to train for the OR.

I personally don't understand the obsession with the ICU. To me, it is either boring (which is good for the patient) or not boring, which means the patient is in trouble.

I am in orthopedics and we have intermediate and stepdown patients. Many think that ortho is "lower" in the hierarchy. It is medically challenging-not only do I deal with fresh post ops, we have to deal with all the comorbid conditions, surgical precautions, PT/OT and pain management.

I work at a top 10 hospital (and to the person who says we "pay" for a ranking, that is not true-we do some very innovation surgeries that are not done anywhere else).

Enjoy the time you have now to learn, it will make you a better nurse. Don't be in such a hurry to move around. They are not going to want to take you if they think they are going to change your mind again in another 6-12 months.

Best of luck!

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Specializes in M/S.
7 hours ago, Pixie.RN said:

How long is the actual residency? Most don't just end because you are off of orientation.

The residency is a total of 6-8 months orienting. After that, I’m just a staff nurse. Thanks for replying.

46 minutes ago, JadedCPN said:

OR or ICU God? ?

Lol what a reaction!!

By God, I just mean I wanna be GREAT. By no means am I trying to be arrogant! I just wanna be the best I can be in all aspects of my specialty! I even have that written on my stethoscope. It’s my motivation!!

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Specializes in M/S.
7 minutes ago, mmc51264 said:

I had a 6 month residency (I did ortho rehab at a facility and it was a great experience learning time management) in the specialty I wanted. After 4-5 months, I was trained to work in our sister unit which was plastics. I was not allowed to go from a CNI to a CNII until 1 year. I had a 2 year contract WITH the unit I was hired in.

ICU and OR are two very different specialties. At my hosp, it is another 6 month orientation to train for the OR.

I personally don't understand the obsession with the ICU. To me, it is either boring (which is good for the patient) or not boring, which means the patient is in trouble.

I am in orthopedics and we have intermediate and stepdown patients. Many think that ortho is "lower" in the hierarchy. It is medically challenging-not only do I deal with fresh post ops, we have to deal with all the comorbid conditions, surgical precautions, PT/OT and pain management.

I work at a top 10 hospital (and to the person who says we "pay" for a ranking, that is not true-we do some very innovation surgeries that are not done anywhere else).

Enjoy the time you have now to learn, it will make you a better nurse. Don't be in such a hurry to move around. They are not going to want to take you if they think they are going to change your mind again in another 6-12 months.

Best of luck!

Firstly THANK YOU for being encouraging rather than condescending. I appreciate it. My floor is ENT, oral max and orthopedic. I honestly like it. It’s what encouraged me to take a look at SICU and OR specialties because that’s where my patients come from. And I like the trend of care and patho of it all. I will take your advice and stop being so anxious and take advantage of what I’m learning! THANK YOU

7 hours ago, Nurse SMS said:

The "ladder" you speak of doesn't exist. If you wish to be in a different specialty, great. But thinking of it as a hierarchy where ER, OR, ICU, NICU and others are higher up than med-surg, rehab, LTACH or any other kind of nursing is a delusion. Do not foster this kind of thinking.

Only your employer will be able to tell you when you can change departments per their policy. As far as political wisdom, you should stay a year to two years where you are.

By “ladder” I’m simply referring to where I am vs my end goal. Not putting the specialties in tiers. Thanks

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10 minutes ago, TtheIndecisiveRN said:

Firstly THANK YOU for being encouraging rather than condescending.

Nobody was being condescending to you. I think you might need to slow your roll just a little.

10 hours ago, TtheIndecisiveRN said:

I was wondering when the best time to make the switch once I feel ready.

It's more like when they feel you are ready. At one year of experience you're still a novice. Take this next year to really hone those assessment and critical thinking skills.

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

The time frame for transferring is going to depend on many things, the policies of your hospital and the interest of the transferring units/management are involved so answering specifically would be hard. Getting the best knowledge base and ability to assess and treat patients is an important goal of your residency program, try to enjoy your time and learn as much as you can. The ICU and OR aren't going anywhere and you're still very young so you have plenty of time. To give you a more specific answer, I work in a small hospital and we have had new grad residents that have transferred to the ICU as early as 8 months after starting. That's a very quick transition and some have done well but some have not. Get what you can out of where you are and when you feel ready you'll know it's time to move on. Good luck.

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No one on the internet can answer this, look at the policy manual for your facility, that’s the only opinion that matters.

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