L&D vs Med Surg for a first job after graduating.

KatfshhRN · Jan 20, 2012

I started out in L&D as a new grad. I still love it, and don't regret my decision. However, currently our unit is only hiring L&D experienced nurses. If that is what you want to do in the long run and you have the opportunity take it. There are two schools of thought and many people feel like you need the med surg background. However, L&D is so unique that I don't feel like the nurses I train from med surg are any further ahead of the new grads that I have precepted. At times we have patients that are antepartum and s/p some other sugery and that knowledge would be helpful. But, I got enough experience on L&D though the years to feel comfortable with that sort of patient. Also, we do have C-sections, so you get comfortable with the post op aspect of nursing from that if you do post-partum at all. We do at times because we have to float or we are holding when MBU is full.

annoddle · Jan 22, 2012

Thanks for your input KatfshhRN. I am leaning towards Women's Health. It is what I did the best in during clinicals and in class.

88nurse2010 · Jan 23, 2012

I have worked in L&D for the last 7 months, but worked med-surg my 1st year out of school. While I don't regret working med-surg, I didn't enjoy it. If your hospital is like most, you will be have way too many patients if you take med-surg. I never felt like I could take great care of all my patients, and that was the most stressful for me. It's very easy to get burnt out. On the other hand, in L&D I get to provide mostly 1-1 & sometimes 1-2 patient care. I always wanted to work in the maternal-child field, but I had been encouraged to get a foundation in med-surg before looking for a specialty. If you are passionate about Women's Health, take this job now!

I did feel that working med-surg gave me confidence as a nurse and a foundation of basic skills. However, you will have to learn a skill set that is unique to women's health. Most of the nurses in my department have no experience other than L&D.

tablefor9, RN · Jan 24, 2012

The only way I would recommend a new grad moving straight into specialty area, even L&D, is 1. the specialty is her/his passion and 2. the orientation will be extensive and supportive.

While L&D is a law unto itself in many ways, after several years of precepting all kinds of people in the L&D, I'll say this: experienced ICU and post-surgical RNs have the easiest time making the transition. Why? They have solid assessment skills, they have a good grasp of basic nursing scope, skills, and time management, and they are comfortable in their own skin as a nurse (trust own abilities to prioritize, speak to physicians, initiate chain of command as needed, work collaboratively within the unit setting, and have the backbone to deal with ancillary departments that may or may not see the childbearing unit as a priority).

Certainly, one can get every bit of this experience in the women's center, and many of the qualities I just listed may be ones you, as a more mature individual, already possess. If so, great! I'm precepting a 25yr old new grad right now that is going to be an amazing nurse, but she still allowed herself to be ejected from a patient's bedside by an US tech who didn't prefer to have an audience. She's had 12 weeks on mama-baby and gyn. She'll get 14 weeks in L&D, after which she will go to nights and be paired with a mentor with 20+ years of labor experience. She will complete AWHONN basic, NRP, PALS, and ACLS during her dayshift orientation. From an academic standpoint, I know it's plenty. Whether it'll be enough real-world experience, I guess we'll see.

carrie_c · Jan 24, 2012

I would do women's health over med/surg, hands down! I did med/surg for about 3 months. Everyone kept telling me I needed to do that first, even though I wanted to do OB. Med surg was so hard. We would have 7-8 pts per night, and no tech. My back couldn't take it. So when I was offered an OB position, I took it in a heartbeat. We usually have 4 couplets, which is 8 pts, and there are nights I want to scream, but it is so much easier than med surg.

cas213 · Mar 24, 2012

I just graduated in December with my BSN, and I am facing the same predicament. I have received two job offers, one in L&D at a major city hospital, the other in med-surg at a smaller community hospital. I also was not expecting to get the opportunity to choose my first nursing job, but now that I have a choice to make, I am having a lot of trouble deciding what path to take. I really enjoyed my L&D rotations, it a specialty I have always been interested in, however I am not positive if it is a specialty that I will always want to stay in. All throughout school we were told to get a foundation in med/surg, but I know that med/surg is not something I am interested in doing long-term, so I feel like it might not be worth it to start there.

In my future career, a possibility I would like to explore is moving into the operating room, my hope is that L&D would give me some solid OR experience, more so than a med/surg unit would.

Any thoughts, suggestions, experiences that anyone could share with me about their first job after nursing school, working in L&D, med/surg, or the OR, would be much appreciated so that I can make the best decision.

beachmom · Mar 25, 2012

I did med-surg on purpose for my first two years to get that good foundation. I was concerned that if I did L&D first, it would be possible that ten years down the road I mignt move and not find an L&D job. It would be embarrassing to be a 10 year nurse and need help putting in my first NG or bandaging an ugly foot wound.

I didn't like med-surg, but I'm so glad for that foundation. Our unit does L&D, postpartum and GYN surgeries. I'm a lot better than some of the other nurses at knowing what to do about chest pain, when to put the bedalarm on, and other non L&D/Gyn problems that we get on those rare occasions.

RNnicu42 · Mar 27, 2012

I am a new grad and accepted a full time position on a perinatal unit (L&D, antepartum, MBU and newborn nursery). I am so thankful for this opportunity because I did not want to start out in Med/surg. I know that women's health is passion and I am almost positive I will stay in women's health for the rest of my career. I agree that med/surg gives you a stronger foundation, but if women's health is your passion then I do not see the need to start on a unit that you will just transfer off of.

busymommy · Apr 1, 2012

I am SO GLAD I read this thread. :yelclap: I will graduate in December and the professors at my college are from both schools of thought regarding med-surg before specializing. Some say "Yes, you absolutely must have med-surg first!" and others say "If you know what you want, go for it, because I did!" I'm in a unique position, because I'm a nontraditional student (read: I'm in my 40s!) and I've had a genuine interest/curiosity about women's health since I was about 12 years old. I read A Child is Born at the library for FUN when I was in jr. high (anyone know/remember that Leonard Nilssen book with the cool photography?) My points being, #1 I'm passionate about this field of nursing and #2 I won't be leaving it to work in some other specialty - this is truly what I've been working toward for the past 5 1/2 years.

My program is giving us med-surg clinicals all 4 semesters, along with 1 other (last semester was peds/maternity & this one is psych). When I graduate, not only will I have my BSN, but I'll have a LOT more med-surg clinical hours compared to students at other schools in the area. I'm hoping that will work in my favor, since I would love to work in postpartum. What advice would you give to a new grad in postpartum? I for sure won't be precepting in this area (you guessed it - med-surg!) but what makes one new grad better than another when they start working? What things have you noticed from those you've worked with that make them great nurses and great team members?

laraclaire · Apr 16, 2012

I went into L&D straight from school and I don't regret it at all. My hospital had a 12week orientation program which was great and helped me learn how to be a nurse and how to be a good L&D nurse. Now that I've been doing L&D for a while now, I am starting to get curious about other areas of nursing but I don't think that comes from going straight to L&D, I think I'm just a curious person.