Med surg first?

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Out of curiosity, if you went to Labor and Delivery right out of school..or something similar like postpartum/mother and baby ect.... and then decided to switch to something very different a year or so later...would you have problems switching because you never had med surg experience?

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Specializes in ICU, Home Health, Camp, Travel, L&D.

Anytime you change specialty, there's a learning curve. I went to work in a 27 bed mixed ICU right out of school. After 6 months of whiteknuckling on my way home, replaying pt care over in my head, I began to find my feet. I didn't go to L&D until I'd been a unit RN for 7 years, and had done camp nursing and home health "on the side".

I felt that having the background I came from was a tremendous blessing moving into L&D. The critical thinking ability to handle quickly changing pt conditions, and rock-solid assessment and triage skills made my move an easy one.

I don't know that it would be the same, going the other way. Postpartum/Couplet care is real nursing, and I don't want to say otherwise. However, it's not the same as med/surg or cardiac or unit nursing. Basically, the perinatal period is a wellness event, not an alteration in health, and the details of assessment/assessment skills and time management are not the same.

My usual recommendation, esp for students/GNs interested in L&D and advanced practice is to get the med/surg assessment down first. This serves to build confidence and knowledge base for later practice.

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Specializes in ER, Trauma.

Your post sounds like a loaded question. Define "something very different" please.

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Your post sounds like a loaded question. Define "something very different" please.

If I wanted to move to ER/Burn Unit/Psych/Transplant...just anything vastly different than L&D. Would they pass me over because I didnt have med surg experience and only LD/PP/Mom and Baby?

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Anytime you change specialty, there's a learning curve. I went to work in a 27 bed mixed ICU right out of school. After 6 months of whiteknuckling on my way home, replaying pt care over in my head, I began to find my feet. I didn't go to L&D until I'd been a unit RN for 7 years, and had done camp nursing and home health "on the side".

I felt that having the background I came from was a tremendous blessing moving into L&D. The critical thinking ability to handle quickly changing pt conditions, and rock-solid assessment and triage skills made my move an easy one.

I don't know that it would be the same, going the other way. Postpartum/Couplet care is real nursing, and I don't want to say otherwise. However, it's not the same as med/surg or cardiac or unit nursing. Basically, the perinatal period is a wellness event, not an alteration in health, and the details of assessment/assessment skills and time management are not the same.

My usual recommendation, esp for students/GNs interested in L&D and advanced practice is to get the med/surg assessment down first. This serves to build confidence and knowledge base for later practice.

This is why I was questioning whether its best to start in med surg......Im pretty sure that I want to be a CNM but dont want to close myself off to other possibilities as well...and if med surg is a must to be able to switch in and out of specialties then I guess its an idea I need to get used to..instead of thinking I should bypass it.

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Specializes in ER, Trauma.

There's not a good single answer to your question. It really depends on the department you're moving to. ER's have a little of everything in an emergent setting, though childbirth outside of L & D is highly discouraged (cleanliness issues) but ER's will see lots of miscarriages or threatened miscarriages, which L & D wont. L & D experience would be more appreciated in a Peds unit for instance, and not much value in psych.

Med/Surg experience is encouraged for newly licensed nurses because it gives them a lot of experience in routine things such as medication administration. I attempted to precept a new grad who would choose a 30 cc syringe to administer a 0.5 cc im injection. Not the ideal choice.

I hope I've helped you without sounding too prejudiced for or against any particular department. I'm very proud to be an ER nurse, but greatly admire the nurses who do what I could never do, like L & D or LTC. For all the diversity in nursing, all types are needed, none are more special than another, as with all hospital personnel. Just pi$$ off a housekeeper and see how fast the hospital becomes dysfunctional!

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Specializes in MCH,NICU,NNsy,Educ,Village Nursing.

I would like to address the patient assessment issue. The maternal/ob/postpartum, etc. assessment SHOULD be as thorough as a "med surg patient" assessment. Even though pregnancy/L&D/postpartum are usually healthy events, there is often the unexpected. Good assessment skills are a must. Are they hemoynamically sound? Any murmurs heard on auscultation? What about breath sounds? I think you get my point. For instant, DVT's are a risk for a C/S delivered patient. How are you going to know if she has one if you don't check for pulses and Homan's?

I remember the chart I once reviewed for a legal case. If ONLY the pp nurse had done a thorough assessment......

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Specializes in Utilization Review Radiology Onc, Women's Health.

I believe regardless of what specialty you may get into, Med/Surg is an excellent place to start right after graduating. You get to use and perfect all the skills you learned, and there is nothing like doing that on the job. I really don't know if employers would like to see that experience first, but it would be great experience for you to get personally. You wouldn't believe the vast range of patients and diagnoses you will come across and learn about. I think Med/Surg provides a strong basis with which to build upon.......maybe not necessary, but certainly an advantage.

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Specializes in Critical Care/Coronary Care Unit,.

My suggestion is that you start on a telemetry (cardiac) floor. It's a higher acuity than a med-surg floor although you will see surgical patients. However, it's a lower acuity than the unit, but you're still considered to be in the field of critical care. It won't hurt and it'll definitely help you develop those critical thinking skills since if you work tele, you'll have to know both BLS and ACLS (for codes). I'm glad I started on tele and now I'm in the unit. I work post-partum sometimes and I love it...the patients for the most part are healthy and happy. However, I know that it's not something that I would want to do for the rest of my career. I know one nurse who was a post-partum nurse for years and then she moved to cardiac tele and they considered her to be like a new nurse b/c of the acuity level. However, I think it really depends on the employer. Med-surg and ICU experience help in all fields (even psych patients and postpartum mothers code). When I work postpartum, I see a lot of nurses who used to work icu or tele and decided to switch specialties.

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thanks for all the suggestions! I really appreciate it!

I think I'll take the advice and start out in med surg/tele. It definitely wouldnt hurt to get all that experience.

There is just so much to think about. I cant wait to get in and start doing clinicals..very excited!!

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