Med/Surg vs. Specialties for new nurses

josefhrn · Aug 31, 2008

First and foremost, med/surg is a specialty. And secondly it doesn't matter if you choose OR or NICU first or second, they are both completely different specialties. You just have to do well in whatever one you start with, then when you feel the time is right start applying to the other specialty. It may be difficult to get a job based on your experience and the change but an interviewer is more likely to hire you if they see an honest interest in a long term switch.

Joe-Telemetry

mom2michael, MSN, RN, NP · Aug 31, 2008

M/S is a speciality. So are NICU and OR. They are vastly different. Each one is going to hold a different type of learning curve regardless of the experience you have.

Pick the job that your heart desires.

If they are dead tie - then pick the one with the best orientation process. Being a brand new nurse is hard enough - you need a good job with lots of support all the way around.

Nursing is so versatile - if the job isn't for you - then quit and find another one.

Good luck and congrats on almost being done with school!!!!!

wooh, BSN, RN · Aug 31, 2008

Med/Surg vs. OTHER Specialties for new nurses

Fixed that for ya!

RNsRWe, ASN, RN · Aug 31, 2008

The very look of the float nurse from other (read: specialty) units who float to my surgical unit should clue in anyone that they are, in fact, in a specialty area.

Otherwise, certainly ANYONE who came from the ER, ICU, cardiac, neuro, etc would have no problems handling their patients and load in med/surg, right?

To the OP: I don't understand the "transferability of specialty" question...if one has experience in a NICU, that's that. Obviously, different facilities will have different policies, and different states might see differences in procedures as well, but bottom line is a TN NICU and an AZ NICU both are dealing with the same issues. You'd find you'd need updating and "retraining" pretty much anytime you switched hospitals, even in the same town.

ArwenEvenstar · Aug 31, 2008

Maybe my view is old-fashioned....But I think it is best for new nurses to work med-surg for at least a year or so because you do gain such a variety of experiences. Yes, med-surg is a specialty too, but you do get a real variety of patients and procedures. I started out med-surg and my experience base served me very well.

Later I worked a "post coronary care unit" for several years, and certain things we very rarely saw - like NG tubes or PCA pumps for instance. Most of the nurses on this cardiac unit had come straight from school to this unit (no med-surg first). And they would FREAK out over a NG tube or PCA pump! (Really! It was rather amusing!) They had no idea what to do. In my med-surg days, I cared for hundreds of pts with NG tubes and PCA pumps...

Many times over my 17 years of nursing, I have been thankful for my initial med-surg background where I saw a little bit of everything.

At least that was my experience. But this could vary on the size of the hospital though - at small hospitals all types of patients tend to be lumped together in "med-surg". While in a large hospital there would be less variety on med-surg because some patients would go to the specialty units designed just for them.

I worked med-surg at a small 100 bed hospital as a new nurse. On med-surg, I would have patients with all of the following diagnosis': total hip and knee replacements, pancreatitis, exac COPD, pneumonia, small bowel obstruction, new colostomies, end stage liver disease, total hysterectomies, mastectomy, CVA/TIA's, seizures, etc. You get the idea! At the large teaching hospital I later worked at many of those patients would have gone to specialty units - the joint replacements to the ortho unit, the hysterectomies to the women's unit, etc.

Anyhow I am very wordy - could have said this is in half the words....sorry.

nrsang97, BSN, RN · Aug 31, 2008

Maybe my view is old-fashioned....But I think it is best for new nurses to work med-surg for at least a year or so because you do gain such a variety of experiences. Yes, med-surg is a specialty too, but you do get a real variety of patients and procedures. I started out med-surg and my experience base served me very well.
Later I worked a "post coronary care unit" for several years, and certain things we very rarely saw - like NG tubes or PCA pumps for instance. Most of the nurses on this cardiac unit had come straight from school to this unit (no med-surg first). And they would FREAK out over a NG tube or PCA pump! (Really! It was rather amusing!) They had no idea what to do. In my med-surg days, I cared for hundreds of pts with NG tubes and PCA pumps...
Many times over my 17 years of nursing, I have been thankful for my initial med-surg background where I saw a little bit of everything.
At least that was my experience. But this could vary on the size of the hospital though - at small hospitals all types of patients tend to be lumped together in "med-surg". While in a large hospital there would be less variety on med-surg because some patients would go to the specialty units designed just for them.
I worked med-surg at a small 100 bed hospital as a new nurse. On med-surg, I would have patients with all of the following diagnosis': total hip and knee replacements, pancreatitis, exac COPD, pneumonia, small bowel obstruction, new colostomies, end stage liver disease, total hysterectomies, mastectomy, CVA/TIA's, seizures, etc. You get the idea! At the large teaching hospital I later worked at many of those patients would have gone to specialty units - the joint replacements to the ortho unit, the hysterectomies to the women's unit, etc.
Anyhow I am very wordy - could have said this is in half the words....sorry.

Very nicely said.

I cannot agree with you more. I have been a nurse for 7 years and agree that if I didn't start in med surg I would not be the nurse I am today. You learn time management and prioritization as well. You can just look at someone you have been taking care of for days and suddenly say "Something isn't right". Also med surg is it's own specialty. I am really glad I did med surg before I went to the Neuro ICU. You will see such a wide variety of diagnosis as well. So you may want to consider starting in medsurg. Don't say no until you give it a good try.

Kyrshamarks, BSN, RN · Aug 31, 2008

The old you learn time management and prioritazation on med surg argument is passe..you learn those skills on any unit you start on. It is kind of insulting to ICU nurses or ER or NICU or any other unit to say that. All units require a different skill set from each other and all can terach you something. Drop a med surg only nurse in the ubit and watch them flounder when their patient goes south and now you have to manage 4 or 5 drips that you are titrating and your other patient has med induced diarrhea and you have no aide to help out, and the doctor is calling with 2 new pages of orders for your patient who you are about to intubate. Or how about in the ER where you have 4 rooms and you do not know what is going on, 1 kid in active ststus epilepticus, a little old lady from the NH who fell and fractured her hip and is denmented, the overdose who is combative and the family of four who wants to be fed. See, in all areas you learn how to prioritize and time management.

IPrepU · Aug 31, 2008

I started my RN career in Med/Surg and now, as a Surgical RN, I am glad I did. The skills you learn and knowledge base you get will only enhance your capabilities in any other field of nursing. I'm not saying it was easy, and at the time when I graduated you almost had to do Med/Surg first. Specialty areas woudn't let you in without it. Now, with nursing shortages, it's easier for new grads to get in those areas I couldn't as a new grad. I think though, if you give yourself at least one year in Med/Surg you'll find working in a specialty area less stressful. Good luck in your decision!

nessajune21 · Aug 31, 2008

. My question is, is it easier to begin O.R nursing and then transfer to NICU? Or is it simpler to begin in NICU and transfer to O.R? .

I think it would be just as difficult to transition from either to the other. They are entirely different specialties with entirely different skill sets and transferring would be difficult both ways.

Scrubby · Sep 1, 2008

My hospital prefers nurses to have worked in a ward area like med/surg before going to the OR because a lot of the skills you need in theatre area learned on the wards. When you go to work in the OR it's assumed you know basic nursing care like manual handling, pressure area care (yes we do this in the OR!), basic life support so you ready to learn your instruments, how to scrub and circulate straight away.

The reason I don't feel the OR is not a good place to learn the basic care is that theres such a small window of time to get the patient in and give basic nursing care before the surgery starts (everyone wants it done quickly to avoid surgical delays) and not really a supportive environment to learn. On the ward area you don't have a surgeon standing over you wanting to get started so theres less urgency involved.

NursingAgainstdaOdds · Sep 1, 2008

The old you learn time management and prioritazation on med surg argument is passe..you learn those skills on any unit you start on. It is kind of insulting to ICU nurses or ER or NICU or any other unit to say that. All units require a different skill set from each other and all can terach you something. Drop a med surg only nurse in the ubit and watch them flounder when their patient goes south and now you have to manage 4 or 5 drips that you are titrating and your other patient has med induced diarrhea and you have no aide to help out, and the doctor is calling with 2 new pages of orders for your patient who you are about to intubate. Or how about in the ER where you have 4 rooms and you do not know what is going on, 1 kid in active ststus epilepticus, a little old lady from the NH who fell and fractured her hip and is denmented, the overdose who is combative and the family of four who wants to be fed. See, in all areas you learn how to prioritize and time management.

Yes, in all areas you learn prioritization and time management. Point taken. Your post, however, seems more intent on antagonizing conflicts between specialties and operates under the assumption that 85% of what you listed isn't also something I see on my floor on a daily basis.

I could sit here and list 800 details of a single day in an attempt to intimidate others into agreement. However, I think every single one of us could do that, and it's also not very productive.