New grad: ER or Med-surg?

Specialties Emergency

Published

Hello all.

I'm sort of in a predicament. I am not sure on which position to choose after I graduate next month.

I was offered a position in the Emergency Department at a trauma level I hospital, but it is in a city that I do not want to live in for 2 years. The pros for having this job is that it is my dream job and fits my professional goals. The location of this hospital is a 45 minute drive from my house so one consideration is to commute.

I am also in the process of hearing back from another Magnet hospital who interviewed me for a med-surg/trauma unit. This hospital is only about 20 minutes away from where i live. I want to be closer to home so the location of this hospital is the best. If i get offered this position I am not sure if I should commute from home and work in the Emergency Department or take the med/surg unit and possibly do an internal transfer in a few years.

Can anyone here offer some advice as to what a new grad should do?

Specializes in Emergency.

*decide.. edit to add. ALSO med-surg just isn't the same cup of tea. As I've not even applied to any other type of job but ER, becuase that's in my heart. If that's what you want, go for it. This opportunity will not be there long.. I personally think that you can handle it. I've been a tech in the ER for a year, and that definitely solidified where I wanted to be, but ultimately it's up to you. Good luck. Let me know what you decide.

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Specializes in Med-Surg/Neuro/Oncology floor nursing..

DEFINITELY take the ER position. I commute about an hour to work each day. Granted I only work three days a week, but if the commute is the only thing holding you back, take the ER Job. I work in Manhattan(live on Long Island, the suburbs of the city) but I also have co-workers that commute about an hour and a half from New Jersey..Its a great, big hospital with many different units/departments to work in and it's always rated by NY magazine as one of the best hospitals, the best doctors and units. So with that said I'd take the ER job.

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Wow, I'm amazed at how many said do the ED. As an ED/critical care nurse of 28 yrs, and now as a nursing instructor I say Med/Surg/Trauma unit. You need to BUILD on your, likely limited, clinical experience from school. Even if you were a tech in the ED or something, it's VERY different in a fast paced Level I Trauma ED. Keep your eye on the prize, but give yourself at least a YEAR on the floors to refine your skills, and build your knowledge base and confidence. The ED will be there when you're ready. I waited 7 years before going to the Level I Trauma Center. Build your resume, take ACLS, PALS, ENPC, TNCC. You have your whole career ahead of you. Best of luck.

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Specializes in Emergency.

But even if the OP is going to need to "build" on their clinical knowledge wouldn't that be the purpose of this new grad program? Plus our program is a certificate seeking one, so with all that said we would get ACLS, PALS etc I just personally could never do floor nursing that to me is career suicide. Medsurg is horrible and I absolutely hate it. I know that if I want to enjoy my career I've got to do something I enjoy...I don't want to go to work and hate my job..especially as a new grad. That's just my opinion. Essentially the OP will make the decision that's best for them. If they think they can handle it then go for it. I love this forum so many different opinions.

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You will learn more about pt care, time management, relationships, etc in the trauma med-surg and be able to carry that throughout your career and really advocate for that. BUT the ER is a specialty that you can use forever if you want to. Jobs are easier to come by if you move, want to travel, work per diem etc. Also, it is very difficult to find positions in the ER after starting in Med-Surg. Whereas, it is easier to find floor jobs after starting in the ER - but be aware that moving from ER to Medsurg will require relearning organizational skill sets and is a completely different mindset from ER nursing.

My advice after 15yrs of working and teaching: Take the ER job, move close to the hospital for two years. There are some new grads who have to move to a different state... 45 min away is nothing (I do that 4 days a week even though I dislike it). After two years, reevaluate.

Good luck

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Thanks for all of the responses. I wasn't expecting so many people to respond, haha.

I have been working at this trama level 1 facility for a year and half already (as a tech). Not saying that I have gained mounds and mounds of experience, but I believe it has helped me with certain skills that one just cannot learn right away in nursing school. I have floated to all of the med-surg units, and I just have to say that I am NOT above working on a med-surg unit.

After reading this thread and talking to other people about my situation, I am going to take the ER position. It fits perfectly with my professional goals and I know that I will learn a lot. During my interview they told me that all of the new interns will have an opportunity to get our ACLS, PALS, etc. certifications within the first 6 months of orientation. I have worked with the employees at the trauma level I facility and it is great. The nurse manager also mentioned to me that if I realized during my internship that the ER just isn't the job for me then she would contact managers in other units to see if I could do an internal transfer to see if that job is better.

I have also talked with other nurses who work at this hospital and they have a much longer commute than I do. I am looking forward to taking this plunge. I figure that even though I do not like the location it is not the end of the world. I will gain a lot of experience and skills with this job which will help me in the future wherever I plan on moving to.

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Specializes in ER.

Congratulations brother! Hope its going good over there. I came straight out of school and went into the ED! LOVIN' IT!! Have fun and good luck!

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Congratulations brother! Hope its going good over there. I came straight out of school and went into the ED! LOVIN' IT!! Have fun and good luck!

Haha, i'm a sister...but thanks!

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Specializes in ER.

Lol! I apologize! Referring to your post about certifications see if you can get your TNCC; which being a level 1 center you probably wont have any trouble getting.

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I'd go with the ED position. 6 months is a great orientation: I got just over 4 months and that was just fine for me.

45 minutes isn't a bad commute- that's what my commute is right now without traffic, and I listen to my pandora radio stations on the drive and enjoy the scenery.

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I don't understand why people say to do a year of med-surg first. If the ED offers a good sized orientation, the new graduate can learn how to prioritize patient care in the emergency setting that way. If someone were to start in med-surg and then transition, they'll have to learn everything all over again because ED and med-surg are different beasts. As someone who would rather start in the ED or ICU than in med-surg, why should I take the time to learn one way of learning to do things, and then throw it out the window when I transfer to the ED or ICU.

Anyway, congratulations. I can only hope and pray that I am as fortunate as you when I graduate. Best of luck with orientation.

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Specializes in Emergency.

I'm glad you decided to go ER, see you in orientation!

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