New grad: what are my options other than Med/Surg?

[secondfiddle]

Hi everybody. I'm not a new grad yet but starting to plan - I graduate from my ADN program in May. I have been working as an extern on the Med/Tele (essentially a CNA) for the past year at the local community hospital where I will most likely seek employment upon graduation. For better or for worse, I'm doing my preceptorship in the ICU which is a medical (not trauma) ICU. I'm not sure that was the right decision, but our program has not exposed us to very many clinical areas and I had to choose something.

Here's the problem: the longer I work on the Med/Tele floor, the more I realize that I am going to be very unhappy working there. I could suck it up for a year or so to get the experience, but it isn't going to be a fun year. I just don't like the work atmosphere, the patient population (many very sick total care geriatrics) and I just don't feel "at home" there. It seems to be a high-stress area for the nurses without being fast-paced like the ER.

I am wondering what my options are as a new-grad for employment. I don't want to dread my job, but us it best to just suck it up with Med/Surg to open the door to other areas later? Or, are there other possibilities I should look into for my first job? I felt that the ER would be too much for me as a new grad, and I did not like the OR. Thanks in advance.

[S.T.A.C.E.Y, LPN]

Theres lots of specialty area externships/internships/preceptorships for new grads! Just start surfing the net. I finish after next semester too, and I'm planning on going straight into an ER program for New Grads.

Med/Surg is recommended by most as the place to start, but if you don't want to, there are plenty of other options out there. Have you thought about peds? If you are feeling tired of nursing the geriatric population, maybe starting in a peds hospital or peds floor would be a welcome change?

[EricJRN, MSN, RN]

Definitely look at new grad internships. The bigger hospitals often offer them. It can be a great way to start in a critical care setting.

[cardiacRN2006, ADN, RN]

For better or for worse, I'm doing my preceptorship in the ICU which is a medical (not trauma) ICU. I'm not sure that was the right decision, but our program has not exposed us to very many clinical areas and I had to choose something.

I work in a Medical/surgical ICU (not trauma) and I love it! So many different things! A quick summary of my last few months: Rhabdo, DKA, myasthenia gravis, thyroid storm, parathyroidectomy, lots of dead bowel, resp distress, serotonin syndrome (and all the regular medical things too)....lots of crazy cool things to learn! I'm never board and constantly challenged.

One thing that I found when interviewing is that although most places say they will take new grads, they still require that you have had so many clinical hours in an ICU. So that meant that they were only hiring new grads that did a summer externship or final preceptorship in an ICU. So you're lucky to have chosen that for your preceptorship.

[jamonit]

i'm starting in a new grad orientation program right into the PICU at the children's hospital in town. a lot of places are hiring new grads and provide classroom learning/bedside teaching, etc. i finish school in february, and to tell you the truth, i'd rather poke my eye out than work on a med-surg floor. most of the people graduating from my class are going directly into the o.r. the e.d., i.c.u. i think a year of med-surg is a good idea in theory and for the experience, but i don't think it's for everyone. start somewhere you like. that's my opinion.

[nursekatie22, RN]

I hated med/surg until I found a hospital with supportive staff. For me, if the people are great to work with, then anything can be fun. As for getting into other departments, I only know of two other people in my class of 60 that DIDN'T go into a specialty area! A lot of hospitals hire new grads for specialty areas, though, so don't lose heart!

[dansamy]

In my town, a classmate was interviewed for an OR internship. When she turned it down saying she decided OR wasn't for her, they asked her to tell them what area she was interested in and they would find her a place.

Instead, she went with Pediatrics at another hospital. I did too. She'll be on night shift and I'll be on days.

[all4schwa]

i work at a bigger hospital, but did my clinicals in small community hospitals. now when i see the nursing students come in i'm jealous because i didn't get to do or see all this stuff that i think is so cool. i hired into a specialty area, but i did an internship that allowed me to check out different units first. you'll find with bigger hospitals it's so broken down into so many different units (cardio, pulmonary, renal, neuro, ortho), it's hard to find a general medsurg floor. for instance, where i work you can be assured (ideally) that the acuity is appropriate for the nurse patient ratio because there are many advanced care floors these patients can be transferred to if their condition deteriorates.

[NYCRN16]

In this day and age, we have options! Dont settle for a job that is not what you want. Plenty of new grads start into specialty areas, and if one hospital does not have what you want, you interview at another. I dont necessarily agree that a year of med/surg is going to prep you for another area other than a different med/surg floor. I was a new grad in ER and let me tell you, the new grads that have started there are adjusting well and becoming great ER nurses. Some of the nurses with experience that are transitioning from the floor are also doing well, but are a little overwhelmed with the different focus and pace of the ER, so its like they are learning all over again as well. Hospitals will tell you to get a med/surg job first because they have problems filling the floor jobs. ICU is so different from the floor that you will learn from the start how to function in an ICU from experienced nurses, you will succeed. We are not interchangeable. I work ER, but I probably would be terrible if you placed me in OB. Sure I am an expereinced nurse, but Im not an OB nurse. A floor nurse and an ICU nurse are not interchangable either. They would both have to learn how each floor/unit works in order to function well.