New grad question for all you pros out there :)

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i'm going to be graduating in december and i want to work either in ob or the er, but i've heard it's better to get med-surg experience first. i know that's probably true, but i hate m/s and was wondering if there were any of you who went straight to a specialty from school and how it was for you.

thanks!

.....

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Specializes in Gerontology.
Not all of us who think most every nurse should do M/S are M/S nurses.. Actually, I think they should more so since I left M/S than when I did it.

I have a friend who is a nurse and I just met another nurse who has went from med/surg to the ICU and they both said that med/surg was a job for a pill pusher you don't get to spend quality time with the patient or the family of the patient and since going to the ICU their assessments skills have gotten so much better. SO I guess to each it's own when it comes to the area of choice to work. But I too am a new grad and I work in the ICU and it is hard at times but I love it and wouldn't trade the experience for the world. It's just the nurses that I work with who are the trouble at times:mad:

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I started as a Psych RN in the prison system, then changed to Emergency Medicine when I found I could no longer take prison environment. I had to virtually start over, with a long orientation etc. I love what I do, and have never worked med/surg. While I am sure there is knowlege that each specialty brings to the table, and that all depts. have something to give, I don't feel any specialty will better prepare you than another for ER work. Best you start in ER and learn from ER RNs than work in something you dislike. Who knows you may not like the pace and the chaos, or you may love it, but working on med/surg will not answer that question or prepare you for the atmosfere of most ERs. I say go for it!

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Having been a nurse for a long time, all I can do is speak from my own experience.

I think you graduate with a license to learn, and the best place to start is in Med/Surg. There you get the basic nursing skills needed in general. After a few years there you can then branch out into specialty areas if that is what you want to do - with an excellent background.

As an LPN, I went directly into OB after school. Worked ante/postpartum, nursery and from there NICU. After years there I found it very hard to find a job in another area. I was labeled an OB nurse. Thus, that is where my advice comes from.

When I got my RN, I was careful to go to work in Med/Surg, and felt much more confident doing that. Then ICU and ER. Felt I had a great background of knowledge to draw on.

The only area of nursing I've ever had difficulty in finding work is in OR. Unless you're a new grad, every job offer wants at least two years experience. And of course, they will not train. Anyone know why that is?

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The only area of nursing I've ever had difficulty in finding work is in OR. Unless you're a new grad, every job offer wants at least two years experience. And of course, they will not train. Anyone know why that is?

Yes. Orienting a nurse who has never scrubbed or circulated before is a very long and expensive process to the hospital.

Nurses rarely get much OR clinical in school so they are literally starting from scratch when someone doesn't have any OR experience.

It's a big investment to train a nurse to the OR. At least from the hospital budget's standpoint.

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I graduated last March & started on a cardiac floor and lasted 4 months...it wasn't true M/S but a real mix of pts in just for acute cardiac problems as well as those w/a laundry list of problems including cardiac problems...many docs just admitted them to our floor b/c they got more monitored care (tele). I learned a lot of things in a short time, but bottom line was that I hated it! I'm now in a dialysis clinic & am enjoying it far better than the cardiac floor. I asked nearly every nurse I came into contact w/during clinicals, on the street, etc. that same question about the year of M/S before specializing and did find that more experienced nurses recommended the year vs. newer nurses saying that you don't need the year and shouldn't waste your time on something you're not interested in. If you don't know which specialty you'd like to go into I think it's a good starting point to get experience while you decide. If you know what you're interested in though, I say go for it. A lot of what I heard from others was that working M/S first builds your time management & critical thinking skills, but I don't think that if you specialize they don't develop. Much of what they don't teach you in school you'll learn on the job. So, I don't regret my time on the floor b/c I learned a lot and I have the highest amount of respect for those nurses who are M/S b/c it is so difficult...but if it's not what you want to do, then follow your gut.

Good luck!

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I was hired as a new grad into ED last april and I don't regret my decision at all. Yes I realize that M/S experience may have helped me gain a broader knowlege base before starting into the ED but if your hospital offers the right orientation and CE courses (ACLS, PALS, ENPC, TNCC etc.) then you'll be fine. This also gives them (in the ED) the chance to mold you the way they want . . . before you pick up "bad habits". Just know your limits . . . if something new comes up that your not experienced in don"t be afraid to ask for help. Others are usu more then willing to offer a hand and you can learn so much from the more experienced nurses. Besides, you'll be a much better nurse if your doing something that you enjoy. Good luck!

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Specializes in 5 years peds, 35 years med-surg.

As a med-surg nurse for 40 years and now being in my 60's....I'm wondering who's going take of ME when I get old if no one wants to work in med surg. Yes, it's hard, hard work....but someone has to do it and I felt that I was much more versatile because of my experience. I was able to float to all the units and feel pretty comfortable....even though I HATED floating. My ms experience is also helping me in the home health nursing I'm doing since I retired. There are only so many openings in the specialty areas so SOMEONE is going to have to work the floors.

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As a med-surg nurse for 40 years and now being in my 60's....I'm wondering who's going take of ME when I get old if no one wants to work in med surg. Yes, it's hard, hard work....but someone has to do it and I felt that I was much more versatile because of my experience. I was able to float to all the units and feel pretty comfortable....even though I HATED floating. My ms experience is also helping me in the home health nursing I'm doing since I retired. There are only so many openings in the specialty areas so SOMEONE is going to have to work the floors.

Yes, SOMEONE is going to have to work the floors, but it's not going to be me.

And I know that I am far from alone in feeling this way.

You hated floating? Me too.

Yes, I too, felt very versatile because of my experience.

But where did it get me? More money? Respect? Advancement? Recognition of any kind? Nope.

My "versatility" was often an excuse by management to float me anywhere in the hospitals they saw fit.

I was a regular full time staff nurse and floated more than agency and float pool people due to my ability to work multiple areas.

I worked with agency and float pool people who were able to work in fewer units than I could, so my reward for that was to get pulled to different units, sometimes within the same day, all the while I made less than agency and float staff.

You asked who is going to take care of you when you get old?

I don't know.

What I do know is that until it becomes completely unacceptable to give any med/surg nurse 7-8+ patients, and tell them that the CNA called in sick, and that there will be no unit clerk as well, and that they will have to float to a unit where they have received no orientation/training but will still be expected to take on a full group of patients with little or no help, and simultaneously have it thrown in our face that our license is on the line if anything goes wrong.......

Plenty of us will continue to refuse to work the floors.

Working conditions are often horrible enough in ICU and other areas, but they are flat out unacceptable on the floors, IMHO.

My heart goes out to any nurse who sticks it out and makes a career out of med/surg. I did it for 6 years but now I flat out refuse.

Never again.

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Specializes in 5 years peds, 35 years med-surg.

I worked with agency and float pool people who were able to work in fewer units than I could, so my reward for that was to get pulled to different units, sometimes within the same day, all the while I made less than agency and float staff.>>>

I know what you mean. We floated a lot! They seemed to hire mostly for our floor....and then float us all over the place. Probably because we didn't get unit differential. Heck, I started out one morning as a secretary because ours had called in and I could do the secretary's job....which I loved because it gave me a break from the floor. Then about 0900 they called and sent me to cardiac stepdown as a nurse. That was fun because I got a late start. A couple of hours later....they sent me to PCU as a secretary again because the no-show nurse on stepdown arrived thinking she had been off. Of course I had the meds passed but had to open my 6 charts on stepdown. After 3 pm they sent me back to my own floor to work as an aide! Fine with me....no charting, but to be on four units in one day was a little ridiculous! So much for being versatile....lol.

But PLEASE.....will some of you do med surg so I have someone to take care of me! ;)

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I started out on a Med-Surg floor for 4 months and then went to Pediatrics. We have a small unit and in the Summer time we are sometimes closed.Well, do you think we get to sit there?..No! we are pulled to med-surg, ER, whereever!...so My comment is..Yes it is good to be able to work on a Med-surg Floor or anywhere else for that matter. It is good to be able to keep up your skills also. sometimes in a specialty area, you may not use all the skills that a Med-surg Nurse may. You never know when you will need them.

Thanks!

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I worked with agency and float pool people who were able to work in fewer units than I could, so my reward for that was to get pulled to different units, sometimes within the same day, all the while I made less than agency and float staff.>>>

I know what you mean. We floated a lot! They seemed to hire mostly for our floor....and then float us all over the place. Probably because we didn't get unit differential. Heck, I started out one morning as a secretary because ours had called in and I could do the secretary's job....which I loved because it gave me a break from the floor. Then about 0900 they called and sent me to cardiac stepdown as a nurse. That was fun because I got a late start. A couple of hours later....they sent me to PCU as a secretary again because the no-show nurse on stepdown arrived thinking she had been off. Of course I had the meds passed but had to open my 6 charts on stepdown. After 3 pm they sent me back to my own floor to work as an aide! Fine with me....no charting, but to be on four units in one day was a little ridiculous! So much for being versatile....lol.

But PLEASE.....will some of you do med surg so I have someone to take care of me! ;)

I often think the same, If no one wants to work med-surge who will care for us when we get old. That being said I would rather have a nurse that wants to be in med-surg (there are some...lol) than one that does not want to be there, who got stuck there or is just using it as a six months to one year stepping stone thing... I just believe if they reduce the patient load, more collaboration with docs, nsg managers more open with nurses, it would actually be a much better place to work. The ideal patient load in med-surge should be no more than 4 patients to one nurse with assigned CNA. The reason I say this is because people on med-surg floors are no longer your fluff patient like 10-20 years ago. These patients go back to the floors with multiple system disease going on at once. You have to deal with different doc's and ALL the family members. Let's not forget if you get the patient that needs to have pain meds Q2.

I just think they need to re-vamp med-surg and until there is big walk out or laws passed out just like Cali ( I hope that other states will soon follow) management and new/old nurses will never stay on med-surg floors.

I just left a med-surg floor after 6 months for ICU and if I can help it I won't look back.

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