new RN/BSN - where to work for the most experience

I feel that MedSurg is the best way to start. Your time management skills is one of the first things an RN should build up.

I gained very valuable experience working LTC. LTC's vary though - the one I worked in had lots of interventions (IV therapy/ maintenance, TPN, g-tubes, ortho patients, respiratory patients etc) in some units. Assessment and critical thinking skills were encouraged. It was a steep learning curve and hard work, but it gave me a great foundation of nursing skills.

I guess it depends on what you mean by 'most experience'. Do you mean just seeing lots of different things, patho, patient populations? If so, then Step-Down / Progressive Care is the way to go. Worked my first 2yrs at a high acuity med/surg step down unit. Saw everything from CT Surg to Oncology. I precept now in one of our ICU and would have been terrified to have started here. The only new grads our ICU seems to hire worked here for a yr as a CNA, part of their nursing school program.

I am just getting my prereqs done so I can apply to nursing school for next fall, so I have no experience. But a friend of mine who is a Nurse Practitioner was giving me advice and said to take the hardest jobs I could find first to get the experience and to jump in feet first. He said after doing the hardest job everything else seems easy.

Pretty much anywhere in a hospital will be a good job for you. But have you considered psych? You'll definitely learn how to talk to people.

But one question: how do you know now that you want to be a NP without having even worked as an RN? Just asking because I'm curious.

Thank you for the feedback! I want to work as an NP as my passion since my first time is college is pathophysiology. I am truly passionate about caring for people. I look forward to being an RN with the goal of becoming an NP - I may change my mind completely after working a few years as an RN. RNs and NPs are very different roles.

I've had this conversation with a few nurses and get mix reactions but...

Go to the area you want to be in.

I started in the step down ICU straight out of school after working here as a nurse tech/preceptor. I found out how the unit is ran and how the ICU nurses operates and built my skill set around my fellow ICU nurses. The conventional wisdom is to "Get your time management in Med-Surg for a year before you branch out.". However I feel this attitude is robbing new nurses of time in the area they want to be apart.

Why is it necessary for me to understand how to care for 6 Pt. at one time, when my vent Pt and EOD are my main concerns. It would seem to behoove the nurse to choose an area they have strong feelings for, then as you say, jump in feet first.

Best of luck in school,

-Dave

The conventional wisdom is to "Get your time management in Med-Surg for a year before you branch out.". However I feel this attitude is robbing new nurses of time in the area they want to be apart.

Very true. I also think you don't have to start on med-surge to build time management. I started (and still currently am) on the telemetry unit but have taken care of a few PCU patients that had drips and vents. I think I've built good time management and organizational skills being on a telemetry floor. I've had fellow coworkers that started off at SNFs and LTACs that say they developed amazing management skills and I believe them because they're in charge of 30+ patients. I'm glad I didn't start on med-surge. If anything, I recommend starting on the telemetry unit as you are exposed to both med-surge patients as well as more critical patients. You also start to develop the critical thinking mindset. From there, you can go to ED or ICU.

As an LPN I worked in a small community hospital for 8 years. As flex pool I worked med/surg, tele, behavioral health, and ICU. Since it was small, all the diagnoses got clumped together. If the needed a tele box, they were on tele, if they needed close monitoring, ICU. If they were a BA52, they went down the hall for 72 hours once cleared, if they had insurance, for behavioral health. It was kind of like a one stop shop. I got so much exposure there that it was a great base. It also helped when deciding to work agency, because then you go wherever they send you, sink or swim if you've never seen it before.

That hospital went under and is no longer around. When I got my RN I went to a large trauma hospital. I later found out that if you work on one floor, that's pretty much what your exposure is-because they are busy and always full you won't float much if staffing is done right. If I had not worked at that small hospital before hand, I would have freaked when I went to an ortho floor for an agency shift recently. All the braces and gadgets I remembered from years ago, nothing current. Always good to start somewhere that you'll get to see a lot. It will help later on down the road.

Pretty much anywhere in a hospital will be a good job for you. But have you considered psych? You'll definitely learn how to talk to people.

Having started in mental health, this advice comes with a caveat. You definitely build people skills, and the stuff that you see and hear puts you in a position that nothing fazes you.

The problem with mental health nursing is that in most facilities you get almost nothing along the lines of what most people would consider clinical skills (medical procedures, IVs, etc.). Other nurses also tend to mentally pigeonhole psych nurses, as if they are incapable of doing anything else. I worked for a free-standing mental health facility that was closed by the parent company. I drew unemployment compensation for three months during a time when hospitals were running full page ads in the Sunday paper looking for RNs. I couldn't get an interview with any of them, despite having five years of experience with most of it being supervisory. I finally caught on with a rehab nursing company.