New RN and now trying to figure out which nursing unit I should start in?

Ackeem, BSN, MSN, RN, APRN · May 26, 2016

Do you have any job offers? Most new grads just take what they can get. I was offered a ER position but still considering because the salary is just not right.

Doing another interview next week for a Orthopedic position.

HeySis, BSN, RN · May 27, 2016

As a new nurse, I would apply every where and do as many interviews as possible. It's pretty normal for nurses to have a few different positions until they find their spot, so I wouldn't be concerned about getting the perfect placement right out the door.

I would make sure you research the company before an interview, and be prepared when at the end the say "Do you have any questions for us?"

Along with specific things about the company, I like to ask

1. What is the best thing about working here?

2. What does it take to be successful here? or What are the biggest challenges to new nurses?

3. Can you describe the team I'll be working with?

4. How does management support your team?

This really can tell you a lot about the conditions you are going to be working with, which I think is way more important then where your first job is at.

Ackeem, BSN, MSN, RN, APRN · May 27, 2016

As a new nurse, I would apply every where and do as many interviews as possible. It's pretty normal for nurses to have a few different positions until they find their spot, so I wouldn't be concerned about getting the perfect placement right out the door.
I would make sure you research the company before an interview, and be prepared when at the end the say "Do you have any questions for us?"
Along with specific things about the company, I like to ask
1. What is the best thing about working here?
2. What does it take to be successful here? or What are the biggest challenges to new nurses?
3. Can you describe the team I'll be working with?
4. How does management support your team?
This really can tell you a lot about the conditions you are going to be working with, which I think is way more important then where your first job is at.

Thanks sis :), definitely going ask these on the next interview, I'm not particularly fond of ER, but i love othro alot.

nlitened · May 27, 2016

I agree with applying to whatever position you can find that accepts new grads. Don't be picky about specialties right now. Just worry about getting a job, because as a new grad that is quite a task.

HeySis, BSN, RN · May 27, 2016

It's great if you can find a hospital with a new grad residency program... they only hire nurses with less then one year of experience.

I had an offer for float pool, but I had also interviewed with PACU and had another interview coming up for med-surg. So I asked how soon they needed to know and bought myself some time. The day of the last interview I was offered the PACU job (with a residency program) and took it.

Good Luck Ackeem, BSN, RN, with the interview next week. I hope you get the ortho position.

Murse1975 · May 27, 2016

I'm with the rest, land a job and get some experience. Diversify a bit. Hone your chops. If you had a certain area you loved in school, pursue that fervently like I did, you might get lucky and catch a break, but get a job, unless it's in an area you know you'll hate, as it will ultimately reflect poorly on you based on performance most likely. I landed in pediatrics straight of school and have been there ever since, also working PRN in inpatient psych for extra cash. That's parlayed into several different job offers in the 4 years since. Keep your nose clean, be a team player, and work hard and you'll go far, but getting your basic skill set and critical thinking/customer skills up to snuff are your first tasks. Being licensed and being a competent nurse are worlds apart, and it's an ever changing and growing challenge. You may fall into something that you were iffy about and wind up loving it!

cocoa_puff · May 28, 2016

Apply for everything you qualify for in your area, or even further out if you plan on moving or commuting. If you get called in for an interview on more than one unit, then you can begin to consider which one would be a better fit for you as a new nurse. Although even if you just have one interview, you should still definitely still ask these questions!!!

During the interview, ask them questions about the orientation process, how much time you get with a preceptor on the floor, what shift you will be working, what is the nurse to patient ratio, how much support for a new grad, how is the nurse retention on the unit, are the nurses mainly new nurses or nurses with 5-10+ years of experience? Ask to shadow on the units to get an idea of the attitudes and personalities of the staff. Observe how the nurses and other healthcare team members work together, how they treat each other, and ask to meet some of the recent new grads to get an idea of how the transition and orientation process went for them on the unit.

The best unit to start in depends on the support and orientation on the unit, and there are many factors to consider. Each unit can be very different. At one hospital, an orientation for new nurses in the ED could be 10 weeks in a negative, unsupportive environment, while another hospital could offer 12 weeks on orientation for med-surg plus a nurse residency program and classes on IV pumps, Wound Care, Diabetic Management with a positive, supportive environment.

Also, depending on the job market where you live, you might not have the choice to be picky, especially as a new grad.

Good luck! :x3:

Short & Sweet: Apply everywhere, see what you get, ask questions in interview, ask to shadow on the unit, support and orientation are important, don't be too picky.

Maevish, ASN, RN · May 28, 2016

Hi everyone, I finally passed my NCLEX exam and now trying to figure out which nursing unit I should start in. Is there any that you guys can recommend and think is better for new nursing graduate? Also, what is the difference between General medicine vs MedSurg? And what is a typical day when you're working in a particular unit? Thank you in advance for your responses!

Whichever one will give you a job!! :roflmao: I would love it if we could all choose where to work whenever we wanted, but sometimes you have to take what you can get. Plus, you'll be learning no matter where you are. The only thing I might say is to try to stay away from nursing homes, etc because people tend to get burned out there even faster than in hospital, but that's just my 2 cents.

Also make sure they're flexible with their orientations (give you less or more time, if needed) and get everything in writing.

General medicine isn't really a thing anywhere I've worked here in California and Med/Surg is another way of saying "whatever fits the skill level of the nurses" (lol). Some Meg Surg floors (like the one I started on right out of school) are monitored and the patients are on telemetry so that will give you another set of skills you wouldn't get on a plain medical or surgical floor.

As for work, I'm mostly in ICU (though I try to go to post partum sometimes because I love babies) so the day goes a little differently each shift.

1900-Get report. Sometimes it goes for 15 minutes (even 10 minutes if it's just an update) for both patients and sometimes it goes 45 minutes for a complex 1:1 patient.

1930- Peep in on pts if we didn't do bedside report so I can see if any gtts need changing or will be running out in the next hour.

1945- Look at the meds I have due for the night and make a quick list of my PRNs so I have them on the report sheet in case a family member or pt asks when they can have (for example) their pain medicine again. Also, if I'm not familiar with a medication or I'm unsure of compatibility, I look that up as well.

2000- Do my assessments/VS and give whatever meds I can at this time as well. Hopefully family is getting ready to leave for the night and asking some final questions.

2100- If I can get help turning, get baths over with (otherwise, do them at about 4:30-5 am) so that's done.

2200- If baths were just finished, then make sure no meds are due and then start charting my first assessment (if baths weren't able to be done, then start charting assessments around 2100 hopefully).

2300-Usually the last of the HS meds are done by this time (some docs like to order 3 antibiotics to go in at 2000 when the patient only has two lines to run things through... :banghead: ).

Now hopefully, the rest of the night goes relatively smoothly, but even a "good" night is peppered with odds and ends and interruptions: A medication needs to be re-timed, a family member keeps calling for the same thing over and over, you have to call the doctor's personal cell because he's not answering your page about the BP that's 55/35, etc etc. Then, god forbid, a patient codes (or does it more than once on the shift), someone falls, or you get called out to the floor for a rapid response that turns into a code because they waited so long to call us....the list of what can go wrong (and often does) is a mile long. It ranges from the big stuff I just mentioned to someone's colostomy bag coming off and having to put a new one on or having a patient yelling because their tea water isn't warm enough.

It's ridiculous, but it's what we do. Anyway, that's what I try to make my shifts like (that beginning bit anyway;)), but I try to not plan too much because that way I won't be disappointed as much when things go sideways!

That's on ICU and things are different when I work PACU or post partum, but I hope that helped a little.

xo

TheCommuter, BSN, RN · May 28, 2016

Beggars are in no position to be choosers... Accept the position at the workplace that is actually offering you employment. Once you have experience, you'll be in a position to choose the area of nursing you want. Good luck!

krodRN · May 29, 2016

Thank you so much for these pointers, I'll definitely keep them in mind when I'm doing my interviews :)

krodRN · May 29, 2016

I'm applying to all the hospitals near me hoping that I'll get some/any offers. I don't really care where I end up I just want to start working already. Lol. I'm just wondering what a shift would be like in a particular unit.