New RN - Should I take an unappealing Med-Surg offer?

Nurses Nurse Beth

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Dear Nurse Beth,

I am a recently-licensed RN looking for some career advice and guidance. This summer, after graduating nursing school, I have been working at an outdoor education summer camp as a camp nurse, which I love, but is soon coming to an end because the position is seasonal. I have a couple of options and choices to make as I move forward...

1) Accept an offer to work full time on a Med-Surg unit. This will be as a "New Nurse Residency" in a city I am unfamiliar with and don't know anyone in, but in a very supportive work environment. Also, I will get full time benefits (health insurance, tuition reimbursement, etc...)

2) Accept an offer to work part time in a local Wound Care Center, and also as per diem at the environmental education center I currently work at. This idea appeals to me because I won't have to move far away, both work environments are also very supportive, and I enjoyed Wound Care during nursing school. The cons are I wouldn't get any benefits until I go full-time, and I would be working more hours during the week.

I understand that generally, it is a good idea for all new nurses to get that "year of Med-Surg" under their belts, but the truth is, Med-Surg never appealed that much to me; I would more like to specialize in a specific area. The crux of my issue is that I am not sure Wound Care is a field I would want to stay in forever, and I'm concerned the skills I would acquire are not transferable, or nursing "marketable."

My bottom line question is: How possible is it to get out of Wound Care once I'm in it? Are those skills eventually transferable to other fields?

Thank you folks ahead of time for your time and attention!

Dear Sarah,

Congrats, Sarah RN! :)

Take the MedSurg New Grad Residency position. Please, please, before it's gone.

You can learn wound care at any time later, but you can only get a new grad residency opportunity now and for a few more short months. It's not about whether MedSurg is your ultimate specialty of choice, it's about a year of supportive training and transition to practice that will give you experience, credibility, and make you marketable.

Working part time and per diem as a new grad is a career death sentence. It is possible to find yourself painted into a corner with few options. You don't want to take that risk.

Good luck to you,

Nurse Beth

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Specializes in nursing education.

If you were my student, friend, or family member, I would tell you this: the idea that med surg is the only way to start is old thinking. Take the specialty you want right away. Med surg is its own specialty with an ANCC certification exam. Too many nurses take a med surg job right out of school and leave...and the units become a revolving door staffed by inexperienced staff who don't want to be there.

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Specializes in Tele, ICU, Staff Development.
I would take the wound care. If you are not keen on med-surg, you could really be miserable. Take a look at the multitude of threads on people who are not happy in their jobs. Also, the hospital may want you for 1-2 years, ideally more. Do you really want Med-surg for that long if it is not something you are interested in? The wound care job sounds really interesting. make clear to them you are a new grad and would need a REAL orientation, not just 1-2 weeks. it sounds like it would be a good match, plus coupled with the environmental job.

Good Luck

Remember a residency provides the new grad transitional support for months and often up to one year in an acute care setting. This vs working part-time without benefits in a narrow field. It is easier to go from broad to narrow than from narrow to broad when you are job seeking.
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Dear OP: where did you do your Preceptorship? I'm currently in the middle of mine and can tell you I do NOT want to work Med-Surg for a month much less a year. I went back to school to finally finish my nursing degree and fulfill a lifelong desire to help people. Not just pass meds, but help the whole person! I'm not sure where I will land my first job, but my advice to you is to follow your heart. I know from previous experience that working a job that you are unhappy it is harmful to your health, your spirit and your happiness!

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Hi Sarah, congrats on getting offers! Hospital and Med-Surg is the way to go, despite being difficult to move away. That pathway would open your career choices: think BIG. While wound care is very interesting (I worked in a nursing home, so have seen enough of them), it narrows down your choices, at this point in your nursing career. Best of luck!

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Nursing is such a broad field. In the course of a 40 year career, you will likely practice in a wide variety of specialties. It's possible, but probably unlikely, you will not want (or possibly be able) to do wound care for 30, 40+ years. I'm an older, second career nurse, and I knew pretty quickly that I would not want to do bedside care for 10, 20+ years. I started to look at job postings. For the jobs that got me interested, I looked to see what the preferred qualifications were. So, I'm in the dreaded med-surg position. Is it hard as hell? Yup. But, I consider it a step to my ultimate goal.

However, I am not you, so your career goals are different from mine. Good luck with your decision.

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Specializes in nursing education.
Remember a residency provides the new grad transitional support for months and often up to one year in an acute care setting. This vs working part-time without benefits in a narrow field. It is easier to go from broad to narrow than from narrow to broad when you are job seeking.

One thing to consider is what the "residency" is actually comprised of and what it actually offers. One hospital here has a seminar once a month or so and calls it a residency. It's not very supportive. Get more details, talk to the residency coordinator, talk to some of the new grads in the program before you base your decision on this.

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So true. The large teaching hospital that I worked at for three months had a Residency Program for new nurses. It was indeed a once a month seminar. The residency coordinator was lovely, but overall, I didn't see how helpful the program was for new nurses. But it is a nice label for the hospital to hang out to entice new employees.

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Specializes in ED.

While job satisfaction is important, you will learn so much during a new RN residency I would say take door #2. If it is wound care you are wanting to specialize in you will get a lot of wound care in Med/surg. And its a great thing to have on a resume if you ever want to move to another area of nursing, much better than a per diem job.

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Specializes in DNP, NNP-BC, RNC-NIC, C-ELBW, DCSD.

Don't take the residency. You will be miserable the entire time you're there because your heart is not in it.

As for the "year of general RN experience," that rule doesn't apply anymore. As a new Grad, I went straight into the NICU because that's what I love! I then went to General ED to give it a try and am now back in NICU. LOVED ED, hated adults. During my time in NICU, I was able to cross train in General Pediatrics and Newborn Nursery!

I branched out because I wanted to make sure NICU was for me before I go back to Grad school. I am happy to say I have submitted my applications and am playing the waiting game!

good luck to you! Remember do what's right for you!

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Really, Nurse Beth, a "death sentence"? Dramatic much?

I was an older new grad five years ago. MedSurg is not for me. It would never be for me. I can't even imagine doing it for a day. Just not my thing.

Five years ago as a new grad I took three PT jobs in three different cities in two different states to avoid the hospital. Fast forward to now and I am working in an outpatient procedure clinic...no nights, weekends or holidays and making $46 per hour. If that is a "death sentence" I'll take it.

I know this post is old, but I hope the OP took the position that will make her happy and satisfied!!

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Specializes in Tele, ICU, Staff Development.
Really, Nurse Beth, a "death sentence"? Dramatic much?

I was an older new grad five years ago. MedSurg is not for me. It would never be for me. I can't even imagine doing it for a day. Just not my thing.

Five years ago as a new grad I took three PT jobs in three different cities in two different states to avoid the hospital. Fast forward to now and I am working in an outpatient procedure clinic...no nights, weekends or holidays and making $46 per hour. If that is a "death sentence" I'll take it.

I know this post is old, but I hope the OP took the position that will make her happy and satisfied!!

lol I am so guilty as charged! Of hyperbole. You nailed me, because in real life, yes, I am dramatic and passionate.

However, it would be a nail in the coffin of being a career counselor (oops I did it again) to advise new grads to start out working part-time and/or per diem. Your example non-withstanding, it takes at least a year of full-time work to achieve competency.

For some new nurses working 12 hour shifts, even 3-5 days off in between shifts is too long while acquiring new skills.

Thanks for sharing and glad it worked out like it did for you :)

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med/surg at the beginning of your career will make you a BETTER nurse. sometimes in life, its not about what you WANT as much as what you NEED. the people ive worked with on specialty units that have never worked med/surg are lost and flustered when they got floated to us. i can promise you, you will be a better nurse starting out in med/surg than a specialty. if you just want to do what you want to do, go to wound care to start, but if you want to be the best nurse you can be go with the option that exposes you to all aspects of healthcare, not just wounds. (btw, there is tons of wound care done on med/surg floors).

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