new RN's in specialty areas

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I have been noticing many posts of new nurses being overhelmed. Many seem to be entering specialty areas soon after finishing their RN programs. Does anyone else see that perhaps a trend here that going right into the toughest areas before getting comfortable in assesment skills or even just time management is not the wisest choice? I was an LPN for 10 yrs before I got my RN and I was offered a job right out of school in my hospital's SCU. I turned it down ...I felt that I needed to feel more comfortable in getting my skills down before I entered one of the most high stressed areas in the hospital. I worked on the Med-Surg floor and although it wasn't glamorous it made me a better SCU nurse... I learned charge duties and how to call miserable docs in the middle of the night and all sorts of valuable education that I might have felt overwhelmed in a high stress area while learning these other invaluable lessons......

I agree hiker -also see your age :) not bad for a new grad

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Feel free to call me old-fashioned but...

I believe that nurses should have to work for at least 1 year on a Med-Surg area before they can work in a specialty area.

I feel it cements the basics of nursing from which to build the remainder of your career.

I also felt the same way 29 years ago when I began nursing.

Neil Drucker, RN

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Specializes in ER/EHR Trainer.
Feel free to call me old-fashioned but...

I believe that nurses should have to work for at least 1 year on a Med-Surg area before they can work in a specialty area.

I feel it cements the basics of nursing from which to build the remainder of your career.

I also felt the same way 29 years ago when I began nursing.

Neil Drucker, RN

You don't mention your specialty, I wouldn't consider you old-fashioned it's your opinion and you are entitled to it.

We agree to disagree.

It really depends on your experiences, doesn't it? As I said in a former post, my recent med-surg experience with FIL was not gratifying at all.....I know what I have learned during the past few years, I experienced what my peers did not! My FIL is now suffering because of it! That's my current experience.....that's what I have to work with. Maybe you and your peers were better nurses.

Maisy

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If the workload weren't so crazy, then I wouldn't argue much against new nurses starting out on med-surg. But even experienced nurses seem to barely keep up. During students' clinical experiences, the med-surg nurses often seem the most frazzled, unsupportive (as they are too busy to explain things to the students), and unavailable (where on the unit might the nurse be at any one time?). In the more specialized environments with lower patient ratios and more intense focus on just a few patients, there may be more opportunity for the students to see what the nurses are doing and for the nurses to explain what they're doing and why they're doing it. So it's no wonder that students are looking to avoid med-surg, even for 'just' one year. It's not because they think it's not glamorous enough or that it's below them or not intense enough (though some may be of that opinion, I suppose). It just looks like a miserable environment to be a newbie in when you know you're going to need the support and guidance of your colleagues. And in many places it is (a miserable environment, that is - and as a newbie, you aren't exactly experienced enough to be able to tell at interview time how good or bad a unit is to work on). What's the point of putting new grads in an environment where they're likely to want to quit because they are being asked to carry a workload that even experienced nurses struggle with? Talk about setting folks up for failure! So while I agree with the rationale behind encouraging newbies to start in med-surg, with the realities of current workloads of many med-surg units, I have a hard time standing behind that view. I'm really not sure what the answer is.

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hey neil my wife has been a nurse 26 yrs - she started im open hearts that doesnt make her bad does it- each person is different and we DO NOT HAVE ENOUGH nurses to all start in med surg get a reality check - i have had to work 20 hours in a row due to NO relief damn id take a janitor with BCS

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Thanks to everyone for their views on this topic. I am graduating with my RN in December, and have received a lot of flack for focussing my sights and attention on OB.

I do agree for certain specialties a firm foundation in med-surg would be valuable beyond measure. However, I am not certain that working for a couple years in our local single floor, 45 bed hospital, treating patients of all ages, with any reason for hospitalization imaginable, will truly prepare me for the reality of working on a busy Labor and Delivery unit in a larger hospital. Even more so, I fail to see how taking a year or two to learn how to assess the routine patient or administer insulin, etc. will fully prepare me for my first experience with preterm labor or a still born delivery.

In short, for many, acute care is the best choice immediately after graduation. For some, diving head first into a specialty may be exactly the path they need to succeed in nursing. Personally, I was called to nursing by a force larger than myself. I was drawn to the profession to help women during pregnancy, labor, delivery, and beyond. For many, labor and delivery is not a specialty they would ever consider. Those people are not judged for knowing they have no desire to or could not handle working there. Why then should I be judged for knowing myself well enough that labor and delivery is the only place I truly want to be? Why am I wrong for knowing what I want and more so, for knowing where I will be the very best nurse I can be?

Please do not get me wrong, I am not speaking from a sense of entitlement or a position that I know it all. I am very new, and have a lot to learn. I just choose to work hard in a direction that will lead me to my goal. Ultimately, working in a specialty area will be the best decision I can make for myself and most importantly for my patients.

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Specializes in ER/EHR Trainer.

FIL passed today. Hospice nurses were wonderful-that is truly a calling and a gift from God specialty!

Back to..... go where you want. ER and Telemetry were great, it was Med-Surg that let him and our family down. His downfall was directly proportional to the care received there!

Maisy:stone

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Specializes in Cardiac Telemetry, ED.

I'm sorry for your loss.

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Many people mention working at least 1 year in med-surg was the key to acquiring assessment skills and becoming a good nurse. Of course everyone will say that working a year on a med surg floor would help, who is ever going to say, working a year as a nurse on any floor DID NOT help in gaining nursing skills! Great nursing preceptors and nurses that are available to help or answer questions are more important than anything when it comes to keeping great nurses in the future.

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Well all have to start somewhere as a new grad..it is unfortunate that you have some nurses who feel as though they were born nurses and never had to start from scratch.

I'm still a pre-Nursing student so I could be wrong but I must say that I agree with those who find nothing wrong with new grads going into specialty fields. I, myself, want to do ER. I really think I would hate Med/Surg and I have always believed that a person should take a job that they truly enjoy because not only will it be better for their stress level but for the stress level of all involved. When I get up to go to work I don't want to do it begrudgingly.

Either way the new grad is going to come to any area somewhat "green" and must be trained for that specific area so whats the difference which area they are trained in?? Am I misunderstanding something or missing a point somewhere?

I have spoken to experienced nurses and have heard both views. Personally, if I can help it I will not go to Med/Surg but if I must do an area before ER I was advised that ICU would be best for someone who would eventually like to go to the ED. But thats just my humble opinion.

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I am sorry to hear about your FIL. I pray that you and your family are getting through this okay.

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I apologize grantyRN06 after reading the next few posts I realized that I misunderstood yours. :flowersfo

Originally Posted by grantyRN06 viewpost.gif

Well all have to start somewhere as a new grad..it is unfortunate that you have some nurses who feel as though they were born nurses and never had to start from scratch.

I'm still a pre-Nursing student so I could be wrong but I must say that I agree with those who find nothing wrong with new grads going into specialty fields. I, myself, want to do ER. I really think I would hate Med/Surg and I have always believed that a person should take a job that they truly enjoy because not only will it be better for their stress level but for the stress level of all involved. When I get up to go to work I don't want to do it begrudgingly.

Either way the new grad is going to come to any area somewhat "green" and must be trained for that specific area so whats the difference which area they are trained in?? Am I misunderstanding something or missing a point somewhere?

I have spoken to experienced nurses and have heard both views. Personally, if I can help it I will not go to Med/Surg but if I must do an area before ER I was advised that ICU would be best for someone who would eventually like to go to the ED. But thats just my humble opinion.

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