Non "floor nursing"

ukstudent · Dec 7, 2007

You could go to icu. Then again if you want to do er and there is a hospital with a good and long orientation for new grads to the er, just go straight to the er.

llg, PhD, RN · Dec 7, 2007

I think ukstudent makes a good point. What is most important is whether or not the unit you choose has an orientation appropriate for a new grad -- not the type of unit itself.

Any choice (even the most general of med/surg units) can be a bad choice if that unit does not supply the education and support you will need to make that transition from student to practicing professional. Any specialty unit can be the right choice if (but only if) the unit provides the education and support you will need.

Evaluate the jobs available to you in terms of whether or not they will give you the education and support you need -- and don't just think in terms of the specialty.

CRNA2BKY · Dec 8, 2007

Hello
I graduate in 2 semesters and I plan on eventually working in the ER.
I was told by a previous instructor that I should work in med surge for 1-2 years for experience. I really don't like floor nursing...could anyone recommend an area that would give me nursing experience prior to working in an ER.

There are 2 schools of thought....a right one, and a wrong one. The wrong one (the more traditional view) says that everyone needs to go to med-surge for a year or 2 first. The right school of thought is that you should by-pass med-surge and go directly into the field of your choice.

If you do not want to do med-surge, then why the heck would you put yourself through 1 or 2 years in an area that you have no interest in. It will only make you bitter, tired, and unsatisfied in the field, leading you to burn-out quickly. The experience you gain (while good) will be negated by the fact that different departments do things differently, and there will be a negative transfer of learning. You will have to "un-learn" things, and then "re-learn" the stuff the way the new department wants it done.

If you go directly to the department you want to work in right after graduation, they will teach you everything you need to know. Many hospitals around the country offer new graduate residency programs that provide extensive and excellent training in various departments, such as the ER. They spend lots of time educating you to make you a very proficient ER nurse, and they won't let you loose until you feel comfortable in what you are doing. So, if the ER is where you want to be, then that is where you should go after you graduate. Good luck.

jackson145 · Dec 8, 2007

I'm longing for ED also. I know of 1 guy who went right to work in the ED after graduation. Less than 6 months later he was in charge of ICU. Pretty big promotion! My hospital has discussed making 1st 6 months employment mandatory in Med/Surg. I hope they don't get it done. Several of our ED nurses started their careers in the ED and have been there many years, so apparently it can be done.

meme75 · Dec 8, 2007

You could go to icu. Then again if you want to do er and there is a hospital with a good and long orientation for new grads to the er, just go straight to the er.

I do agree...

locolorenzo22, BSN, RN · Dec 17, 2007

the number 1 issue is that you HAVE to have your assessment skills down pretty quickly....Personally, I'm planning to go work on my own floor as an RN as I get along well with all my techs, know whats going on, know protocols, understand rationales, and love all my fellow nurses.....

After 1-2 years of getting my basics down...thinking about getting to some sort of speciality teaching/education related nursing before my BSN or masters starts.....

mark3274 · Dec 18, 2007

I would go to the unit you want to... that you need med surg for a year is old thinking.

most eds have a new grad training program now.

carol72 · Dec 19, 2007

I just don't get it. Everyone tells nursing students they should work on the floor for 1 - 2 years before moving on to what they really want. I strongly disagree.

SteveNNP, MSN, NP · Dec 19, 2007

I just don't get it. Everyone tells nursing students they should work on the floor for 1 - 2 years before moving on to what they really want. I strongly disagree.

The notion of getting our feet wet on a med/surg floor is an ancient one. It used to be that you HAD to work there before moving to another unit, primarily due to the seniority of nurses on the units, and lack of nursing shortage years ago. Now that there is a shortage, hospitals/units are putting new grad residency programs in place that are (usually) an effective way to train new critical care nurses. I would recommend choosing whatever specialty you find interesting and find a hospital that is willing to train you for at least 12 weeks in that specialty. Best of luck!

Stephen

llg, PhD, RN · Dec 19, 2007

As I have said many times before ... I am all in favor of going directly to the specialty of your dreams. IF that unit has an appropriate orientation program for new grads. Personally, I started out as a new grad in the Neonatal ICU many years ago.

However, there are some legitimate reasons why so many people recommend starting your carereer on a general med/surg unit -- and those reasons should not be ignored. They should be weighted into your decision making. They may be relevant to your situation or they may not be. But you should at least consider them in your thinking and not dismiss them lightly.

1. Most nursing students get more clinical experience on adult med/surg units during school than in specialty units. Therefore, many find they are more prepared to work in that area than any other. Some people find that student experience helpful in making their transition from student to professional.

2. Most of the content on the NCLEX exam is based on adult med/surg nursing. Those new gradds who have not yet taken the NCLEX who work on adult med/surg floors have the advantage int that what they are learning and doing at their jobs helps them review for NCLEX. The same is not tre for a unit such as NICU, where there is virtually no overlap in the content. The new grad is trying to focus on learning NICU stuff -- and that may take away from their ability to also study different content for taking the NCLEX. It's hard to learn two very different fields simultaneously.

3. Many adult specialty units (such as ICU and the ED) require that the new employee has exceptionally strong patient assessment skills, organization skills, family interaction skills, etc. Even a good orientation program may not be enough to fully prepare a new grad to function at the needed level in 4-6 months. Some of those units find that nurses with a little experience behind them are more likely to succeed because they come with a stronger foundation.

4. Many students get only the briefest of experience in some of those specialty units and may have unrealistic ideas about their ability to step into the job as a new grad. Again, having some experience on a general med/surg unit may help new nurses develop a more realistic view of their own capabilities and preparedness for handling the most complex situations.

So ... I recommend assessing the situation thoroughly. Assess your own strengths and learning needs and also assess the unit's orientation program.

ICURNGUY · Dec 23, 2007

I'm right there with you KFF! I work on a med/surg floor and graduate in 1 year. I am transferring to the ED in our hospital because that is my calling. They are more than willing to work with me when I am done. They also told me to try to start in med/surg, but that is not for me by any means. ED and ICU.....I hate getting more blankets and jello! Go with what you want, what's calling you!