Med-Surg or Specialty??

[Nurse Beth, MSN]

Dear Nurse Beth,

MED SURG OR SPECIALTY?

I have a few different residency job offers, two for Med Surg and one for ER. I love the ER and that is where I want to advance my career. However, I am nervous about jumping into it with no confidence. I hear that nursing is transitioning away from that one of year of Med Surg and going straight into specialties is bringing about better outcomes. I have no idea what to do but I graduate in less than a month and need to decide!

YIKESSS

---

Dear Nervous,

My short answer- ED.

You love the ED setting and plan to stay there.

New grads going straight to ED have done very well in recent years, dispelling the old "needs one year of Med-Surg" experience advice.

Med-Surg provides an excellent background which serves you well wherever you go-

so it's a very positive experience in that regard.

However, I've come to believe that it is not a negative to not have the Med Surg experience.

Many excellent ED nurses we have on-boarded over the last few years went directly to ED. One ED nurse who initially went to Med-Surg had such a difficult time performance-wise that she questioned her choice to be an RN and inspired me to write an entire article about her.

While still in Orientation, she transferred to the ED. She has been there 2 years and is happy and competent. This is anecdotal, I know, but still.

My opinion only :)

Best wishes,

Nurse Beth

[RN-dancer]

I picked a medsurg residency and they even offered me a sign on bonus as new grad. However I am still torn because I love the ED/Critical Care, it gets my blood pumping and my brain gets so intensely focused. I hope one day I can transfer there. Thank you Nurse Beth :)

[llg, PhD, RN]

Med/surg is a specialty.

Pick the specialty that interests you the most -- assuming that they have a good orientation program and are used to hiring new grads. I am always wary of placing new grads on units where they are not used to hiring new grads and are unprepared to deal with the learning needs of new grads. However, if those things are in place ... follow your heart.