Should I skip med-surge?

rnbeauty · Sep 2, 2006

Maybe you should consider going to a stepdown unit instead of med-surg. i actually wish I would have spent my yrs on PCU, IMC rather than med surg. You still learn basic assessment skills with a little more complexity. Average patient load 1:3 ratio instead of 1:8. The only thing you really would learn on a MS floor is how to short cut your way through things. You have so many patients with so much going on, time managment will be your only focus...

Just my two cents.

asianrn · Sep 2, 2006

I precepted a lot of newly grad nurses in ICU and for the most part is not that bad. I guess it depends if you are a fast learner and your preceptor's PATIENCE...

Outdoor1 · Sep 2, 2006

If you want to be a CRNA don't waste your time in med surg. The skills you will need are those that you aquire in ICU/Critical care.

piper_for_hire · Sep 3, 2006

Just go right into the ICU.

Stella-Ohio · Sep 3, 2006

Another vote from me for straight to ICU.

jewelcutt · Sep 4, 2006

I don't know why med surg nurses always think that you learn organization on their floors. You have to be very persistent in order to work in ICU straight out of school. You will learn so much about organization there, and you're way more involved with every aspect of the patients. You get very involved with rounds and learn a great deal from the docs that are around. I agree completely with the poster that stated everything you need to get into anesthesia school is learned in the ICU. Skip med surg, it will be extra time you could have spent preparing for anesthesia school. And once you do school, you will realize what everyone else does eventually, I should have done this sooner. Anesthesia school teaches you everything you need to know about anesthesia, yeah working in a CVICU made gtts and swans something I didn't have to learn, but anesthesia is diverse. We have peds cvicu nurses in our class that learned more easily about peds. The point is that anesthesia is diverse, you will learn how to take care of every population in 2 1/2 years. I think that many nurses don't realize that. If I were you I would be more concerned about what looks best on an anesthesia app rather than working med surg (ie working in different ICUs for experience, CCRN, certifications).

Dreamweaver2be · Sep 4, 2006

Another vote for going straight into ICU. I was a nurse tech during nursing school on a med-surg floor and knew from the first few days it was not the area of nursing I was passionate about so it was not a good place for me or the patients I was caring for. I also knew in nursing school that I wanted to pursue nurse anesthesia, so I saw it as a waste of time. I heard pros and cons for both sides, but I went straight into the ICU and I am doing fine. You do learn good time management skills, assessment skills, etc. in critical care--you have to. If you do decide to go straight into critical care, find a hospital that will give you the benefit of a strong residency program for new grad. RN's.

GregRN · Sep 5, 2006

i suspect the differences in opinion you are getting have to do with the experience of the individuals you are asking. they either couldn't see themselves making that jump, or they couldn't see themselves making that jump in their current facility. so, when you ask them their opinion on the subject, keep in mind that their own experience is all they really have to draw from. that said, i'll wax philosophical in answering your question.

there are many variables that need to come together in order to go straight into the icu out of school and be successful. some of them have to do with the person, some have to do with the hospital. first, is the icu where you really want to be? are you aggressive/assertive enough to move at that pace and not get pushed aside when things turn south? do you work better getting to know 1-2 patients very well and at a deep level, vs. 5-8 patients on the surface? do you like the detail involved in putting together the puzzle of an icu patient? when the fit hits the shan and your patient crashes, do you want to be at the forefront in getting them stable again or would you rather let someone take care of the crisis and then you take the patient from there? can you navigate the delicate waters of family members' anger and anxiety when their loved one becomes acutely ill and they have nowhere else to place that energy except on the nurse? are you prepared to handle/learn end of life issues, both from the patient's perspective and their family's? those are just a few things to think about. if you answered "yes" to those, then the second part becomes the most important.

secondly, does the hospital where you are considering going into the icu have a track record for successfully placing new grads in the icu? what is their training program like? how long? are you 1:1 with a preceptor? does that person have a successful track record as well? what resources are available to you as a new grad icu nurse, i.e., education and training departments in the hospital, cns's, access to doc's, resource books and material, computer applications and training, hand's on education, etc? how acute is the facility in which you will be working? how long is training before you will be expected to work independently? what is the culture like on the unit in which you will be working? are they receptive to new grads or would they rather beat them up for a bit to see if they can "make it"? when working independently, is the unit very helpful to new grads just off orientation or do they give the attitude of "sorry, you're on your own now"?

i've seen very smart, driven and capable people fail miserably going straight to the icu because the facility in which they were working was not adequately set up to take on new grads. the system failed them and no matter who was placed there, it's likely they would have failed as well. likewise, i've seen people who were not quite ready for the icu get through a very good training program, only to decide later that the icu wasn't quite right for them. where you fall in the middle of all this, and the facility in which you work, will likely predict your success in going directly to the icu from school.

Ann RN · Sep 5, 2006

Hi everyone,
I'm in my seinor year of nursing school and have a question I would like to pose to everyone. I have been getting conflicting advise from different floor nurses, CRNA's, and instructors about whether I should do a year in me-surg before going into the ICU. The CRNA's I have met have downplayed the importance of med-surg experience and say that I should just try to get into the ICU right away. My instructors and other nurses advise me to do a year on the med-surge unit because the experience will make me a stronger nurse in the long run (better assessment skills). So my question is, what would be the wisest deciscion to make?
Thanks, B.H

I'm going to be the bad guy here and some of you may hate me for this but...

A year of med-surg or PCU can be invaluble. Yes, if you're going to be a CRNA you should have good ICU experience first. But, if you're going to be an ICU nurse. you should have a good knowledge base and experience first. Sometimes the fastest way is not the best way.

j-bird · Sep 5, 2006

I agree that 1 year in med/surg or a stepdown unit would give you different types of skills. Going to ICU, straight out of school, generally is a bad idea.

I vote for 1 year in either med/surg or stepdown.:wink2:

cardiacRN2006, ADN, RN · Sep 5, 2006

Straight into ICU. I have mad assessment skills because of starting off in the ICU. I have to assess my pts every 2 hours at least, if not more. Plus, as a new grad, the staff keeps an eye out for anything exicting or out of the ordinary.