Should a new grad go into med/surg or into the specialty that they would love to be in?

[StudentRNmt]

I am about to graduate in December with my ADN. I would really like some opinions on whether I should apply to med/surg positions or if I should try to get into the NICU, which is where I ultimately want to be. The hospital that I am going to apply at does except new grads into the NICU. Thank you for your comments.

[SqrB3ar, BSN, RN]

You'll be competing with BSN students. Seems to me that many new grads want to work in NICU too, not to mention there may not be many positions posted. It all depends on your area with how many programs are nearby pouring out new grads eager like you.

If you are dead set on NICU, keep your eyes open but I'd go up there in person and speak with the manager with your resume ready. Also, don't limit yourself to that unit only, like others mentioned, check out Peds, OB, maybe even ER/ICU for acute care experience. If you haven't had any luck in a certain time frame, I'd suggest widening your search to other specialties - this is all dependent on how long you're willing to job search for NICU. Getting a job in the hospital with a NICU can possibly allow you to transfer to that unit as an internal. You may also have to consider commuting - less desirable areas/hospitals may be more likely to hire NGs due to staffing needs. But if you know someone that can get your foot in the door, that'll save you headache!

All in all, it's all about getting experience. Good luck and congrats to nearing the end of nursing school!

[jennligh]

Hi OP!

I just graduated from nursing school and started applying for positions before I took the NCLEX. I had heard different nurses telling me that I should start with med surg, but I went with my gut and applied to some psychiatric nursing positions as well. I have always wanted to do psych, but my professors kept warning me that I may find that it's not for me. Well, I accepted a position as a psychiatric nurse on the adolescent unit and I love it! I would imagine with the NICU you would have to be very strong in your nursing skills before entering, which med surg is a basis for all. But I would apply to some positions and even meet with some of the nursing managers to figure out the best route. Good luck!

[Meriwhen, ASN, BSN, MSN, RN]

Most nurses don't start out in their dream specialty...but as a new grad, getting that first job is the priority.

So yes, apply to the NICU, but apply for everything else that you can. If you end up landing a NICU position, grab it and don't look back. If you end up starting elsewhere, get that first year (or two) of nursing experience under your belt. Once you have experience, you'll be eligible for more positions and could start working your way over to your dream.

Best of luck!

[AutumnApple]

My advice is to go into the specialty that you want. Dismiss any inclinations that you must "Learn your basic skills on a general floor first."

I did M/S to start, but I did so because I wanted to. Not because I saw it as a stepping stone towards something else.

Once you're on the M/S train tracks, it's very difficult to switch rails to go another direction. Lots of my peers went into M/S just for "basic skills" and were BITTER once they realized they were railroaded into staying right there. Once a hospital system has you trained for a unit such as this, they're not going to ever see letting you transfer elsewhere to learn a different specialty as a "good thing".

It's MUCH easier to go from a select specialty to M/S than the other way around. It's just the culture of things.

[FolksBtrippin, BSN, RN]

Go for what you want. You want NICU, so go for it. If you can't get into the NICU go somewhere close, like mother-baby. If you've tried for 6 months to get into mother baby or NICU and can't, then start looking elsewhere, but give yourself a fighting chance first. It's very hard to retain nurses on hospital units and it costs a lot of money to train a new nurse. Med/surg units should not be places full of new nurses leaving after one year. Every unit should have the nurses that want to be there. Nursing is very difficult, especially when you first start out. You need to be the place you wanted to be to get you through that rough spot.

I went straight into psych because it's what I wanted. I have no regrets about this. If I change my mind one day, and decide to go into something medical, I will take a course on the technical skills we don't use in psych.

Your first job will be hard enough even if it is exactly what you always wanted. If you're going through all that stress for something you weren't that interested in anyway, you are more likely to burn out from the field altogether.

[Ruby Vee, BSN]

My advice is to go into the specialty that you want. Dismiss any inclinations that you must "Learn your basic skills on a general floor first."

I did M/S to start, but I did so because I wanted to. Not because I saw it as a stepping stone towards something else.

Once you're on the M/S train tracks, it's very difficult to switch rails to go another direction. Lots of my peers went into M/S just for "basic skills" and were BITTER once they realized they were railroaded into staying right there. Once a hospital system has you trained for a unit such as this, they're not going to ever see letting you transfer elsewhere to learn a different specialty as a "good thing".

It's MUCH easier to go from a select specialty to M/S than the other way around. It's just the culture of things.

I wonder where you've worked that Med/Surg folks cannot switch specialties. I've never found that to be true. Med/Surg nurses are snapped up in a heartbeat when they apply to ICU.

[Rebelution]

Go do what you want. If you really want it, you'll learn it and do fine if you're willing to deal with the ups and downs of learning something that might be more complicated. The advice to "go do medsurg" first is crap if you won't be happy there. I started in a busy trauma ER and have survived. I've seen new grads come in and excel at ER and ICU, and I've seen others bomb out. After years of doing it, you can almost tell who will do which when they come, and it's all in their drive, work ethic, and intellect.

[elijahvegas, ASN, RN, EMT-P]

Get whar you can get whenever you can get it . But youll burn out quick if you go into something you have no interest in

[Sour Lemon]

I wonder where you've worked that Med/Surg folks cannot switch specialties. I've never found that to be true. Med/Surg nurses are snapped up in a heartbeat when they apply to ICU.

in some cases, employers may be reluctant to allow internal transfers- particularly from a hard to staff and retain area to an easier to staff and retain area. When switching from one hospital to another, I agree that med/surg experience is considered valuable for most specialties.

[SqrB3ar, BSN, RN]

Go for what you want. You want NICU, so go for it. If you can't get into the NICU go somewhere close, like mother-baby. If you've tried for 6 months to get into mother baby or NICU and can't, then start looking elsewhere, but give yourself a fighting chance first. It's very hard to retain nurses on hospital units and it costs a lot of money to train a new nurse. Med/surg units should not be places full of new nurses leaving after one year. Every unit should have the nurses that want to be there. Nursing is very difficult, especially when you first start out. You need to be the place you wanted to be to get you through that rough spot.

I went straight into psych because it's what I wanted. I have no regrets about this. If I change my mind one day, and decide to go into something medical, I will take a course on the technical skills we don't use in psych.

Your first job will be hard enough even if it is exactly what you always wanted. If you're going through all that stress for something you weren't that interested in anyway, you are more likely to burn out from the field altogether.

Great advice!

[KelRN215, BSN, RN]

I strongly disagree with the notion that "everyone" needs 2 years of med/surg experience. I have been a nurse for 11 years, all 11 in pediatrics, and med-surg experience would have served me in no way in any of my jobs.

I do agree with previous posters who said a NICU position as a new grad with an ADN will be hard to come by. I don't know about your area of the country but in my region, an ADN new grad would have a very difficult time finding a position in a NICU. The new grad positions at the Children's Hospital I worked at as a new grad were exclusively for BSN new grads. You may have a bit of an easier time finding a position in a special care nursery in a community hospital and then once you have experience, may have a path to obtain a NICU position.

[RNperdiem, RN]

Are you willing to move for the specialty you want? Most hospitals in my area don't have NICU. The vast majority of jobs are for adult patients.

The ADN is probably a disadvantage. In big academic teaching hospitals (where you find NICU), having a BSN is a big deal, so keep your options open for adjacent positions like L&D or newborn nursery jobs at smaller hospitals.