1st choice for a fresh grad?

chylerlove · Nov 25, 2015

First I want to say congrats on getting into school and pursuing a career in nursing! I have 5 years of nursing experience: first 3 were on a neuro med/surg unit, the last 2 have been in Education and I've worked PRN in the ED (every Saturday so approx 50-60 hours a month). I LOVE the ED and wanted to go there straight out of school, however, I would not give up my med/surg experience for anything! The time management, skills and communication I learned there have proven crucial elements in my success as an ED nurse (or my strive for success i guess i should say! ) and as an educator. Anyways, just food for thought! I know lots of people who went straight to ED and wouldn't have it any other way.

Good Luck!

MassED, BSN, RN · Nov 28, 2015

I worked med surg for about a year. Great foundation and would recommend floor nursing for any ER nurse. Good luck!

chivon101 · Nov 28, 2015

I went straight out of school to a level 1 trauma center. I've been working in the ED for 7 years, I do not think you med/surg experience as long as there is a good internship program. Med/surg and ED are two totally different beast.

emtb2rn, BSN, RN, EMT-B · Nov 28, 2015

Med/surg is a specialty too. If you want er, head straight in. I watch nurses with m/s experience often struggle to lose the floor approach & get comfortable with the focused er style.

Join the darkside.....

Lev, MSN, RN, NP · Nov 29, 2015

I agree that floor nursing helps in some ways and is a hindrance in others. Whether you go in as a new grad or come in with floor experience, having a good and supportive orientation is necessary to succeed.

desert_MP, BSN, RN · Dec 2, 2015

If ER is your passion-go for it. When I first got into nursing the OR was my passion and I did it for almost four years. I then wanted something more fast paced...so I went PACU at a level 1 trauma center. I've been in more "fights" in the PACU than when I was in the military. It's all in what you want to do. That's the beauty of nursing!

chylerlove · Dec 2, 2015

I agree that floor nursing helps in some ways and is a hindrance in others. Whether you go in as a new grad or come in with floor experience having a good and supportive orientation is necessary to succeed.[/quote']
That's a great point! I have good time management skills and assessment skills but have still have trouble keeping up sometimes because the ED requires the same skills but you have to apply them in a unique way. I agree that you can be successful any route you go as long as you have a good orientation and support post orientation. good luck!

wannabecnl · Dec 3, 2015

I just answered another post from a 6-months-in new grad in the ED who is miserable! But that doesn't mean it's not for you.

My advice? Shadow at least one whole shift before you commit to working in the ED or any other department. Make sure you know the workflow and that you like to work that way. I shadowed med-surg and disliked it, then had 2 semesters in m/s in nursing school and disliked it, but I still took a med-surg-ish job in a step-down unit, thinking that the higher acuity would keep me interested. WRONG. I hated it the first day and moved on rather quickly (for other reasons, but it was the best thing I could have done). Now I'm in PACU, and I love the flow, the variety, the narrow but deep focus on 1-2 pts at a time, and assisting with procedures. I didn't know I would like it so much until I shadowed and fell in love.

Good luck in whatever you decide to do!

emmy27 · Dec 3, 2015

I'm not sure how much my m/s experience directly prepared me for ER life, but I do think it was a less terrifying way to start my career than being a new grad in the ER. While both specialties are challenging, the scope of problems, pace of work, and degree of autonomy and split -second judgement required in the ED is much more intense than on a M/S floor (your floor patient may go bad, but when they do they've already got a history, a diagnosis, an IV, and a doc- your ER patient might go bad ten second after staggering through the front door with nothing except their presenting symptom to guide your actions). I've seen new grads in the ED flounder because they simply don't have the confidence in basic skills and assessments (which is reasonable- they're new!) that are absolutely necessary to function, especially in an ED that's understaffed or doesn't have a solid orientation process.

I do know new grads who started in the ED, and some of them are happy (although I've also seen a lot of ER new grads burnout and leave after less than a year). If you've got a job offer at a place with a solid new grad program (your ER new grad orientation should be MONTHS, not weeks) and a good reputation, it might be worth considering. But an ED that's hiring new grads is almost certainly an ED that will hire experienced m/s nurses later, as well. And having a year or more of m/s experience is a great stepping stone to many specialties later, if you decide ER is not for you.

Jrhemming · Dec 4, 2015

I graduate in two weeks and ER was what I thought I wanted to do since I got accepted into nursing school. This semester I got to do days on ER and ICU to see what their day to day is like and I was hooked. I was like you before, not sure if I should go to med surg first, but after getting my feet wet I don't want to do anything else. I made really good impression and a highly respected ER nurse told me to bring my resume to her and she would take it to her manager. I have an interview lined up now. So my point is if you haven't had a chance to go to ED in clinical see if you can. If you like it go for it and try and make good impressions. Good luck!

12rn · Dec 8, 2015

I started in a level 1 trauma center right out of nursing school. I love it and recommend ER nursing to every student that passes through. I cannot imagine working the floor- I am positive I would hate it. If the ER is what you want, go straight for it.