where to start after graduation

If your desire is to work with patients that are commonly in a Med/Surg unit then a Med/Surg unit would be a good place to start even if your desire is adult ICU. But, if your "passion" is L&D, Peds, NICU, OR, ER then starting out in an Adult Med/Surg unit is worthless. 90% of the knowledge and skills learned from starting out in an Adult Med/Surg unit would be worthless to me in my NICU job.

I posed this question to my Med/Surg instructor when told by others that it best for new grads to start off in Med/Surg. He said that if you start off as a novice in Med/Surg and work 2 years before moving to your "dream" job, you will be competent in your Med/Surg job at the 2 yr mark. Once you transfer to your "dream" job, you backtrack on your skill level (not back to Novice) and will have to work your way back to being at the competent level. If you start off as a new grad in your "dream" job, you will become competent quicker than spending a year or two in Med/Surg first.

It depends on your local job market. In any given hospital there are more med-surg nurses (and patients) than there are L&D nurses. Adult patients with medical and surgical issues are the bread and butter of hospitals and there are more jobs available there, and they are often willing to hire new grads.

A lot of us started out in jobs we could get rather than the jobs we really wanted.

If you can get into a L&D job, consider that your first choice. If you are unable to land a job there, consider med-surg.

Thank you. This was very helpful I greatly appreciate all of your responses.

Some specialty units want a year of med/surg before they'll take you on. If you can get a job offer in one that doesn't, go for it. If you're willing to move, you have a very, very good chance of getting what you want. If not, your chances depend on the market where you're located.