Tele or M/Surg Exp B4 OR

[loco_lobo]

I am a new R.N. and just interviewed with four units in the same hospital, three med/surg units (group interview) and one telemetry unit. I was told to "expect offers" from the med/surg managers and the same from the telemetry manager. My career goal is to go to the O.R. after a couple of years of floor nursing. I simply fell IN LOVE with surgery my first semester of clinicals and never fell out of love. However, our area hospitals rarely take new grads in the O.R., and in all honesty, I want a stronger foundation before I go play with the big dogs. Soooo...now the question is what is the better pre-O.R. job experience: tele or med/surg (general med/surg, orth/neuro, and women's unit)? All of the units have great staff, reasonable patient ratios (most of the time), and 6-8 weeks of orientation for the new grad. I will get additional ACLS and EKG training on tele, but am concerned that I have limited experience with critical care during school. I feel more confident on the med/surg floors since I spent 3-4 weeks on each of the floors in question in the same hospital. Every five minutes I convince myself that I want to work on a different unit for different reasons. I'm just hoping the community can give me some good advice that will help me find my answer for HR when they call.

[azor]

My Dear,i believe med-surg is a very great place to start off in nursing.Its benefit i believe will help you no matter which area you later decide to go into.For me,i'll say,go to med-surg ok.

Azor

[RNKPCE]

Depends what the tele unit is like. On my tele unit with get a little bit of everything including medical overflow. We get fractured hips pre/post op if they have a heart condition or if they had syncope causing them to fall, some post partum mom's with heart issues, 1st or 2nd day post op open hearts, post op pacemakers, any surgery if the pt has an underlying heart problem, cardiac and carotid stents. I started on tele as a new grad and haven't left. After working my tele I would have the skills to work anymed/surg unit because that is basically what we are.

If the hospital you interviewed at is very different from mine then it would be harder to make the decision.

[loco_lobo]

The unit I interviewed with sounds a lot like yours. When you started working tele, did you feel overwhelmed with the high acuity patients? Had you considered going med/surg? If so, what were the deciding factors for you?

[RNKPCE]

I interviewed a med-surg unit and the tele when I was a new grad. I was offered noc's on med/surg and days on tele(shock huh). So I took tele. My nursing school was a very good program and prepared me well for the tele unit. I also had a good orientation. I was doing charge after 1.5 yrs.

[suzanne4, RN]

If wanting to use the training as strictly a stepping stone, the tele unit would be the best. Acuity is slightly higher, but you will get used to reading monitors and understanding more of the drugs that are used in the OR. And that can come in very handy. Patients do code in the OR, just as they do in other units, so having the more critical experience can be quite beneficial to you.

I always recommend the telemetry units over anything else. And you will get a larger variety of patients, not just strictyl rule/out MIs. But also post surgical patients that need monitoring, etc. You will actually start to see more surgical patients as they are now using metoprolol more in the OR by anesthesia and it requires a monitored bed post-op if the patient is going to require it IV while they are NPO.

[loco_lobo]

Well, just wanted to update: I took the job with the general med/surg unit after talking a little to HR and some friends from nursing school. The med/surg unit offered me evenings and 8 hour shifts, just what I wanted, and the tele unit requires 12 hr shifts on days.

I realize I may miss out on good opportunities in telemetry, but after mulling it over, I decided that I am not ready to jump into critical care unless I am better able to organize and act without having to spend too much time recalling training or reviewing policy. These things take time and experience, which I just don't have right now. And if I need experience, my patients shouldn't be the ones who pay for that. While I don't think med/surg is a walk in the park, at least I am already somewhat comfortable on those units and feel confident that I can safely build on my nursing skills/knowledge there while giving good patient care. The real deciding factor for me was when the HR rep said that they allow new grads to begin applying for other positions within the organization in as little as a year. While I feel that it will probably take more than a year to be ready for the OR, I can still reassess and proceed at that time. I've always been one to proceed cautiously and believe this to be the right decision for me.

Thank you so much for those of you who took the time to respond. It means a lot to me to know that there are so many good experienced nurses who value sharing knowledge and experience with those of us who are not quite "there" but are excited about someday getting where you are.