To specialize or not to specialize...

[stujen]

I am currently in my last semester of nursing school and have gotten mixed feedback on what area of nursing I should try to get into. Some people have told me to begin work on a medical/surgical floor and I will gain better knowledge of skills, and others have told me to go directly into an area I am drawn to. I was wondering what your experiences have been as nurses and if you have a recommendation on where a first year nurse should try to place themselves?

[NurseLoveJoy88, ASN, RN]

Great question. I'm sure you will get mixed responses because everyone has their own opinion and made decisions they thought were best for them.

I hear the same things as you. As for me I pray If I had the choice between medsurg and my desired specialty I would choose the specialty. That is just my personal desire.

I don't believe every nurse should start off in med surg. Yes it is very helpful to do so to gain a solid foundation but I just don't think its' necessary. l (I'm also in my last semester NS, yay for us!!! :D:D)

[ashfost, BSN, RN]

I graduated 1 year ago and began working in the ER. The job market was really bad and I was having trouble finding a job. My initial want was to work in the CVICU or CCU but since I was offered an ER Residency position, I took it without hesitation. I say take the specialty you want because now I find its difficult to move into the CVICU or CCU w/o actual CVICU or CCU experience. I feel I will be in the ER for another year or 2 just because hospitals aren't willing to train experienced nurses in a new specialty. So go to the unit where you'll feel comfortable spending some time . Just my 2 cents.

[NaKcl, BSN, RN]

I agree with above responses. I thought I need to gain basic experience before I move onto the specialty I wanted. I have been med-surg floor since the graduation, and it is very difficult to transfer to different area/dept. It has not been as easy as those nurse recruiters told me at the beginning.

You will gain nursing experience in any specialty. It dosen't have to be in a med-surg unit.

If I can do it all over, I would choose the specialty.

Good luck.

[Daisy_08, BSN, RN]

I'm a recent grad. To be honest I don't know exactly where I would like to work, palliative is a passion of mine though although maybe oncology someday. The first job I took was in LTC, not an area I loved or wanted to have a career in. But, unlike others in my class I did not turn up my nose at it. Due to the economic climate you will not graduate with hospitals fighting over you. Gone are the days where your first job will be your dream job. You will most likely have to work a few casual jobs. For a while I worked three! I work mostly at a hospital now on a complex resp/vent unit that I really enjoy, and pick up on palliative when I can! I still work the odd shift in LTC for extra $$$. All I'm saying is don't turn up jobs because its not your dream area. Take what you can get. I learned so much from the LTC job; meds, troubleshooting, management, complex wound care.... As long as your not behind a desk you will be learning (unless of course that is the kind of nursing you want to do). I am ahead of my classmates who snubbed their nose at LTC. I now have a job in large hospital with options to transfer to other areas later down the road.

PS I would MUCH rather work with co-workers who are supportive, team oriented and fun then in a area I loved but where my co-workers SUCK!

Best wishes,

[NeoPediRN]

I went right into a specialty (pediatrics and pedi ICU stepdown) and never had any trouble. It really just depends on your personality and what you feel is right for you.

[ChicagoICUNurse]

I started out as a nursing tech in a Progressive Care Unit. It was a great base to learn skills, but I knew that I wanted to be an ICU nurse from the moment I started nursing school.

I was able to obtain an ICU nurse residency position during nursing school and accepted a job on that same unit once I graduated with my BSN. It was a great experience, but I soon discovered my passion for neuro ICU patients. Once I moved to Chicago, I accepted a job in the NSICU at NMH and never regretted a moment! My specialty has opened many opportunities in the nursing community from medical device education to patient safety.

Go with what you love and you won't be disappointed!

[GARN912]

It's hard for me to answer because when I first graduated I wanted to work ICU and would have jumped at the chance had it been offered to me. I can only give my perspective on what I gained from working Med-Surg.

I reluctantly took a Med-Surg position when I could not find my "dream" position in ICU, but I think it is the best decision I have made for my nursing career. I worked in a small hospital so the Med-Surg was a general floor, which meant I got to see everything: pediatrics, lots of post-ops, ARDS, renal failure, COPD, CHF, telemetry, even post-partums...and our floor also had specialized "step down beds" so I also got experience with insulin drips and DKAs, chest tubes, cardiac drips, CVP monitoring, "stable" MIs, etc. Depending on patient acuity I could have anywhere from 3-7 patients. When I decided to apply to a critical care position again, I was hired 10 minutes after I walked out of my interview. They were impressed with the variety of patients I had, as well as the number of patients I was able to manage. They also spoke with me about having difficulty with new grads because they're having to teach the basic nursing skills as well as the critical thinking skills that come with experience, on top of trying to teach critical care.

I don't think you have to work M/S to be successful, but I don't think new nurses should look at it as "settling." Med-Surg is definitely a specialty, and you can learn a lot to take with you in the area you hope to go in.