What type of nursing job do you think is the best to start out with?

leosasha · Nov 12, 2008

Med/Surg. It provites the strongest across the board knowledge base.

SpaceCoastRN · Nov 12, 2008

I can only hope that medical surgical floors are better than the one I have been doing clinicals on. It seems I have had more mentoring in poor nursing practice than positive. My clinical instructor has 27 years of ICU experience and just shakes her head at the clincal practices we are witnessing, then educates us on proper care. My plans are going straight to a surgical/trauma ICU or most likely the ED/trauma. But, I also have 18 years of experience as a paramedic in a rather busy, very progressive EMS system so medicine isn't new to me.

oeue2007 · Nov 12, 2008

It sucks but I do think every nurse should start w/ at least six months med/surg too. It just "congeals" everything from school and will help you in any area that you go to. My analogy (being from GA) is anywhere I fly I'm starting from Hartsfield, the busiest (possibly worst laid out) airport in the world. Every other airport is then a breeze to maneuver through.

truern · Nov 12, 2008

I agree with those that said med/surg. I went directly into telemetry and have often wished I had more background especially in the surgical area.

Thankfully, I've learned a lot of that from personal experience the last 6 months :yeah:

emnicams · Nov 12, 2008

I would agree with med/surg even though I've never worked it! I started a year ago in a cardiac stepdown unit and although chest pain, post-PPM's, pulling art lines, etc. is a breeze for me, I know little about the most basic things... had a pt with a chest tube/pleurevac yesterday and knew very little about it. Had a pt recently with a colostomy, I didn't know how to change the bag! the pt had to show me.. and I've been a nurse for a year. (I did learn that skill in nsg school at some point, but it's long since disappeared from memory..) I like where I work but I wish I had more skills.

twistedpupchaser · Nov 13, 2008

Not trying to hijack the thread, would it be a wise move to do overtime/rostered shifts in another area once a month? truern and emnicams make a valid point of not having a range of skills due to their specialty, I am now working medical and still see things that I have only vague memories of from nursing school. I started in ortho and never saw so many things I now know well.

VU RN BSN · Nov 13, 2008

If I could go back and do it all over again, then I would start out on a medical/surgical floor or a medical/telemetry floor. Better yet, I would start out in one of those Graduate Nurse Internship programs.

I deeply regret starting out in Critical Care. When I was in my final semester of nursing school and I went on job interviews, the hospital that was most interested in me offered me a position in CCU because they were beginning a brand new Critical Care Orientation for New Grads program. I had originally told them my interest was cardiac nursing, meaning a telemetry floor. But they thought I would be smart enough to start out in the Coronary Care Unit. They promised me 6 months of orientation, which meant 6 months with a preceptor. The vast majority of my critical care nursing training was done via the computer, not in a classroom setting. We used ECCO (Essentials of Critical Care Orientation).

As a new grad, I didn't know how to start an IV, I didn't know how to draw blood, I didn't know how to insert an NG tube on a live awake patient or a small bore feeding tube, I wasn't comfortable working with multiple IV lines and IV pumps, I didn't know how to read an EKG, I didn't know what to do during a code blue, etc. I was not prepared for the real world of nursing. However, within a couple months of graduating nursing school (BSN), I was having to take classes in mechanical ventilation, Advanced Cardiac Life Support, Intra-Aortic Balloon Pump, Continuous Renal Replacement Therapy, etc etc etc. It was mind boggling. I was overwhelmed.

Needless to say, I only lasted a few months once I finished my 6 months with a preceptor and I came off of orientation. My nurse manager realized I was completely stressed out and scared out of my mind. I was transfered to a telemetry floor.

Now, four years into my nursing career, I have worked CCU, telemetry, PACU, and home hospice. Trying to work as a home hospice nurse made me realize that my clinical skills are still not very strong and I think that is because I never worked Med-Surg. So, here I am, four years later, applying for hospital jobs on medical-surgical floors. Wish I had done this 4 years ago.