What's the best area of nursing to start?


What's the best area of nursing to start out in? Med/surg, oncology, cardiac/telemetry, cardiac/medical, neuroscience, orthopedic, GI/GU, or surgical - ear. nose throat?

Also what's the difference between cardiac/telemetry floor and cardiac/medical floor? Don't all cardiac floors use telemetry to monitor the heart?

The reason I'm asking is I get to pick an externship for my final semester and I"m not sure which one to pick! Any advice would be great!

loriangel14, RN

6,931 Posts

Specializes in Acute Care, Rehab, Palliative.

I wouldn't say there is any one "best" area for a nurse to start out.Many areas can be beneficial to a new grad. You would want an area where you will get a wide range of patients and an opportunity to use/develop your skills.If you have an idea of what area you are most interested in then that may influence your decision.I know it sounds cliche but I would still pick med/ surg.Yes some places have a cardiac/medical floor without telemetry.Best of luck.


73 Posts

Med/Surg will give you the best all around experience

You should pick the area that gives your heart a lil flutter when you are on the unit, the one that makes you "feel" like you belong there. If you haven't experienced what I am talking about yet, then for sure start with med/surg.


157 Posts

As a new grad, I started on a tele floor that deals with cardiac, pulmonary, renal and observational - so we get a little bit of everything... and I love it - I think I'm gaining a really nice all-around experience.


120 Posts

Specializes in OR; Telemetry; PACU.

cardiac/telemetry floor is my vote just because it gives you a great start for critical care if you choose to go that direction. When I worked tele, we had to take the critical care class and talk about gaining knowledge! And if you decide to work med/surg you're ahead of the game imho.


560 Posts

Specializes in cardiac, ICU, education. Has 18 years experience.

If you are getting the privilege of doing an externship and you are able to go where you want, then pick what you think you will like.

We use to tell people to go into med/surg for the 'well rounded experience,' but truth is, med/surg is really now a specialty. Many med/surg nurses (the true med/surg nurses who want to work on that floor) do not like to be the experimental floor. In one of the hospitals I teach in, they orientate the new ICU nurses to the medical floor first, and then after 6 months bring them onto the critical care floor. This is unfair to the preceptors and nurses on the medical floor who see the rotating parade of new nurses. I think it negatively affects the medical unit culture. It should be just as much of an honor to work on a medical floor as it is to work in NICU, ICU, etc.

If you are interested in OB or ICU, then IMO don't go to med/surg because you may get to see a lot, but it is a different animal and you will have to start all over again if you change specialities.


560 Posts

Specializes in cardiac, ICU, education. Has 18 years experience.



230 Posts

Be aware that whatever you pick, this is most likely where you will end up after graduation. Having that on your resume will make it easier to interview for a position on that type of floor. Right now having the preceptorship or externship will give you a leg up to get a job so choose the unit you think you want to work on. I personally would not pick med surg. If you are interested in peds, ob, etc go with that. If you are unsure then I would go with the one you "think" you want.

You can apply for a med surg job as a new grad with any preceptorship background, so I would go for something more specialized. It is so hard to get into a specialty as a new grad I would take any opportunity to get experience.

Specializes in ER, progressive care. Has 7 years experience.

Any kind of med-surg floor or stepdown unit would be very beneficial to a new grad. I work in progressive care (basically like a cardiac stepdown) and although we get a lot of cardiac patients, we see a little bit of everything. It's great experience.

I would choose something that you are interested in, though. It helps to have an externship similar to what you are aiming for for your first job...so for example, if you want to work on a cardiac floor, opt for a cardiac-type internship, etc.

ImThatGuy, BSN, RN

2,139 Posts

I've been thinking I want to extern in a hospital chemical dependency unit. I've lost literally all interest in medical and surgical work. Mental health of any kind seems a better career fit for me, and I want a MSN in psych "NP." I spent some time rotating through there and I felt comfortable. It fits my background since I have seen those people at their worst and can now sadly relate to them better than people I have spent my life knowing. I thought and sometimes still think the ER was "it," but the same crap making me wanting to leave police work, as a full-time job, are in the ER (which I have always known). I just can't fake the interest in being a hands on clinician anymore.


601 Posts

The "best" area to begin in is that which makes you want to clock-in each shift.:twocents: