Where should you start as a new nurse?

ldshaw · Feb 26, 2004

HI to ALL:
I am fairly new here. I just passed my NCLEX and Im applying for jobs. I have no idea where my true heart lies as far as nursing. I have yet to learn. I have heard med-surg is a good place to start for getting basic skills. I have friends though that have started in ICUs and love it, but feel very overwhelmed. My future goals are to go back for an NP in 2-3 years after i've paid off some of my school debt and have gathered my own confidence in the nursing role. Any suggestions for a new grad??? I would certainly appreciate any input from anyone. :)

That is a great question! I too just passed my NCLEX and am searching for the right path. I was a Hospital Corpsman in the Navy for 11 years, but civilian nursing is all new to me. Perhaps some of you more expierenced nurses can give some advice. Thanks

Tweety, BSN, RN · Feb 26, 2004

If you are unsure, I would say med-surg is the way to go. You'll learn a variety of conditions and assessments and can decide where your true heart lies. Good luck!

fergus51 · Feb 27, 2004

Go wherever you want that will give you a good start. That could be med-surg, it could be ICU if the orientation is right.

Katnip, RN · Feb 27, 2004

I agree with Tweety. Especially if you aren't that confident in yourself a year of med-surg can help you build your skills. You'll have to learn to be very organized as well.

You'll also see a wide variety of diseases, disorders, and post-ops that could give you a clue as to where you might like to wind up.

Ortho_RN · Feb 27, 2004

I agree that you should go where you want... But if you are unsure as someone said Med-Surg will be a great place to start. I graduated in December, and started working on an Orthopedic floor. I really like it... Cause most of our patients have other problems, diabetes, COPD, CHF, etc.. Numbers of problems, so I feel like I am getting a good bit of experiance with a lil of everything.

Several of my classmates went straight to ICU (b/c of lower patient numbers), and several of them are doing great, but a few say they feel like it was too early for them to go there. So everyone is different.. I eventually would like either ICU or ER, but right now I want to get comfortable with the "easy" stuff first.

sjoe · Feb 27, 2004

I agree. Med-surg for at least one year is a good background for most other kinds of nursing later on.

unknown99, BSN, RN · Feb 27, 2004

Med-surg for at least a year. It is a great learning experience. Good-luck in whatever you choose!!

mattsmom81 · Feb 28, 2004

I started in medsurg and never regretted it. After several years I moved into critical care, which I see as a natural extension of medsurg hospital nursing. That one yr of med surg is still widely respected in my experience. A good solid medsurg nurse has the background to sucessfully transition to the specialty of his/her choice.

As an experienced critical care nurse, I groan seeing new grads trying to enter my smaller hospital ICU...they need support/help/supervision for even basic skills (let alone advanced) and must essentially work at assistant level for too long. At larger facilities with DEDICATED new grad and critical care internships, they fare better. My facility has none of these to offer. The staff nurses are expected to work short , manage a hectic unit PLUS train the new grad (who quickly realizes what he/she has gotten into, which is WAAAAY over his/her head more than likely.) Not a happy situation.

So new grads: my advice is be very aware of how facilities may operate. Some will hire a 'warm body' and throw them to the wolves...which is unfair to everybody involved. If you want to go right into a specialty area, make sure the facility has a dedicated internship program with a good reputation. Many years ago I learned ICU 'on the job', but it was a different world then...I would NOT recommend it today.

Good luck to all new grads out there!! :)

orrnlori, RN · Feb 28, 2004

I started in trauma step down, which was a fancy name for the place where they shoved the best of the very worst ICU patients when a boat load of new ICU patients got admitted to our level 1 trauma unit. Me, my stethescope and one pulse ox, that's all I had. That and my hands, eyes, ears, and intuition. Learned very quickly that I hated bedside nursing, but boy did I learn a bunch in a very very short time. I used to think in nursing school, will I know "restlessness" when I see it? OH YEAH, you know it. :chuckle

So I stayed there, hoping I'd wreck my car on my way to work each shift so I wouldn't have to show up. Then I went to the OR 7 months later. There I have remained blissfully ever since. So my recommendation is the OR if you can get in, but that's just me. If you like technology, teamwork, and having doctors needing you, rather than abusing you, the OR is the place to be. :)

sharann, BSN, RN · Feb 28, 2004

Congratulation on passing :balloons:

Why not compromise and start out in a step-down/tele type unit. You will have the critical type pts who make it out of ICU plus the med surg type, post op, post interventionals, and overflow pts. You will learn ACLS and heart monitoring, as well as learning how to do 29 things at once! It can be done. Eventually you could decide to move to med-surg, if you are inclined or to ICU (notice I don't say UP to ICU or DOWN to Med-surg, since they are both specialty areas). Good luck with the job search, but try to go for the most comprehensive orientation as possible.

nekhismom · Feb 28, 2004

If you're not sure what you like, Med surg is probably a good start. Tele would also be good, for the reasons mentioned above. But I don't think all new grads need to go to m/s just because they are new grads. If you have a passion, or even desire, to work in a certain area, go for it. If not, start with m/s or tele and you can't go wrong!