Where to work with Nurse Corps Scholarship- Scared to death of MedSurg

Dear Nurse Beth,

I am currently in a 16 month accelerated BSN program. I will be graduating in December of this year and am scared to death of Med/Surg. I know a lot of nurses start there and I know that I absolutely do not want to. I'm open to GI/Endoscopy Lab, OB, PACU, and OR. However, I know these are all specialties. What can I do to increase my chances of attaining a position in one of these areas as a new student, without doing a residency? I can't really do a residency because I am part of the HRSA Nurse Corps Scholarship Program that limits residencies. Your advice is greatly appreciated!

Dear Scared to Death,

I'd love to know what "scared to death of Med/Surg" means to you in order to better understand your concern and answer your question.

However, in your case, what's going to drive where you work more than anything else is your HRSA (Health Resources and Services Administration) Nurse Corps Scholarship repayment obligation.

HRSA Nurse Corps Scholarship Program

The Department of Health and Human Services (HHS) provides Scholarships to nursing students (and Nurse Practitioner students) in exchange for a minimum 2 yr full-time service commitment in a critical shortage facility. Government-sponsored nurse loan programs are designed to provide healthcare professionals in medically underserved areas (MUAs) with underserved populations.

Medically Underserved Areas and Populations (MUA/Ps)

Medically underserved areas and populations are designated by:

• Low provider to patient ratio
• High infant mortality rate
• Poverty-level incomes
• Large number of people over 65 years old

Examples of medically underserved populations include:

• Migrant workers
• Native American Indians
• Homeless
• Low-income

Often patients must travel long distances to access primary health care, and many suffer from chronic illnesses. Medically underserved areas and medically underserved populations are serviced by critical shortage facilities, which often include small hospitals.

There are also Health Professional Shortage Areas (HPSAs).  These areas may be designated by geographic location, or by population group. 

Critical Shortage Facilities

Critical shortage facilities are designated as and serve primary medical care HPSAs.

Critical Shortage Facilities can be public or private nonprofit. Examples include:

• Hospitals
• Clinics
• Critical Access Hospital
• Health Centers

The HRSA does not prohibit you from being oriented in a residency, per se, but it's unlikely that small, rural hospitals will have a residency onboarding program. Orientation to OR is typically very long, so you would have to apply for a deferment or check to see if you would be allowed to postpone working for the length of the orientation.

To fulfill your service obligation, you must work in an eligible health care facility with a critical shortage of registered nurses. So typically you would work in a medically underserved area working in a small hospital.

It could be as small as a 30-bed hospital. There are fewer specialty services in smaller facilities, and proportionately more MedSurg beds.

All this to say that it may be difficult to exclude MedSurg in your future. Feeling "scared of" MedSurg may simply mean you need more exposure. Once you are comfortable with the setting, you can gain a lot of valuable nursing experience. Try to have an open mind. 

Best wishes

Beth, I enjoyed your response,. Very informative.

10 hours ago, amoLucia said:

Beth, I enjoyed your response,. Very informative.

Thank you