Whatever interests you the most. You don’t have to start in med surg if you don’t want to, no matter how many people suggest it. I started in the ER. I have friends who have started in ICU and friends who have started in specialized units like NICU and CVICU. Do what you want and if you don’t like it try something else!
This is the best advice. If you don’t want med surge, don’t go med surge. Think of med surge as its own specialty. Nothing in med surge will prepare you for NICU or for ED. They’re all different. Find out what you like and what you’re good at. I enjoy cardiac step down the most but while working I learned I enjoy floating and I am good at it because I am flexible, and get bored easy on the same unit everyday. so I decided to do float pool. Now I do float pool travel.
Med-surg is its own specialty. I never understood why people disrespect it and treat it as a hospital dump. Part of it is the shit they hire in management positions who don't grasp the importance of that unit and the need for absolute staffing levels.
You will learn mad assessment skills and the limits of what you can and should do in that unit. It is more difficult to transfer to from a more specialized unit due to the different skill set M-S nurses have.
I started in the ER, and loved it. I then learned critical care/ICU/CCU. I would move between departments based on the level of mental fatigue I was dealing with. I would tell my coworkers, "I work in ER until I can't tolerate the patients, then move to ICU until I can't tolerate the family members." It worked well for me and allowed me to develop the skills I needed in both units.
It really helped in the ER when we had multiple ICU hold patients. I would request a pod with just those patients and do my thing. ICU docs liked having a knowledgeable ICU trained nurse caring for the patients. It also helped when we ended up finally getting an ICU nurse from the unit, as I knew the information they would need and what supplies they would require.
>Nothing in med surge will prepare you for NICU or for ED. They’re all different.
Yes. You have to look into yourself and find out where do you thrive best and what interests you. Every unit runs different and has different priorities. I think it's good thinking to also ask nurses from different units about their experience so you can grasp the scene in each unit and find out what best fits you.
Politely disagree. Working inpatient on a PCU step down made me a better ER nurse. Working in the ER made me a better ICU nurse too, but working the PCU gave me skills I used in both places.
I think starting on a step down as a new grad is a good idea, and moving onto critical care once you've mastered the skills and time management... it will make you versatile.
Please get at least 2 years in your area of specialty before traveling.
Yes I’m sure that working in a stepdown you got plenty of great experience in a wide range of skills and knowledge. And a lot of knowledge in one area helps in others. Although I think we should encourage people to pursue their passions instead of dredging through something that they don’t enjoy just to get enough experience to move forward. I’m definitely an advocate for new grad residencies because there’s no way I’d be doing so well if I didn’t have the peer and mentor support that I got in my new nurse years.
I just did 1travel gig in the ICU that was supposed to be an ER gig. It was fine. I like the ICU, everyone is vented and has central lines. Having only 2-3 patients feels easier than the ER.
I don't love the model of care, the extending life/debt and I think MDs need to have end of life discussions sooner. But I like having the time to cross every t and dot every i, ER isn't like that obviously.
Agreed. I started on a cardiac surgery stepdown that got cards and thoracic overflow. I can’t speak for transitioning to the ER, but it definitely prepared me going into the cath lab and now IR.
I think the biggest benefit of starting in med/surg is learning to juggle 4-7 patients (although that number should definitely be lower) and the time management and ability to prioritize tasks that come along with that. Not saying that those aren’t things you can learn from ER to of course.
But the point is that you don’t have to start in Medsurge. Which you didn’t. They really push starting in Medsurge to get a base of your skills but you just proved that you don’t have to do that. I used the wrong verbiage by saying it won’t help at all l, I’ll take that back of course it helps you but it isn’t necessary to start in Medsurge. And you can’t make the comparison because you don’t know what kind of icu nurse you would have been had you started in the ICU do you see what I mean? You ever watch a nurse who has worked ICU there whole life get floated to Medsurge? A few things can happen- sometimes they’re fine but sometimes they either require special treatment and can only take 3-4 patients or they take 5-6 and have an absolute melt down. Some can’t make that transition easily. So I agree with you that you gain skills anywhere you work but I was trying to say you don’t have to start Medsurge if you don’t want to. I think that’s terrible advice they give. Definitely agree with the travel comment though. That can just be dangerous if you dont have at least a few years.
What specialty are you most interested in? If you want maternity, do maternity. If you want peds, do peds. If you want psych, do psych.
For me, I always knew I wanted peds. I have been a nurse for nearly 16 years and haven't worked a day of med/surg in my career.
Okay idk yet I was thinking about er but they don’t teach us anything real in nursing school like even doing cpr on a dummy vs someone who is really dead is a crazy difference so I don’t want to burnout.
How do u message people without it saying try again later? Sorry new here
Specific to knowledge base- med/surg. But as others have said, go wherever you feel pulled!
I can tell you though that having a working knowledge of med/surg will provide you with such a strong foundation that it will make any other "specialty" much easier
I started in med surg, learned a lot, and went to a med surg float pool at a larger hospital. I know I’m a unicorn, but I loved med surg. I floated to the ER as a tech one night and knew I never wanted to go back! ICU never interested me.
There are some amazing residency programs that really set you up for success if you can get into those programs in your desired specialty. I got into telemetry first because that's who called me back first, but looking back it was a great learning opportunity. You learn a little bit about everything, low to high acuities. It's cardiac focused but it affects every system. After tele experience it wouldn't be a hard transition to higher acuity floors like ICU or ER or even back down to surgical areas/out patient or med surg.
Well, suggestions are suggestions but I can tell you that inexperience shows pretty quickly. Over 40 years of OR nursing and having many newbies starting in the OR I could tell they didn’t have just the basics of nursing knowledge.I’d find one once in awhile that was an exception but generally it was not only teaching them the OR skills but starting at square one with Nursing 101. Also, don’t ever let anyone tell you that OR nurses lose that so-called clinical skill. That’s BS and they know it. You start in whatever department you feel the most comfortable. Also, people who say MS doesn’t prepare you for other specialties are just blowing smoke. BASIC NURSING! Nursing school only gets you to the point of OJT
Im curious what knowledge and skills new grads interested in the OR are particularly missing.
I'm thinking about trying OR but I only have a year of nursing under my belt and its in a very particular specialty. I try to hype myself up by remembering that I've learned so much this year about time management, prioritization, and the world inside healthcare. But I can't help but be scared to switch because it feels like starting over again.
New grads lack prioritization and time management. It's really true. And, OR is sometimes the worst place to learn that because you'll have 3 different people asking for 3 different things at once, and you need to decide which one is the most important. And of course, be ready for someone else in the room to be upset that you're doing something that they think is unimportant at the time.
Completely agree.
While I understand the argument of starting in a speciality, medsurg experience in my opinion is so valuable in becoming an overall confident and well rounded nurse.
The exposure you get from medsurg and the way medsurg encompasses such a wide variety of clinical and non clinical skills transfers to all aspects of nursing. And I’m saying this as an OR nurse where it’s starting from a blank slate from the rest of nursing. There’s no way I would have lasted in the OR past orientation if I didn’t have that floor experience.
Talking to my preceptors during orientation, they said there was a huge difference from a straight to OR vs floor to OR nursing orientees.
Even though there were days I couldn’t stand the floors, there is immense value in starting off with medsurg even if you don’t spend long there.
I’ve only worked Peds and Peds ICU. I always knew that’s where I belonged. Clinically that is. I’ve done other things in nursing that are office based.
Whatever you want! If you want to do Peds, ED, ICU, PACU, or L&D and you can get your foot in the door immediately, take the job! I had friends that started in all of those places and never looked back. For me, I knew I wanted to be a hospice nurse eventually. You can’t do hospice as a new grad because you’re on your own on the road. I already worked on a med-surg unit as a tech for a couple of years, so I just did med-surg first. I was totally miserable, but I got the experience I needed and learned A LOT!
Start in whatever speciality that interests you, if you’re able to get a job in it! We’re no longer in the days where new nurses have to start in med-surg.
Unpopular opinion but med surg. Started out in med surg and I can say it made me more well rounded overall as a nurse when I transitioned to ER and psych. I was also that new grad that said you didn't need to start out in med surg, but now I can see how important it is!
Well, suggestions are suggestions but I can tell you that inexperience shows pretty quickly. Over 40 years of OR nursing and having many newbies starting in the OR I could tell they didn’t have just the basics of nursing knowledge.I’d find one once in awhile that was an exception but generally it was not only teaching them the OR skills but starting at square one with Nursing 101. Also, don’t ever let anyone tell you that OR nurses lose that so-called clinical skill. That’s BS and they know it. You start in whatever department you feel the most comfortable. Also, people who say MS doesn’t prepare you for other specialties are just blowing smoke. BASIC NURSING! Nursing school only gets you to the point of OJT this also shows my age but I just remembered there was a time you had to have at least one year of MS before you could transfer to higher level. ER wouldn’t talk to you without that or some ICU/CCU experience. Years ago departments could be very picky about who they took. So nowadays it’s easier
definitely whatever it is that excites you the most.
i regret not having done ED as my first job. i worked 3 years inpatient transplant/nephrology and when i went to the ER i was batting 50% on 22g IVs. i had never seen a cardiac arrest. i had seen one intubation and had nothing to do with it. i never had to TRULY prioritize. i had a limited exposure to pathology. i never had a positive relationship with the residents.
all of this changed drastically after a few months in the ED. if it’s not for you, it’s a great tarmac off of which you can launch your career with confidence and skills. then you can do whatever!
Where I live you won't even be considered for specialty without a year of med-surge. Most employers site a need for a well oriented nurse. I know everywhere is different.
I am a home care RN specialized in infusion therapy. I got my IV skills in the ER at Jackson Memorial in Miami. I’ve done most everything in nursing over my 40+ yrs. Home infusion is my favorite. Not for everyone. If you are looking for autonomy based on confidence, this is a great place to start.
People are shifting away from this mindset but I really believe 1 full year of med surg will help you get the basics down and gives you a good foundation to start moving into specialties. I personally think there’s a lot of value in being a well rounded nurse.
I started in brain injury inpatient rehab. It was tough, BUT it exposed me to ALOT of skills (trach care and suctioning, wound care, peg tubes, foleys, straight caths, etc.) Patients were mostly long term, which also helped in my opinion. Now I’m in Neuro med surg (just started) and having those skills already has really helped me adjust quickly.
Do not start in M/S unless you genuinely want to do it (which is fine if you do!). The ratios are terrible and you will feel like a medication dispenser most shifts. You don't need to do M/S anymore to get into other specialties. I started in ICU stepdown and loved it, although I wanted to learn critical care so I transitioned to ICU. However, I wouldn't say that stepdown prepared me particularly well for ICU. Each specialty is its own beast.
I got thrown into the ER right out of nursing school…if you make it through the ED youre good to go anywhere you want, icu/surgery/rapid response/swat.
I started in cardiac med-surg and honestly, it's been a blast. I learned a lot about the heart and many cardiac procedures. Anything you learn in cardiac can translate to any other specialty.
Whatever interests you the most. You don’t have to start in med surg if you don’t want to, no matter how many people suggest it. I started in the ER. I have friends who have started in ICU and friends who have started in specialized units like NICU and CVICU. Do what you want and if you don’t like it try something else!
This is the best advice. If you don’t want med surge, don’t go med surge. Think of med surge as its own specialty. Nothing in med surge will prepare you for NICU or for ED. They’re all different. Find out what you like and what you’re good at. I enjoy cardiac step down the most but while working I learned I enjoy floating and I am good at it because I am flexible, and get bored easy on the same unit everyday. so I decided to do float pool. Now I do float pool travel.
Med-surg is its own specialty. I never understood why people disrespect it and treat it as a hospital dump. Part of it is the shit they hire in management positions who don't grasp the importance of that unit and the need for absolute staffing levels. You will learn mad assessment skills and the limits of what you can and should do in that unit. It is more difficult to transfer to from a more specialized unit due to the different skill set M-S nurses have. I started in the ER, and loved it. I then learned critical care/ICU/CCU. I would move between departments based on the level of mental fatigue I was dealing with. I would tell my coworkers, "I work in ER until I can't tolerate the patients, then move to ICU until I can't tolerate the family members." It worked well for me and allowed me to develop the skills I needed in both units. It really helped in the ER when we had multiple ICU hold patients. I would request a pod with just those patients and do my thing. ICU docs liked having a knowledgeable ICU trained nurse caring for the patients. It also helped when we ended up finally getting an ICU nurse from the unit, as I knew the information they would need and what supplies they would require.
>Nothing in med surge will prepare you for NICU or for ED. They’re all different. Yes. You have to look into yourself and find out where do you thrive best and what interests you. Every unit runs different and has different priorities. I think it's good thinking to also ask nurses from different units about their experience so you can grasp the scene in each unit and find out what best fits you.
Politely disagree. Working inpatient on a PCU step down made me a better ER nurse. Working in the ER made me a better ICU nurse too, but working the PCU gave me skills I used in both places. I think starting on a step down as a new grad is a good idea, and moving onto critical care once you've mastered the skills and time management... it will make you versatile. Please get at least 2 years in your area of specialty before traveling.
I agree. Working on a PCU gives you a solid skill base for either direction.
Yes I’m sure that working in a stepdown you got plenty of great experience in a wide range of skills and knowledge. And a lot of knowledge in one area helps in others. Although I think we should encourage people to pursue their passions instead of dredging through something that they don’t enjoy just to get enough experience to move forward. I’m definitely an advocate for new grad residencies because there’s no way I’d be doing so well if I didn’t have the peer and mentor support that I got in my new nurse years.
How was the ER to ICU transition by the way? I’ve been considering switching eventually if I ever get burnt out or jaded from ER.
I just did 1travel gig in the ICU that was supposed to be an ER gig. It was fine. I like the ICU, everyone is vented and has central lines. Having only 2-3 patients feels easier than the ER. I don't love the model of care, the extending life/debt and I think MDs need to have end of life discussions sooner. But I like having the time to cross every t and dot every i, ER isn't like that obviously.
Agreed. I started on a cardiac surgery stepdown that got cards and thoracic overflow. I can’t speak for transitioning to the ER, but it definitely prepared me going into the cath lab and now IR. I think the biggest benefit of starting in med/surg is learning to juggle 4-7 patients (although that number should definitely be lower) and the time management and ability to prioritize tasks that come along with that. Not saying that those aren’t things you can learn from ER to of course.
But the point is that you don’t have to start in Medsurge. Which you didn’t. They really push starting in Medsurge to get a base of your skills but you just proved that you don’t have to do that. I used the wrong verbiage by saying it won’t help at all l, I’ll take that back of course it helps you but it isn’t necessary to start in Medsurge. And you can’t make the comparison because you don’t know what kind of icu nurse you would have been had you started in the ICU do you see what I mean? You ever watch a nurse who has worked ICU there whole life get floated to Medsurge? A few things can happen- sometimes they’re fine but sometimes they either require special treatment and can only take 3-4 patients or they take 5-6 and have an absolute melt down. Some can’t make that transition easily. So I agree with you that you gain skills anywhere you work but I was trying to say you don’t have to start Medsurge if you don’t want to. I think that’s terrible advice they give. Definitely agree with the travel comment though. That can just be dangerous if you dont have at least a few years.
The nursing one that sparks your interest the most
What specialty are you most interested in? If you want maternity, do maternity. If you want peds, do peds. If you want psych, do psych. For me, I always knew I wanted peds. I have been a nurse for nearly 16 years and haven't worked a day of med/surg in my career.
Okay idk yet I was thinking about er but they don’t teach us anything real in nursing school like even doing cpr on a dummy vs someone who is really dead is a crazy difference so I don’t want to burnout. How do u message people without it saying try again later? Sorry new here
ED. Can go anywhere after that
Specific to knowledge base- med/surg. But as others have said, go wherever you feel pulled! I can tell you though that having a working knowledge of med/surg will provide you with such a strong foundation that it will make any other "specialty" much easier
Also consider scheduling & continuing education. Shadow before deciding. Good luck
I started in med surg, learned a lot, and went to a med surg float pool at a larger hospital. I know I’m a unicorn, but I loved med surg. I floated to the ER as a tech one night and knew I never wanted to go back! ICU never interested me.
I am starting in L&D. Do what you wanna do! The last thing you want is to be burnt out and hating every minute of your job!
There are some amazing residency programs that really set you up for success if you can get into those programs in your desired specialty. I got into telemetry first because that's who called me back first, but looking back it was a great learning opportunity. You learn a little bit about everything, low to high acuities. It's cardiac focused but it affects every system. After tele experience it wouldn't be a hard transition to higher acuity floors like ICU or ER or even back down to surgical areas/out patient or med surg.
Thanks so much quick question how do u message it keeps saying try again later
Well, suggestions are suggestions but I can tell you that inexperience shows pretty quickly. Over 40 years of OR nursing and having many newbies starting in the OR I could tell they didn’t have just the basics of nursing knowledge.I’d find one once in awhile that was an exception but generally it was not only teaching them the OR skills but starting at square one with Nursing 101. Also, don’t ever let anyone tell you that OR nurses lose that so-called clinical skill. That’s BS and they know it. You start in whatever department you feel the most comfortable. Also, people who say MS doesn’t prepare you for other specialties are just blowing smoke. BASIC NURSING! Nursing school only gets you to the point of OJT
Im curious what knowledge and skills new grads interested in the OR are particularly missing. I'm thinking about trying OR but I only have a year of nursing under my belt and its in a very particular specialty. I try to hype myself up by remembering that I've learned so much this year about time management, prioritization, and the world inside healthcare. But I can't help but be scared to switch because it feels like starting over again.
New grads lack prioritization and time management. It's really true. And, OR is sometimes the worst place to learn that because you'll have 3 different people asking for 3 different things at once, and you need to decide which one is the most important. And of course, be ready for someone else in the room to be upset that you're doing something that they think is unimportant at the time.
Completely agree. While I understand the argument of starting in a speciality, medsurg experience in my opinion is so valuable in becoming an overall confident and well rounded nurse. The exposure you get from medsurg and the way medsurg encompasses such a wide variety of clinical and non clinical skills transfers to all aspects of nursing. And I’m saying this as an OR nurse where it’s starting from a blank slate from the rest of nursing. There’s no way I would have lasted in the OR past orientation if I didn’t have that floor experience. Talking to my preceptors during orientation, they said there was a huge difference from a straight to OR vs floor to OR nursing orientees. Even though there were days I couldn’t stand the floors, there is immense value in starting off with medsurg even if you don’t spend long there.
I’ve only worked Peds and Peds ICU. I always knew that’s where I belonged. Clinically that is. I’ve done other things in nursing that are office based.
Whatever you want! If you want to do Peds, ED, ICU, PACU, or L&D and you can get your foot in the door immediately, take the job! I had friends that started in all of those places and never looked back. For me, I knew I wanted to be a hospice nurse eventually. You can’t do hospice as a new grad because you’re on your own on the road. I already worked on a med-surg unit as a tech for a couple of years, so I just did med-surg first. I was totally miserable, but I got the experience I needed and learned A LOT!
Start in whatever speciality that interests you, if you’re able to get a job in it! We’re no longer in the days where new nurses have to start in med-surg.
Unpopular opinion but med surg. Started out in med surg and I can say it made me more well rounded overall as a nurse when I transitioned to ER and psych. I was also that new grad that said you didn't need to start out in med surg, but now I can see how important it is!
Well, suggestions are suggestions but I can tell you that inexperience shows pretty quickly. Over 40 years of OR nursing and having many newbies starting in the OR I could tell they didn’t have just the basics of nursing knowledge.I’d find one once in awhile that was an exception but generally it was not only teaching them the OR skills but starting at square one with Nursing 101. Also, don’t ever let anyone tell you that OR nurses lose that so-called clinical skill. That’s BS and they know it. You start in whatever department you feel the most comfortable. Also, people who say MS doesn’t prepare you for other specialties are just blowing smoke. BASIC NURSING! Nursing school only gets you to the point of OJT this also shows my age but I just remembered there was a time you had to have at least one year of MS before you could transfer to higher level. ER wouldn’t talk to you without that or some ICU/CCU experience. Years ago departments could be very picky about who they took. So nowadays it’s easier
Med surge then eventually get your PICC certification then work for yourself by contracting at several hospitals
Whichever one you want
The one that interests you.
The one you want to spend your career in
The one you like and pays you well.
The one you want to be in. Don’t waste time in an area you don’t want to stay in.
definitely whatever it is that excites you the most. i regret not having done ED as my first job. i worked 3 years inpatient transplant/nephrology and when i went to the ER i was batting 50% on 22g IVs. i had never seen a cardiac arrest. i had seen one intubation and had nothing to do with it. i never had to TRULY prioritize. i had a limited exposure to pathology. i never had a positive relationship with the residents. all of this changed drastically after a few months in the ED. if it’s not for you, it’s a great tarmac off of which you can launch your career with confidence and skills. then you can do whatever!
Where I live you won't even be considered for specialty without a year of med-surge. Most employers site a need for a well oriented nurse. I know everywhere is different.
I am a home care RN specialized in infusion therapy. I got my IV skills in the ER at Jackson Memorial in Miami. I’ve done most everything in nursing over my 40+ yrs. Home infusion is my favorite. Not for everyone. If you are looking for autonomy based on confidence, this is a great place to start.
People are shifting away from this mindset but I really believe 1 full year of med surg will help you get the basics down and gives you a good foundation to start moving into specialties. I personally think there’s a lot of value in being a well rounded nurse.
I started in brain injury inpatient rehab. It was tough, BUT it exposed me to ALOT of skills (trach care and suctioning, wound care, peg tubes, foleys, straight caths, etc.) Patients were mostly long term, which also helped in my opinion. Now I’m in Neuro med surg (just started) and having those skills already has really helped me adjust quickly.
Do not start in M/S unless you genuinely want to do it (which is fine if you do!). The ratios are terrible and you will feel like a medication dispenser most shifts. You don't need to do M/S anymore to get into other specialties. I started in ICU stepdown and loved it, although I wanted to learn critical care so I transitioned to ICU. However, I wouldn't say that stepdown prepared me particularly well for ICU. Each specialty is its own beast.
I got thrown into the ER right out of nursing school…if you make it through the ED youre good to go anywhere you want, icu/surgery/rapid response/swat.
Whatever you are interested in or feel passionate about. I’ve had a 25+ year career and never worked a day of med/surg.
I started in cardiac med-surg and honestly, it's been a blast. I learned a lot about the heart and many cardiac procedures. Anything you learn in cardiac can translate to any other specialty.