nursingaround, where do you work? i didn't know there was a place that separated medical from surgical, where i've worked we always called it med-surg and that's how we put it on our resume'. watch closely, somebody's gonna read this and tell me that i've actually worked in environments that were separated but didn't know it because of overflow and all that, i can be dense sometimes. however, honestly, i didn't realize you could get them separately.

i was told by all my instructors "do at least 1 year of med-surg before anything else so you can really get the basics down", i've seen through many nurses in the 9 years i've worked that those who've had at least a year of these basics fare way better in sudden and emergency situations than those who haven't. of course i'm not including those who have worked ED, ICU, CCU, etc., i'm talking about the countless nurses who've gone from graduation to a position in clinic or office, psyche, school, etc. no, no, no, i'm not saying those nurses aren't any good, i'm saying i've observed those who have a year or better in the medical/surgical area seem to do better.

if you can find an environment separated like nursingaround mentioned, i'd say go for medical first, then go for surgical. if not, follow your instructors' advice go med-surg. you'll cover a lot of very important things over and over. then no matter where you go you'll have at least touched almost everything you might encounter elsewhere. and you'll have done it while people are still cognizant of the fact you're new and inexperienced, so they might not be as hard on you for not knowing what you couldn't have known without the experience.

waiting to get lamblasted for my comments ...
ce

I enjoyed working on the Stepdown units-patients came there immediately following surgery and I got the chance to see them get progressively better-sometimes they were able to be discharged to home-other times they would go to medical floor to recover. This was very interesting and I learned alot there, It was nice to actually see the patients get better unlike the geriatric unit where the patient goes back to the nursing home or dies.

I am not a 'long time' nurse but I can say to know that we do not know everything. not even close really. So don't be shocked to find that out. It is overwhelming at times but everyday is a new learning experience to make us better and stronger 'new' nurses.

I TOTALLY agree with nursingaround! I started on a medical floor (not med/surg) and learned the art of nursing. I learned how to adjust my tone, attitude, and approach from room to room, because I had a little more time to get to know each patient and would often have the same team of patients the entire week . I became the Queen of NG tubes, dressing changes, you name it. I moved to a specialized surgical transplant unit where we had post op kidney transplant patients. Got to learn the drips and meds, CVP and cardiac monitoring. Finally, moved to ER where I always knew I wanted to be. The three years preperation gave me great confidence when I went to the ER. I knew how to take care of patients. Except for peds and trauma, I KNEW these patients. Though I was offered a job in the ER as a new grad, I am very happy with my experience. As an ER Charge/Trauma nurse, I find it a much smoother transition for the "floor" nurses than the new grads. One of my first conversations with all the new nurses is about their comfort level and how they want me to teach them about ER nursing. The floor nurses are VERY spacific about what they are comfortable with, and what they are worried about. This makes it very easy to addess issues. The new grads often look at me with wide eyes. "What exactly do you mean? I want you to teach me EVERYTHING about ER!" Please don't get me wrong. Some of the greatest ER nurses in our dept. were new grads. I just feel the experience gained from a few years med/surg prior to critical care can offer a broader, more complete education/preperation for any critical care area. Pro's and con's to every situation though. With the new grads, we get to train them from the get go. Sometimes the floor nurses have a hard time letting others "help" with their team. They want to do everything themselves and take a long time charting. Good luck all you new grads. I hope you find your way. All areas of nursing take special people. Find your special place. Never, EVER do anything you don't understand. Always ask questions. If something doesn't feel right, it probably isn't. That's my advice.

I'll be the one with a different opinion here. I have noticed that many of the floor nurses who transfer to our ER have a rough go at it. Believe it or not, in the past 2 years since I've been the educator for the ER I've watched the vast majority of our new grads thrive and excel while often times surpassing nurses who have transferred from inpatient units. I was a new grad in our ER and have apparently done well. It is true that we can mold and shape their young nursing minds vs. retraining those who are used to a completely different type of nursing and pace. Another benefit of hiring a new grad is their enthusiasm for what they want in their career. I watch them develop critical thinking, and the ability to respond in a crisis. 2 years in a trauma center/ ED with a respectable volume and acuity and they can do anything. But, you know, to each their own.

This debate is a long standing debate amond my professor and I. I believe that a new grad should start out on the med-surg floor first. On these types of units the new grads will get to use their new acquired skills more often than anywhere else. I work on a CVICU unit now and we have just hired a new grad. Yeah she appears to be doing well but she has not been in a real critical situation yet. Most of my experience and reasoning on this topic comes from working on other units and seeing that some of the older nurses didn't even know how to anchor an NG tube because they have not had the need to keep that skill up to date. I worked four years on a med-surg unit and learned a ton of stuff. Yeah I worked my ass off but for it have become a more experienced and well educated nurse because of it. If a new grad starts out on an intensive care unit if they are very motivated to learn they generally do well. But when it comes to critical thinking I think that they will be lacking in that skill. It takes time and practice to develop the skill of critical thinking.

And see that is where the difference in institutions lie. And in my community where the new grads will be working they are lacking the critical thinking skills they would acquire if they worked on a med-surg unit. When you go to work in a critical care environment the nurses don't have time to babysit and make sure they do their job right. If a nurse goes into critical care they should be able to handle a critical situation without asking what they should do. It is great that your new grads are able to get that experience but on my unit the nurses are expected to uphold a higher degree of education. Yeah we did hire one new grad but she hasn't had a critical situation yet so for me to justify her skills would be hard to do. Yeah she has the basic assessment skills but what would happen if it was life or death for her to do something with her patient.