Med Surg or ER for New Grad

I just wanted to get your opinions on whether you think a new grad nurse should start out on a Med Surg floor or in the ER. Eventually, I know that I want to work in the ER but I was told that Med Surg nursing would give me the time to develop the skills to be successful in the ER. My only concern about becoming a Med Surg nurse first is that I'm worried after spending time in Med Surg no one would be willing to hire me in the ER (or at least this is what I have been told). I just accepted a nurse extern position at a well known local hospital and I have the choice of what department to apply for after graduating. Working in the ER seems intense and the last thing I want to do is get in over my head right after graduating. What are your thoughts about this? Thanks in advance for your input!
In this economy my honest opinion is to apply to everything and accept whatever offer you get. There is a lot of debates on these boards whether or not new grads should jump into specialty areas right away. I would make my decision based on what the hospital offers for orientation to specialty areas, what kind of support systems they offer new grads, and your own personal feelings of confidence.
Kudos !! To you....
Congratulations on your extern position! I do not believe that new graduate nurses need to start out in med/surg. If you are interested in the ER, I think it would be great to start off learning how things are done in the ER vs starting in med/surg where things might be different. A lot of the Nurse Managers I have spoken with prefer new grads over experienced nurses who come into the ER without ER experience because they can "shape" new grads into the er way. But the hospital cannot hire new grads so they take the experienced nurses. My friend was hired into the ER as a new grad and has the same orientation length, preceptor, etc as the experienced nurse. The other nurse is struggling because he learned a different way of doing things. But this is only one example, I am sure there is more for both sides. Plus, if you start in the ER you can build hours to become certified. You will also be able to obtain your ACLS, EKG leads, possibly Pals and so much more. http://www.ena.org/BCEN/Pages/default.aspxGood luck with your decision.
I'm worried after spending time in Med Surg no one would be willing to hire me in the ERThat's a load of crap, and nothing to be worried about! I work in a community hospital where they pretty much won't hire any new grads into anything except Med-Surg. This summer I'm transferring to the ER and I know I've already been approved. If you get hired into Med-Surg first, you still learn alot (I sure have!) and make connections... I wouldn't have had as many opportunities as I've had if it weren't for all the various departments/employees I've met and got to know.
I worked ER as a nurses aid. I felt it was too steep a learning curve to try right after graduating. So I decided to do something 'slower' and went to a telemetry/step down unit. That learning curve nearly defeated me, but I understand a whole lot of what I saw in the ER much better after working tele. I think the hardest thing to understand about the ER apposed to working on a floor is that ER is what I call 'sloppy' nursing. Please do not misunderstand my wordage to mean that the ER nurses do a half - butt job. Far from it...but floor nurses are much more detailed oriented when it comes to a lot of things. Exampleish? Report from a floor nurse includes last pain medicine, a slew of labs, dressing change orders, activity orders, etc. A report from an ER nurse can pretty much go like their blood pressure is better, they're breathing with good oxygenation, and they'll be there in 10 minutes. :P In the ER you have to assess, stabilze, and ship them out because there's a whole crew of new ones waiting in the lobby. On the floor your planning what's going to happen to the patient on your shift and over the next couple of days. What I also noticed in the ER was that ER nurses usually get out on time....very rarely was a patient so critical that the nurse couldn't give report and leave. ER nursing reports are bare bones and you kinda figure out the rest on the way. Floor nurses will get miffed if you forgot to report the tinest thing. And for the floor nurse that is rightly so because missing tiny details can cause great delays in care on the floor. I don't know what is right for you. I'm glad I was an ER aid first, and I'm very satisfied that I decided to go to telemetry and I'd like to hit the ICU before I tried the ER as a nurse.What Nursedolphin says about ERs liking to hire new grads is somewhat true, but they also have a great preference for ICU and critical care experienced nurses. Some of that want to hire new grads over experience has nothing to do with 'molding' the new grad as you would think. In the 4 years I worked in a large teaching hospital I saw many rounds of new grads come through. They got very excellent teaching for a new grad, but there is no education that even comes close to experience. The hospital I worked for always had tons of new grads and very few experienced nurses. New grads get paid less and are willing to get 'molded' into doing more by management...if you get my drift. The constant turn over and the fact that tons of new grads always want to start somewhere exciting like the ER made the experienced nurses more dispensable which is really, really bad for new grads. You have no idea how bad you are going to want plenty of experienced (5 yrs or more) nurses around you in ANY hospital setting until you get out of preceptorship and are on your own.
Nonsense. If you want to work in the ER and you have a chance to do that, I say go for it! Why waste your time with med surg and then go to the ER? Med surg and ER have different skill sets you will have to learn. In my opinion one does not necessarily set you up for success in the other.
Quote from BABYJADE06 My only concern about becoming a Med Surg nurse first is that I'm worried after spending time in Med Surg no one would be willing to hire me in the ER (or at least this is what I have been told).
Quote from KalipsoRedI think the hardest thing to understand about the ER apposed to working on a floor is that ER is what I call 'sloppy' nursing. Please do not misunderstand my wordage to mean that the ER nurses do a half - butt job. Far from it...but floor nurses are much more detailed oriented when it comes to a lot of things. Exampleish? Report from a floor nurse includes last pain medicine, a slew of labs, dressing change orders, activity orders, etc. A report from an ER nurse can pretty much go like their blood pressure is better, they're breathing with good oxygenation, and they'll be there in 10 minutes. :P In the ER you have to assess, stabilze, and ship them out because there's a whole crew of new ones waiting in the lobby. On the floor your planning what's going to happen to the patient on your shift and over the next couple of days. What I also noticed in the ER was that ER nurses usually get out on time....very rarely was a patient so critical that the nurse couldn't give report and leave. ER nursing reports are bare bones and you kinda figure out the rest on the way. Floor nurses will get miffed if you forgot to report the tinest thing. And for the floor nurse that is rightly so because missing tiny details can cause great delays in care on the floor.
I agree with you IMTHATGUY. Just trying to trying to go over some pros and cons.
I graduated in December and started my first nursing job at a level 2 trauma center in February. I knew I wanted ER and went after it, and that was the best thing I could have done for myself because I LOVE my job. My coworkers are amazing, my preceptor is knowledgable and a great teacher, and all the more experienced nurses are very supportive of me. That said, it isn't easy, but having that strong support really has helped me learn quickly and grow much faster than I would have if I'd been somewhere that didn't have adequate support for a new grad. My coworkers make sure I am not only learning the routine parts of ER nursing, but that I get the chance to handle codes, traumas, and critically ill patients. If you have a good preceptor and supportive nurses around you, ER won't be any harder to adjust to than med-surg.
I was an ED tech for 3 years, and did my senior preceptorship in the ED, I loved it there. I know that is where I want to be unfourtnantly all the hoslpitals in my area require either 1-2years expereince or a BSN to get into the internship programs. So I am working on getting bothIf you know that you want the ER then go for it, if you do not like it you can always go somewhere else, but if it was me I would jump at the chance to work back in the ED.
I'm a new grad in the ER. I think you need to honestly assess your learning style and how you handle stressful situations, AND find a hospital that will give you the support you need. I don't think it's for everyone, but I really love it. Do I have bad days? Yes. Have I left work in tears- only once, lol. Usually the day flies by for me and I get what KalipsoRed means by "sloppy" nursing. A lot of things you spend a lot of time on in other situations are really pared down to the essentials. For example, I read this article on cultural competence in emergency nursing and the article suggests having these detailed discussions with patients about how their culture and beliefs are influencing how they perceive illness and how they manage their care. If the patient is well enough for this to be a priority....I'm probably spending minimal time with the patient because I have other patients who are sicker and need my time more.I have a fantastic preceptor and a long orientation and was told that I can extend if I'm not feeling comfortable when the set orientation is up. My coworkers are all really welcoming and helpful (I make sure to offer what help I can to make up for the help I need to ask for), and management is supportive and understanding of the fact that I'm a new grad. My ER has a history of selectively hiring and successfully orienting new grads. I asked a lot of questions during my interview about the training process and paid attention to the tone of the department when I shadowed. As far as not being able to transfer from med-surg- I've never heard of anyone having issues doing that. It's definitely it's own specialty but plenty of people perceive it as a good basis for other types of nursing. Of the nurses I work with, a bunch started as new grads, and the rest were floor or ICU nurses.