Why I Turned Down a Position as an ICU Nurse & the Truth About Med-Surg Nursing

Why I Turned Down a Position as an ICU Nurse & the Truth About Med-Surg Nursing

If you asked me 6 months ago where I’d be after graduation, I’d tell you that I’d be somewhere in the hustle and bustle of an intensive care unit (ICU). So, you can imagine my excitement when I got offered a position as an ICU nurse before I graduated. Since then, however, I have come to realize that it was somewhat of a hasty decision, and what I wanted then is not what I want now…and here’s why:

During my last semester of nursing school, I completed my practicum/preceptorship in an ICU and fell in love with acute care. I liked the fast-paced environment and the on-the-spot critical-thinking aspect of the field. Everyday, I’d be learning something new, and that’s ultimately all that I wanted to do. Prospectively speaking, there was another reason why I wanted to be in an ICU, and that’s because most certified registered nurse anesthetist (CRNA) programs across the country require you to have at least a year (or sometimes two years) of full-time employment as a registered nurse in an ICU in order to enter. So really, I’d be killing two birds with one stone by being on a unit that I love, while also fulfilling program requirements.

So, now you’re asking, why did I turn down the job?

As I would suggest to other nursing students getting ready to graduate or are post-graduates looking for employment, apply to several positions. As such, I applied to several RN positions and was drawn into the medical-surgical (med-surg as it is affectionately known) unit of which I currently am employed. Now, whether you’re a nursing student or post-graduate, med-surg can sometimes get a bad wrap. To the lay person, med-surg is likely the type of traditional nursing you commonly think of. In essence, an emergency room, a labor and delivery unit, a nursery, an operating room, a psychiatric ward, a dialysis clinic, a nursing home, etc. does not constitute med-surg nursing.

Many post-graduates, at least the ones in my class, were wanting to get positions in the ICU or ED (emergency department), both of which require much of a “green” nurse.

In my opinion, the ICU gets glamorized as being the place that everyone wants to be. Undoubtedly, it takes great skill and practice in order to master the level of care of patients that enter that department, but in actuality, that can be said about any unit.

When I graduated, I was so focused on getting into an ICU that I didn’t stop to think about the bigger picture. I had to ask myself what I really wanted out of my first year of nursing–and to this day, my answer is the same: experience. After much thought, I knew that I would get the experience that I was looking for on a med-surg floor.

The particular floor that I work on has a reputation for having a variety of patients, and we often get difficult, very sick patients with high acuity levels. I get cardiac patients on telemetry, bariatric patients, psych patients, cancer patients, orthopedic patients, and many more.

If you ask any professor or nurse which direction you should go after nursing school, I guarantee that they’d tell you med-surg, and here’s why:

On a med-surg unit…

  • …you are learning patient care. You are learning how to change dressings, insert Foley catheters, start IVs, pass a variety of medications, etc. In specialized units, some of these skills may fall by the wayside if you’re not using them regularly.
  • …you are learning skills that will help to advance you in the future. For example, if you’ve worked on a med-surg floor for a year, then decide you want to transition into a pediatric ICU, then it would be much easier to care for that patient having the proper knowledge base of patient care; conversely, it would be much more difficult to transfer from the pediatric ICU to a med-surg floor because the ICU doesn’t engage in more traditional patient care practices.
  • …you are learning your skills at a slower pace than in an acute care setting, which allows you to master those skills in their entirety.
  • …you’re learning time management skills. On med-surg floors, you are handling 5-7 patients at a time. In the ICU, you are only managing 1-3 patients at a time. Time management is invaluable in nursing.

I won’t deny that med-surg nursing is very stressful. Patients who aren’t wanted by other units tend to get ‘dumped’ on us, and since we aren’t staffed as well as the ‘specialty’ units, we often have to scramble like crazy to meet their needs as well as those of our more traditional patients. But there’s nothing like med-surg nursing to teach a nurse those all-important critical thinking skills, and it gives you such a broad view of the conditions that can afflict human beings.

Here’s my advice: if you’re a new nurse and want to get the most out of your first year or two, give med-surg nursing a try. You’ll be building invaluable skills that will last you a lifetime. Med-surg nursing also provides a solid foundation for those wanting to transition into a different field in the future.

So…what’s next for me? That is to be determined. I’m going back and forth between NP (nurse practitioner) school and CRNA school, but for now, I’m continuing to build my foundation in med-surg so that I’m ready to take that next step, whatever and whenever it may be, in the near future.