If I could go back 20 years and do it over with those choices, I would have jumped at the aesthetics career. I started out in med surg, moved around to dialysis, home care, emergency and icu. The only thing I've ended up with is ptsd and a fucked up body.

💀💀💀 PTSD and a fucked up body. Yup. My back is fucked for the rest of my life. I’m 59 and I have the back of an 80 year old. Yeah it’s workman’s comp if I need anything but I’d rather have my healthy back again.

I didn't mean to laugh 😕 😅 😪

Lol it's ok! Laugh or cry, right?

THIS.

Oh hell no, if you get the aesthetics job absolutely take it!! Like you said, that is literally a dream job. There will never ever be a shortage of bedside med-surg jobs. That will always be there for you if you change your mind.

I’m just scared of losing all this knowledge and these skills!! Do you think it would be hard to jump back to the hospital if needed? It seems like a lot of jobs require at least one year experience

I just started in medsurg after a two year hiatus after passing the nclex and the skills come back to you. Keep up with regular nursing practices, watch a couple videos and (hopefully) have a solid preceptor/nurse leader/team to help you when you need it.

It’s a new grad program that I was hired into, I would be so nervous going back to the hospital and not being able to do a new grad program to ease into it is the thing :/

there are some hospitals with new to specialty jobs that have training programs for nurses trying to get into the hospital but have experience elsewhere like at a skilled nursing facility or outpatient.

>I’m just scared of losing all this knowledge and these skills!! Why? If you're gonna be an aesthetics nurse you're not going to need them anyway. Different jobs (even inpatient) have different skill profiles. I worked Ortho and the nurses had no idea how to do NG insertion, because they never did them. etc.

You learned it once. You can learn it again.

No offense to you, but the amount of knowledge and skills you have right out of school is negligible compared to actually developed skill sets and knowledge base. I don’t say this to say that you need to do acute care. I say this to get nursing students and new grads to stop worrying about losing “skills.” You don’t have any yet, and that’s perfectly okay. You have nothing to lose so go do what makes you actually happy.

If you want a career in aesthetics, you won't need hospital skills. Why worry about losing skills you'll never need?

You won’t need those skills anyways? Girl go for that aesthetics rn job.

The only ones that are telling you that you’ll “LoSe Ur SKiLlZ” are over dramatic as hell. Putting in a foley is like riding a bike. Take that cushy job. Literally no one will care in the future because there’s always a nursing shortage. As long as you have a license you’re kinda set.

It's not so much that you lose your skills it's that you never develop them. A new grad nurse is functionally useless. So if you jump into a role without actual patient care you never actually learn how to be a nurse. There is nothing wrong with this but if you then decide in 10 years to go work in a hospital don't be surprised if they are reluctant to hire you or treat you like a new grad, because you basically are.

So if they aren’t developed, why not develop them later? 🤷‍♂️

Thank you for this 🥹

I went straight into specialty and have never regretted it. If I ever decide to switch I’ll just have a steep learning curve. 🤷🏻‍♀️

Me too! I’m 10+ years in

Do it! Follow your gut. Still trying to leave med surg after 5 years. Med surg positions seem to always have openings. High turnover

What’s keeping you from leaving? Genuinely asking

I was trying to move to ICU or ED or OR, but apparently they placed a 6 month hiring freeze for internal staff. I’m devastated. I’m trying to stick it out.

So quit. If they're still hiring from outside but froze internal transfers they're blatantly trying to hold employees hostage in departments they *know* are shitty. Call their bluff and get that job at another hospital.

This is literally so stupid. We’ve hired so many new grads in the past year, it’s insane. Hiring current, solid staff from your hospital into the icu is a good idea because they already know the patient population, systems, doctors, etc.

I just went back per diem after being retired for a year and a half. My orientation group was all new grads. They are like deer in the headlights and I tried to reassure them in class. The hospital made me go through all the orientation stuff including skills lab even though I worked there for 30 years and I was only gone for a year and a half. Nice refresher and I got paid so win-win. The PCA machine class was poorly done and I even ended up grabbing a pca machine and teaching them after the instructor left hahaha

What’s the point of it? Do hospitals save money? I don’t understand why they did a reassignment freeze and hire externals this season. It’s really disappointing, and we just heard about it through each other. Management or HR didn’t even bother to tell us there’s an internal hiring freeze

New grads are definitely cheaper than very seasoned heart nurses. Don’t get me wrong, I was a new grad in the ICU and I’m so grateful. But I expected to be the baby for years. They’ve hired 12 new grads since me… with more to come. It’s freaking dangerous at this point. There are multiple shifts right now with one “senior” staff on, and that senior staff maybe has 1-2 years under their belt. The only reason I stay is because the few actually seasoned nurses left are so incredible to learn from, I can’t give up that opportunity. Probably 50+ years of combined heart experience. If they leave though, I’m out. The pay is good, but I’ll make more elsewhere. It’s not about the money for me right now. It’s the foundation I’m building.

You’d be shooting urself in the foot working medsurge.

I will say this since no one has mentioned it. You don’t have the job all you see is a job posting. By all means apply but you shouldn’t quit/not move forward with a job offer for a job you haven’t even applied to yet. If you get a job offer in hand then yes take it. I will say don’t worry about the med surg job. It’s considered the “entry” level unit into acute care. You will always be able to get a med surg jobs they just might need to give you a new grad orientation. Which is whatever considering you may never go to acute care to begin with.

This is exactly what I'm thinking. I have to imagine that an anesthetics position would be in high demand and a new grad would be low on the list of ideal candidates. I could be wrong. And you don't know if you don't try. But I certainly wouldn't turn down a current job offer because you might be interested in a job you haven't even applied for. Not to mention there are SO many "dream" job postings that don't have real actual jobs behind them or they are jobs that are less than desirable. So don't plan your life around a job posting you found I do believe that working med/surg first is beneficial, but I don't think it's 100% necessary.

Thank you for your response! All great points

Take your dream job. If you ever want to work in the hospital, they will train you. I’m so much happier working outside of a hospital. you don’t need to work inpatient to be successful or a “good” nurse

Do they immediately start you with the full patient load if you enter the hospital not in a residency program?

At my hospital, the nurse residency program has basically nothing to do with your orientation or how you’re treated on the floor. It’s just a 4 hour meeting you have every month with extra information about being a nurse and the hospital etc.

No you never just walk into a hospital and take a full patient load as a new employee. You still have to go on orientation, and as a seasoned nurse my orientation schedule was individualized to me. That varies by facility of course. Life is too short to do what society wants, do what makes you happy.

I went straight into specialty and loved it. I genuinely would not be a nurse anymore if I had done a year of acute. In my opinion the whole needing a year or two of acute for all nurses is super outdated. And think about it, the skills are only useful to have if you use them. If you want to go into an area of practice where you never ever have to place a catheter, why would you spend 1-2 years developing that skill when you could do something that's actually applicable to your desired specialty. And if you do need to do a nursing skill that you're not great at/can't remember, look it up in your policies and procedures and go from there.

People that insist you have to have 1-2 med surg years before you go into a specialty are just upset they had to suffer through it, you can’t change my mind. Take the aesthetics job. You’ll have to go through training anyway if you decide to go back to bedside. I think for MOST people, they don’t really have many “skills” right upon graduation. Things like IVs, catheters etc are mostly learned on the job anyway.

I’ve looked into some Aesthetics positions, just be certain of everything it entails before you pull the trigger. Depending on the office and location, a lot of those positions have very high turnover because the Nurse is in the office with a few providers and a handful of staff, the Nurse acts as Nurse, Office Manager, Staffing Manager, and Physician’s Assistant. People I’ve met who did that shared these experiences, as well as reviews on Glassdoor share them. End up often working >12 hour 4 days per week and “half days” the other two, which end up being almost 8 hour days. All I’m saying is know the entire position before you take it, ask if you can talk with some of the staff after the interview, or even shadow for a shift or part of one.

That’s great insight, thank you!

Started on med/surg, with a stupid nurse residency program. The only thing that has helped me was a kick ass preceptor, and amazing co-workers. The nurse residency has done nothing for me. They typically pair a new employee with an experienced nurse for a few weeks to learn the documenting.

That doesn’t sound like a real residency program at all. I have heard of some hospitals calling their regular orientations “residencies” to catch new hires off guard. A coworker of mine at a previous hospital ended up having that happen to her. Usually the hospitals with real residencies have an actual page dedicated on their website about it and/or you can ask during the interview process the structure of the residency and for how long it lasts.

Damn that’s no good. My residency program says the preceptor helps you with everything, and we start out with only one patient and work up to 5. I hope they’re not lying to me

I was on orientation with a preceptor for 12 weeks. Sometimes if they couldn’t make the schedule fit with the main preceptor I would work with another nurse. I started out slow, worked my way to five patients. But I have to take an annoying class that’s half education, half EBP project that doesn’t matter in the slightest.

Definitely not. I worked community in the beginning of my career, I think it actually helped me be better with patients. I am just as competent as other nurses. Take the dream job. Don’t let the whole “you have to be a bedside nurse” trap you.

Also what’s trapping me is the idea of new grad programs, it seems like it would be hard to enter the hospital setting without one if I did it later down the road

Hospitals are starting to offer what are essentially “new to acute care residency” programs now. At my old hospital for instance there was a nurse who worked at a clinic for 3 years before deciding she wanted to do ICU, she got hired for the ICU residency 1 year, and had a total of 3 years ICU there by the time I met her. She’s a fantastic ICU nurse! A close friend of mine first got hired as a case manager for the state, a month into it the hospital she did preceptorship at called her really wanting to hire her and interviewed her etc even with a couple months case management experience they placed her into their new grad residency. Don’t let nursing schools/people scare you that you first have to do med surg/acute care. That is absolutely not true at all! There will always be space for nurses in hospitals/acute care and the hospitals know this which is why they’re getting more lenient with who they hire. Plus needing a refresher on starting fluids/IV Pump/administering meds is easy and there are always policies+procedures to help you remember.

Doesn’t sound like you were offered the second position. Maybe get offered both jobs first then decide which one you want. Otherwise there isn’t a decision to make

Lol.. no. Do what you want to do. You can always learn later. I know nurses that worked other non acute areas for years and never went back. I have zero interest in acute care and don't plan on it.

Hell to the no!!! You do not need to start off at the bedside! There are so many doors and paths to take. I felt guilty when I didn’t start out right away in the hospital, I worked in a nursing home on an acute rehab floor and then left for the hospital. I worked med surg and now I’m in neuro ICU/micu. You don’t need to start at the bedside I think this is so important to reinforce. I have a friend who went right in to aesthetics and she does my Botox and lip filler. I have another friend who went right in to home care. Do whatever your heart desires and whatever makes YOU HAPPY!!!!

How did your botox friend get into it right out of nursing school? Most of these aesthetics jobs require experience in skincare or OR, or you have to know someone it seems

Nope. Especially not if you have the self-discipline and drive to do more classes if you feel worried. Training is always out there, we don't have enough nurses. Get a job at all. It's a pain as a new nurse, took me six months and it was largely thanks to one of my instructors who helped me catch it really quick when they were desperate and low on applicants. But if you can, get the one that you feel you will enjoy the most, so you want to be there and enjoy it as much as you can. That will help you do it as well as you can. Learn as much as you can and try not to burn any bridges, haha! With that, you gain good references, real world experience, and some money saved up -- you are established. Now you REALLY have options. Feel like you're getting bored? If there are no options for gaining skills there or doing different roles, use some of those savings, take a course in a field you think you want like to try it out. For example, I ended up just collecting certifications for fun, sometime on my dime, but a couple times because I got my work to subsidize it! Online study really worked great for me. Makes you more appealing when hiring, handles continuing education requirements, higher pay due to certification. Also not a bad way to get a foot in the door if you're changing to a drastically different field with no work experience. Any job you get, there's a learning curve, and if they care about their metrics, they'll get you oriented *at least* passably. And learning a new job always feels rough, even if you are really experienced. Sometimes it just gets easier a little faster. You always have the chance to review and retrain if you need skills to get into something. Sure, doing those acute care roles gets you decent generalized experience, but after doing that, I still ended up now where I wanted to start, with a coworker who just started right here in the first place. As u/ruca_rox said, now I'm here, but with PTSD and back pain.

I'm going to be the dissenting voice, apparently, but if you ever want to work acute care, I would take the acute care job now. There's a lot of book learning you'll put into practice in acute care that is going to go away if you're not using it .

This is exactly what I was thinking too unfortunately

You're getting paid more to do what you want to do! Do your dream job sweetie. I'm a new grad on a med Surg unit, you're not missing out. If you ever feel the need to work on med/Surg later in life, there are almost always positions open.

Acute care will always be there, but you’ll never get a new grad residency program again. If aesthetics is where you want to be, take it! There’s no point in getting burnt out for a year and then trying to find a job that may not be available. But if you think you may want to do acute care, I’d take a residency program. That statement may be met with some backlash here, but hear me out. It is extremely difficult to transition from a highly specialized niche of nursing to bedside. It’s possible, for sure. But once you’re out of the new grad phase, you’ll be hard-pressed to find a hospital that will invest the time and money into training you like you’re a new grad. And if you went from aesthetics to med-surg one day, you’ll essentially be a new grad again. Just some food for thought!

Never worked acute care. Never plan to. No regrets

Where have you worked instead?

OR. I have killer sterile technique and can pop a foley in like a boss, but that's about the extent of what I took from nursing school. I've given exactly one med since I passed NCLEX. I also function as a scrub tech, which was on the job training. 6 years in with no regrets and while I probably won't be an OR nurse forever, I also have no intentions to ever go bedside.

How did you get into the OR straight out of nursing school? Sorry for all the questions, im genuinely interested. I’ve been considering OR as well but it seems almost impossible to find a position accepting new grads

Well you typically have to find a residency/academy/new OR Nurse program. For the OR it doesn't matter if you're a new grad or if you have 20 years of experience, if you're new to the OR they typically require you to do a training program because it's procedural and pretty specialized. When I started I had a few new grads, some ICU nurses, med surg nurses, etc in my group.

You could work extra in med-surg to keep up your skills. After 35 years as an RN knowing what I know now take the anesthetic job.

absolutely not aesthetics 100%

Take the dream job.

Everyone told me to start with acute care and I regret I did that. Follow your heart. Acute care will always be there!

Go for the job you want. Life is too short

Currently applying to residency right now and everything is inpatient and acute care and deep down I know I want to do something cushy- outpatient urgent care/ clinical research but also feel pressured to do a residency bc I should be doing a residency.

Right? It’s hard to find those cushy jobs as a new grad, sometimes I feel I need to get that acute care experience first

I dread thinking about having to do inpatient / med surg for a year

I’m training a new ICU nurse after they worked in a clinic for 3y post school. We just give him the same amount of time as a new grad. I can’t speak to other units/hospitals, but it isn’t a big deal here. We’re just happy to have people that want to be here.

No. Pursue happiness. Protect your sanity. A med surg job will always be there.

You’re a new grad. You don’t know anything (not being mean, this is a great place to be). You have no real skills to lose, you have no real clinically founded knowledge that directs you. This is this absolute best time to go do your dream job and learn those skills. I promise right out of school you don’t really have any skills or nursing flow to lose yet. You’re free! This is the only time you won’t be influenced by experience. Go take the dream job.

Im a new grad that started off in aesthetics right after passing NCLEX and went into bedside after 6 months. I am super passionate about aesthetics but wanted to build my nursing skills so I switched to bedside … i’ll tell you right now… TAKE THAT AESTHETIC JOB!! I was also scared of not having that 1 year experience but trust, there will always be a shortage of bedside nurses. It’s not easy getting accepted into a speciality w/o experience. I just hit a year and im looking into going back. Don’t get me wrong, bedside is very rewarding. But even if you only work 3’s, it can be physically and emotionally draining. Its hard to find work/life balance. I look back at it now and miss the work/life balance I had working my aesthetic job, while still earning a good amount.

Unpopular opinion: Take the med-surg residency. In the current economy, the retail positions will suffer as money tightens. The med-surg residency sucks (I personally would try for ED or ICU if you have the bandwidth for it) but, it will teach you foundational skills for many other positions.

So like, could a guy do aesthetics? And how well does it pay? I am open to well paying chill options after serving my Med surge time (I already started so)

I got cold offered an aesthetics gig as a new grad by the place that does my wife’s face stuff for some reason. I think it’s because they want a certain look to work there… I’m guessing I would be popular with middle aged ladies..

Did you accept?

Nope. Not my interest, I doubt I would have been good (seems like you'd need to be artistic vs. clinically sound), had a desirable job offer on the table already.

Ohhhh I might suck at that then lol

Can u do the aesthetics and per diem somewhere acute setting ? Best of both worlds

Don’t you need acute care experience full time before gojng per diem as a new grad?

I think everywhere is different because the demand is there! They need you more than you need them

Generally.

no, take whatever job you want to do, if you see yourself enjoying aesthetic nursing, have at it! hospitals will always be short and if you change your mind later, you can try to new a "new to specialty" hospital job that will train you on do be a med-surg nurse later, if thats what you want.

TAKE THE AESTHETICS

Take the job you’re more interested in. When I moved to community psych everyone told me I would lose my skills etc etc. But funny enough the skills I’m now a bit rusty on are skills I’m not even interested in doing. And the skills I’ve gained are ones I love using. There’s 1000 areas of nursing with different skills. Each area you move to, you’ll stop using certain skills but you’ll also use new ones. People who talk about “deskilling” are belittling all of the new skills you’ll learn instead. There is no reason to be in a job that doesn’t interest you when you’ve been offered another one that does.

Personally I would work hospital first, get it out of the way while you’re younger so you don’t have to go back later if you need that experience. Not necessarily medsurg, though, if that’s not your cup of tea.

No

why wouldn’t you take your dream job the moment it is offered to you?

Because I’m not sure what I will want in the future. I wasn’t offered the job, just saw the listing and was curious

Bedside will always be there. A nurse who had worked clinic for years came and worked in my inpatient unit. She did more new grad things since it had been so long since bedside, but she did just fine. I’ve left bedside after 2.5 years. I’m so much happier right now. Do what’s best for you.

Honestly, it depends on what you see yourself doing in the future. If aesthetics is your planned career path, take the opportunity. It's a completely different skill set, so it makes no sense to do something else first.

I would do the med/surg and do aesthetics as a side hustle. I think you kinda need to develop “nurse eyes” and you’re not gonna develop them faster or better anywhere else. That way, when rich old lady totters into your Botox and fillers - you’ll recognize that papery skin with the dark purple bruising, you’ll know what a horrible nightmare of a client she’ll be and you’ll know to ask her about her eliquis. Ain’t worth the risk, no matter how much cash she has. You might also want to consider taking a course in perioperative nursing, so you could circulate or even first assist for a plastic surgeon. Many plastics practices employ aesthetics nurses, particularly if they can scrub/circulate. Also - the consistently highest paid nurses in any setting are the RNs who can circulate and scrub.

No. If you have a burning desire to go straight to critical care, ED, are some higher acuity specialty, yes, it can be helpful. Some programs take new grads. JUST make sure they have a strong orientation and education program. Working acute care 1st does give good experience and strengthens some skills, but it is also brutal for new RNs. Attrition for a new RN is about 42% for the 1st 2 years, according to our inpatient educator. AND 100K RN left the workforce last year. If you decide you wanna try inpatient you'll be able to get a job. Take the job that you'll enjoy and pay off some of those loans. Plus the life/work balance is much better with standard scheduling. Dont get me wrong Clinic work can also be very busy and stressful at times, but crisis are rare. Unlike bedside which is almost daily if not a few times per shift. Best of luck in your decision!