Every nurse has probably heard this statement (or something like it): "Without two years of med-surg, your career is going nowhere." While medical-surgical is indeed a wonderful grounding in the challenges and skills of modern nursing, many new nurses simply can't find med-surg positions.

The med-surg mythos

When I was a nursing student in the mid-1990s, the prevailing opinion was that every new nurse needed a job on a med-surg floor. Among my colleagues, there was much angst about the lack of med-surg jobs in our local hospitals, and many students felt that their careers would never get off the ground if they couldn't land that coveted med-surg position.

Going against the grain, I announced that I had no intentions of seeking a hospital position whatsoever, and I was told in no uncertain terms that this was "professional suicide." Needless to say, I've never been without a nursing position in 18 years, and I have been gainfully and happily employed in community health centers, home health, hospice, case management and public health since passing my boards.

Having said that, 21st-century nursing professors still preach the gospel of the "med-surg mythos," even as hospital jobs dry up. What's a new nurse to do?

An awkward sea change

A sea change is underway in nursing, but the growing pains are awkward, at best. As older nurses delay retirement due to a sagging economy and many hospitals simultaneously downsize, hospital-based nursing positions that would normally be opening up for new grads are few and far between.

Meanwhile, nursing schools continue to pump out new grads that want hospital positions but just can't find them.

Add to this situation the fact that many healthcare employers (home health included) still only hire nurses with at least one or two years of med-surg experience, ignoring applications from new graduate nurses who simply cannot manage to land a med-surg job in the first place.

So, if new grads can't find med-surg jobs but also can't be hired for other positions due to a lack of med-surg experience, where does that conundrum leave our new nurses who are educated, licensed and ready to join the workforce?

An awkward sea change, indeed.

Embrace the new paradigm

Let's face it. New nurses are the lifeblood of the profession. As we age, those new nurses are the ones who will care for us and our loved ones, save lives, become managers and administrators, and form the backbone of a profession that is itself the backbone of the healthcare industry. These new nurses need our support and mentoring, and they need to be embraced within the new paradigm that is certainly upon us.

Hospitals need to consider creating programs wherein new nurses can be trained, mentored and readied for their new career.

For healthcare facilities and agencies that usually require two years of med-surg experience, think again. New nurses may lack some technical skills that can be gleaned from several years on a med-surg floor, but most of these new nurses just can't get that experience and are still highly savvy and trainable.

These healthcare employers need to embrace the new paradigm by offering entry-level positions to new nurses so that they can gain professional experience and become gainfully employed members of an industry that needs them.

Let them in

Back in 1996, I was a new grad who was given a chance by an urban community health center, and within eight months, I was managing a team of four doctors, two mid-levels, six CNAs and two LPNs. I made up for my lack of med-surg experience with enthusiasm, earnestness, the drive to succeed and on-site mentors who helped mold me into a savvy nurse and an effective leader.

New nurses deserve a chance like I received, and if those two "golden years" of med-surg aren't possible to obtain, let's offer those new nurses another way to jump-start a promising career. We need these new nurses, so let's open the gates and let them in.