Question for those who started or currently in Med-Surg

  1. I am graduating in May and right now I don't have a job yet but I am debating my options. I am interested in NICU and that is my top interest, 2nd choice is pediatrics, 3rd choice is OB, I am also looking into Med-Surg although that is not my top choice. I am looking at Med-surg as a chance to learn skills I have not yet learned in nursing school like starting IV's and inserting urine caths. I haven't even had the chance to insert an NG yet. I am doing my senior capstone in OB but am not quite sure if I will end up there after graduation. If I can get a job in my top interest which is NICU then I will go right for NICU but if not then I will probably start in Med-Surg.

    The only thing that scares me the most is hearing about all the high nurse patient ratio's in the med-surg area. I am wanting to work nights because I am a single parent and have a 5 year old daughter and my parents agreed to keep her while I work.

    What are your nurse patient ratios. I often hear that night shift nurses have 12-15 patients. Is that true? How in the world can you provide care to that many patients??

    I REALLY enjoyed my med-surg clinicals but because we were required to only have one patient each and then we pair up with a buddy and share the second patient that probably makes all the difference in the world for either loving your clinical or hating your clinical.

    Can someone share their experiences in Med-surg with me or going right into a speciality area.
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  2. 17 Comments

  3. by   RNonsense
    I work on a cardiovascularthoracic surgical floor...our assignment is 4-5 pt's on days....6-7 on nights. We have and use workload if the acuity is higher than average, or if there is quite a few isolations, etc.
    As for skills, it is a great place to learn just about everything. Good luck in your decision!
  4. by   Jenni
    Hi,
    I graduated almost 3 yrs ago...and have been working on a medical unit since then. I started there for the same reasons u are considering....experience. I have learned tons...gained lots of skills. I'm still trying to decide if i really want to specialize in another area...or just stay where i am. I am in canada...so it's likely different here. On days we have 4 pts, evenings 5 and nights 8. 8 on days would be hell...but on nights u can usually count on at least SOME of your pts sleeping thru the night!
    Anyway.....its different everywhere I think..so check it out.
    Good luck!
  5. by   Harleyhead
    Med/Surg is a great learning place. Our night shift ratio is 8 or 10 pts per nurse. some nights yhere are no techs. good luck
  6. by   nicudaynurse
    I went right into the NICU after gradution and I have no regrets. I had no interest in adult care.

    There have been a lot of threads on if a new grad. should have a year of med-surg before specializing. I personally feel that if you are interested in OB/pedi/NICU you should start in one of those areas after graduation. Those areas are pretty different though so I would research those areas before choosing one. If NICU is your first choice I would go for it. You will learn all the skills necessary through an internship.

    Good Luck!!
  7. by   RN-PA
    Hi peaceful2100! I recently posted about Med/Surg nurse to patient ratios on the thread linked below which might give you some food for thought.

    http://allnurses.com/forums/showthre...&threadid=4559

    Hospitals are always looking for Med/Surg nurses and you just have to interview THEM with questions about ratios, nursing duties, and questions such as: is there an IV team? Are there respiratory therapists? Phlebotomy? How many PCT's (nurses aides) per patients? Orientation time? Is staffing based on patient acuity? etc., etc.-- which can all figure in to your decision.
  8. by   Tweety
    Tele med-surg up to seven patients. Usually five, but six is common.

    The non-tele med surg patient goes up to nine patients per nurse.

    You definately work and learn on med-surg.
  9. by   hapeewendy
    right now I work on an acute medical ward with a GI/CV and Respiratory focus
    its hard work, not for the lazy, the patient load can be tough at times but the skills you walk away with are those that will benefit you in any and every area of nursing you pursue in the future.
    on day shift we have 8-9 patients (1 RPN and 1 RN assignment) and on nights we have 8-9 patients on our own...

    if youre interested in the NICU go for it , but med surg is also a great opportunity and learning experience and will enhance you confidence in your skills and ability to deal with the interdisciplinary team...

    good luck with whatever you pursue!
  10. by   CougRN
    Go for what you want. Don't waste your time learning to put in a foley in an adult if you want to work with the NICU population. It's not going to be benefitial to learn how to take care of an adult patient because newborns are way different as i'm sure you know. Apply to the areas you want. You will be learn and be taught everything you need to know in your area. The old philosophy about starting in Med/Surg is dead. It's for the people who don't know that every unit has a clinical educator to teach you what your population will need. You don't have to take 9 patients to learn how to be a nurse. You don't have to pay your dues working in an area you don't want to.

    Best of luck.
  11. by   Q.
    I couldn't agree with CougRN more.

    I went directly into Labor and Delivery when I graduated and I have no regrets. I learned foley insertion, IVs, etc on that floor and have had no reason to insert an NG to date.

    I agree, if NICU is your first interest, don't waste time on adult populations. NICU is an entirely different world. Med/Surg skills won't help you in NICU.
  12. by   welnet66
    It's a shame that med/surg is considered a "starting point" for nurses' careers. It kinda makes those of us there feel a little lower than others in different specialties. But to be honest, I understand your concern about lack of skills just out of nursing school but you'll learn those no matter where you work. Why start in an area you have no real interest in staying. I don't think it will make you a better nurse plus you've got to think about your happiness too. Go for what you want...there are tons of jobs out there!! Good luck
    Cath
  13. by   kelligrl
    tele/med-surg- 4 if on primary care, six with a team. That's days, though, not sure if it changes on nights. thought about going straight into a specialty unit, but i'm glad i didn't. You really don't know just how much you don't get exposed to in nursing school. There's so much to learn, and a lot of it is just pure experience...
  14. by   majrn
    Peaceful----I have worked med/surg/tele/oncology since I graduated 15yrs ago. Med/surg nurses are not "lower" than the other "specialties" Med/surg is a great place to learn as you stated. It gives you those basic skills to apply when you specialize. Think of it, if you know the basics all you have to learn is the special applications for your patient population, i.e. you know how to drop an NG already, now all you need to learn is how to apply to your pt. There are lots of pro and con argument regarding where to start. If you have a good base, and learn good organization skills in the process you can go anywhere and feel confident in just a short time. I happen to love med/surg so I stayed and now have held a certificate for almost 10yrs. I think if you opt to spend some time, even 6 mos to a yr in med/surg, you wont regret it. Good luck to you.

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