Why do so many of you hate working med/surg?

cisco · Feb 25, 2007

I agree with jjjoy, she made a lot of good points. As for myself, I managed a med/surg floor for 7 years and know for a fact, because of networking with many other m/s managers across the country, that the staffing ratios/care hours budgeted for med/surg are usually the highest in the whole hospital system. I fought for the entire 7 years to get better, safer staffing. And now finally 12 years after I left that hospital they are finally being told that their staffing will improve...it's not in effect yet...we'll see.

RN007 · Feb 25, 2007

I love med-surg. To me, that's the care I pictured giving when I started nursing school. I work as an SNA on an oncology floor and love it because it's intense med-surg at its best. However, I do not like the pt loads and how overworked nurses are. I don't blame people for seeking specialties right off the bat to avoid all the bad qualities of med-surg nursing. I plan to put in my years, get the knowledge base I need, and then move on to work with an onc physicians group. As much as I love it, I don't see myself being abused for more than a few years. It's sad, really, because without the pressures, I'm sure I'd work the floor until I couldn't anymore. I think for many of us, it's not the med-surg we dislike. We just hate how hospitals have turned med-surg floors into sweat shops.

CHATSDALE · Feb 25, 2007

med-surg is the hardest work physically and mentally

remember this thread the next time you have a loved one on that type of floor...if they can't do for themselves have someone stay with them and double check everything..if they think you are whiny tell them to suck it up

BeccaRN1970 · Feb 25, 2007

I too got roped into working M/S because I "needed the experience before going to ICU". Here I am, 8 years later, still working M/S and completely burnt out! The ratios are horrendous, and frequently even if I "only" have 6 pts, one or two of them have such a high acuity that the others inevitably get ignored (and then some pt or clueless family member has a fit...)! I usually feel like a drug pusher, running around throwing meds down people's throats, or just being totally task-oriented instead of actually using my brain! The charting starts AFTER my shift and is done in about 1 1/2 hours.

Needless to say I am taking a break from nursing altogether. The ICU where I work has a ridiculous contract that you have to commit to, that in my opinion is not conducive to family life, and there are no other alternatives here in town. Meanwhile I'll just wait & see what happens... :sniff:

BeccaRN1970 · Feb 25, 2007

..if they think you are whiny tell them to suck it up

LOL! How many times have I wanted to say that?! :lol2:

peds4now, RN · Feb 25, 2007

I'm graduating in this semester like a couple other posters, and I also wonder what to do. I work as a tech on a surgical floor and feel I could immediately be productive there as a new grad (well, almost immediately)-but my husband says that means I'll be bored shortly thereafter. I liked the tele floor I worked on for a while, but it was disorganized and the CNAs "disappeared" all the time. I loved my ICU experience, seemed challenging and medical enough to keep me interested-but everyone says one shouldn't go right to an ICU-but I see some posters here saying otherwise.

My question, do you really think it's dangerous to go to ICU first, or a nurse will never learn organization if she goes straight to ICU?

control · Feb 25, 2007

I have done a little of everything and always land back at med surg.
It is true that our patient load is heavier and there are days when you wonder what the heck you are thinking staying on the unit.
One of the most upsetting aspects is that ICU and ER nurses seem to think that we stay on med-surg because we just aren't good enough to go elsewhere.
Med surg is a speciality and should be viewed as one just as ICU and ER and OB and PACU are specialities so are we, it is hard to expect pateints to respect us when we have trouble getting our peers to respect us.
The great thing about nursing is there is a niche for everyone, I know ICU is not mine...med surg is, I have also done ER, OB, LTC all for several years and love the variety. So when I need a break for a few years from Med Surg I go elsewhere but I always come back to my first love.

ita with bolded part....i've gotten this impression as well.

control · Feb 25, 2007

I worked in physical rehab which is an area of med-surg.

I loved working in physical rehab. It was in a free standing rehab center and was great.

My first general med-surg job was in your standard big city hospital. The ratios were ridiculous, and we were understaffed, but if we had a good team everything was ok. Except for the politics...

What I hated about med-surg was having other nurses in the hospital think/act like they're above us med-surg nurses. Specifically ER, ICU, surgery (not PACU, though), and day surgery. I always felt like the ER and ICU and surgery were very cliquish. Surgery was always a political crapshoot....ER and ICU were ridiculously pampered, and whenever we were in the presence of them we're supposed to bow down or something....uh, whatever. I won't even start on nurses who worked in specialty clinics.

Med-surg nurses end up being the lowest on the totem pole in hospitals. Tele/stepdown is just above med-surg (and they let the med surg nurses know it...I used to work in Tele, too. Some of the things I heard were ridiculous.). It all made me miss my community-like physical rehab center where I had my first job.

The politics (like that above) are what made me get the heck out of hospital/clinical environments. Now I work in an office. It is stressful, but I do feel like my colleagues respect me at least.

I think a year of med-surg is good for all new grads, however I wouldn't encourage them to go into general med surg....maybe neuro or trauma or ortho or something more specialized. I would (and don't) ever encourage anyone to do something I wouldn't do myself....going into physical rehab first was the best thing I did for myself, because I learned what a work environment is supposed to be like and did not have the misfortune of being completed alienated and burned out my first year out of school. I've noticed in nursing the more XYZs (i.e., certifications and/or specialties) one has behind his/her name the more "clout" the nurse has. Whatever.... :uhoh3:

hogan4736, BSN, RN · Feb 25, 2007

...I was told that I needed at least 2 years of experience to be a good ER nurse even in my baby hospital and was told that by my manager there... [/quote']

They're still selling this load of crap in 2007????
don't buy it...
to the students, if you want to do _____________ type of nursing, get an externship 1 year before graduation, and get yourself 3-6 months of a new grad class/shadow time after graduating, and you'll do fine...

OC_An Khe · Feb 25, 2007

Med surg is a specialty unto itself. Though most people in the profession don't acknowledge it as a specialty. Thus, Med Surg unfortuneatly gets little respect. The hospital admin surely doesn't as it is typically the most understaffed and underbudgeted area of the hospital. The budgetary process for staffing Med Surg has not kept up with the increased acuity and short stays of todays inpatients as opposed to the acuity level of pre drg days.

And no you really don't have to go to med surg before starting in the "other specialties".

PickyRN · Feb 25, 2007

I work med-surg. Here's my thoughts:

I decided to work med-surg right out of nursing school. I got job offers from a cardiac floor and orthopedics at this hospital. But I decided to get at least one year of med-surg experience before settling into a specialty.

The reason I chose this is that I was told (and this is true) that med-surg nurses have the most varied population of any floor on the hospital. There are patients on my floor that are ready to go home, take care of themselves, etc. There are patients on my floor in droplet isolation with CSF leaks and chest tubes, q hour glucose checks with insulin drips, heparin drips, psych patients on suicide watch, people with rods screwed into their legs for bone correction, endocarditis, CHF, COPD, pancreatitis, cellulitis, etc. Basically, my floor is supposed to be the "diabetic/renal" floor of the hospital, but we get overflow from EVERYWHERE. That's why it's so hard to be a good med-surg nurse...you have to have a large body of knowledge to care for patients with varied problems. I have patients who are 100, patients who are 20, and everything in between.

Another reason med-surg can be difficult is that the patients tend to stay longer without getting better. It can get frustrating when you are taking care of the same people all the time, and they never leave, they never get better.

I am working med-surg now. I will not be working med-surg long term. I think it has been good for me to get a good foundation for my nursing career, but it is not what I want to do forever.

PickyRN · Feb 25, 2007

I do not agree that med/surg is a "specialty", I believe it is a "field". The thing about med/surg is that that is what we are geared to do in nursing school and is a field that does not require extra certs and training (like OB/psych/ICU/NICU/ED and many other fields) this is what makes these "specialties". It's like calling GP's specialists there is no extra residency for them (not to be confused with family practitioners because that is a specialty requiring residency).

There is a "med-surg certification", but it isn't required for my department. I believe med surg nursing is a "specialty", but unfortunately it is often viewed as a "dumping ground" for nurses. While it's true that the acuity of the patients in ICU is higher, I think that there are many patients in the ICU that could have avoided being in the ICU if their med-surg nurse had been able to assess and get the doctor to focus on the problem earlier. Unfortunately this isn't possible when half of the nurses in med-surg are fresh out of nursing school almost constantly.