Bad Rep for Med Surg - page 2

Any med surg nurses out there have any ideas or input about why med surg has such a bad reputation and what could possibly be done about it? We see so many new nurses and experienced come and go... Read More

  1. by   RNsRWe
    Quote from veronica butterfly
    4-5 patients on eve's and 6-7 at night, all with completely different diseases/illnesses, and all we're supposed to be experts on all of them??? .....
    There's just not enough time to do everything. We ALWAYS leave feeling we forgot to do something, check a coccyx, reinforce that dressing on a wound, give emotional support, all that little stuff we thought we'd do when we were in nursing school. There's always a crisis, a fire to put out. Charting sometimes is minimal at best. And helllo???? we're actually supposed to update the careplan? yikes... We wake up in the middle of the night remembering we forgot to pass onto next shift an important detail. OR if we work nights, we wake up at noon remembering this important detail and then, well, forget it, our sleep is wrecked for the rest of the day.
    4-5 patients on evenings? And 6-7 on nights??? That's awesome ratios, in my book. More like 5-7 patients on evenings, 7-10 on nights in my area. And no, there's no way NOT to miss something! But I can tell you that after my first few months was up I *NEVER* lose sleep over what I did or didn't do, did or didn't tell the next shift. I'd be headed for total personal destruction if I did; it's not healthy! I do my best when I'm at work, and when I'm off, I'm *OFF*.

    Which is one of the reasons I think I'm surviving better than many of the newbies on my unit!
  2. by   crb613
    I have been on MS for a year now, and do love it.....but I am sick of trying to care for more pt's than I feel is safe. I have been floated to Tele quite a bit....5 pt's max....what a dream!!!! You guessed it that's probally when I am going.
  3. by   EarthChild1130
    I enjoy med-surg because I'm learning a LOT about different illnesses, and I'm getting to put to use all those critical thinking skills and technical skills that I learned in school...but I will be leaving med-surg...not because of any staffing issues, etc...but when I went to school I went only because I wanted to be a psych nurse...I was a psych nurse at home in Alabama but when I moved here there were no openings on the unit...rumor has it one will be here shortly...so I'm soaking up all that med-surg knowledge and I will be floating out to med-surg for 2-3 shifts a month to keep that knowledge...To me, med-surg and psych go hand-in-hand...they are, to ME, the 2 most important areas of nursing...just my opinion!! lol

    Anyhow, to make a long story short, I suspect that other people have a certain area stuck in their head that they want to work in, and only work med-surg while waiting for openings...I dunno...it's been a great place for me to work so far though!
  4. by   kellyskitties
    I am loving this. So many great replies. I actually have an alterior motive for this thread and I hope you all will continue to post!

    Before I say this I want you to know I'm not delusional. I know my hands are probably tied.

    I've worked on at my med surg job for 3 years. In a short 3 years I AM the senior nurse. Now, I've only been a nurse 3 years. That's some turnover isn't it! But in that 3 years, I've come to love my floor. I hear nurses moving on say how I'm crazy or just don't know any better. Yep, I float to the other floors when they need a hand, but I do actually look forward to returning to my pergatory floor.

    Now the delusional part, I plan to stay at this job. I was thinking if I could find some reasonable suggestions or things I could do myself maybe I could make a small difference. Or maybe I could present the info I get here to my dept in hopes of (delusional part is about to happen) making it better.

    Keep posting. I want to know every angle here.

    I personally think the graduates come to the hospital to work doing everything they can to avoid us because they hear the horror stories and are in fear. Or they see it as where "nurses who can't make it elsewhere" go and they don't want to start there and risk getting trapped in "loser land"
  5. by   jjjoy
    And some new nurses don't want to start there because they've seen and heard the disatisfaction and poor working conditions and fear they'll burn up and give up on nursing altogether if they start there.
  6. by   Ayonti
    I am a new nurse on a busy med surg floor. I've been there for 5 months and everyday I go to work, I want to quit. I just figured it out why. I thought nursing was spending time with pt and getting to know the emotional and spiritual needs as well as the physically needs. This is what we were taught in school and I loved it. The real world is far from this. I only have time to find out (after spending a hour or so trying to find the chart) what I need to know about the pt to get through the day. When they are trying to talk to me about their personal life, Im thinking to myself about the other 4 pt, charting, labs etc. I can not seem to get a handle on this and feel like I am drowning all the time, everyday. It is a horrible feeling and I feel sorry for the patients. We spend so much time with paper work that it's unbelievable. I am thinking about my next move because I do not want to work under these conditions.
  7. by   NursingAgainstdaOdds
    Quote from kellyskitties
    I am loving this. So many great replies. I actually have an alterior motive for this thread and I hope you all will continue to post!

    Before I say this I want you to know I'm not delusional. I know my hands are probably tied.

    I've worked on at my med surg job for 3 years. In a short 3 years I AM the senior nurse. Now, I've only been a nurse 3 years. That's some turnover isn't it! But in that 3 years, I've come to love my floor. I hear nurses moving on say how I'm crazy or just don't know any better. Yep, I float to the other floors when they need a hand, but I do actually look forward to returning to my pergatory floor.

    Now the delusional part, I plan to stay at this job. I was thinking if I could find some reasonable suggestions or things I could do myself maybe I could make a small difference. Or maybe I could present the info I get here to my dept in hopes of (delusional part is about to happen) making it better.

    Keep posting. I want to know every angle here.

    I personally think the graduates come to the hospital to work doing everything they can to avoid us because they hear the horror stories and are in fear. Or they see it as where "nurses who can't make it elsewhere" go and they don't want to start there and risk getting trapped in "loser land"
    I don't think you're delusional. It's nice to see a positive thinker. Tell the nay-sayers you're not crazy, just "obnoxiously positive". That's my motto.

    Not to jinx myself, but I'm going to start my very first job next week in Med-Surg, and I really think I will like it there. With all the training and reading and thinking I have done, I feel I am well prepared to handle the challenge (read : I have the training to know what to do, and the perspective to expect chaos). Maybe all you experienced med-surg nurses out there just snorted at my baby nurse optimism, but I don't care.

    Also, I think another reason for the high turnover (which I don't think has been mentioned yet) is that many nurses, including many med-surg managers view it as a training ground where baby nurses lose their training wheels and then speed off to their fruitful career. It's all about expectations.
  8. by   General E. Speaking, RN
    acuity acuity acuity. Seems no one takes this into consideration or they don't care. One group of 5 patients is not like another group of 5. On my 7th year of Med-surg at the same place (12 yrs total Med-surg experience). I am the senior nurse on my floor. Everyone else has moved on. I have been through about 14 managers at this job. I am biding my time until I get done with my transitional program and I think I will have to hang up my Med-surg towel for a while.

    Personally, I am tired of running to put out fires and feeling like I did not give quality care. I do the best I can but that isn't good enough anymore.
  9. by   NurseRotten
    The original poster of this thread asked how we can change the perception of med/surg nursing. My experience in nursing school was that ICU was "the bomb." I knew right away that ICU nursing was not for me. I distinctly remember a nursing instructor saying to me, "Darling, you are one of the brightest students I have ever had, why do you want to waste your mind by not going into the ICU?" (I'm still bitter!)

    About 4 months after graduation, I read an article about managing geriatric patinets in a med/surg environment. It stated that due to the pre-existing co-morbidities frequent in geriatrics, managing those patients is as complex as managing an ICU patient. I forwarded the article to her. hehe

    But, looking back now - I think that the way that Med/Surg nurses can influence change is through advanced education and teaching. All my nursing instructors belonged to some sort of nursing specialty (ICU, ER, OB, etc.). It is human nature for us to think that what we do is most important. I think that students get a biased presentation.

    So volunteer to precept, obtain more education, and go and teach, teach, teach.

    Also, if you can write, write! I submitted an article to a nursing magazine and found it published just a few months later. Many nursing magazines take reader submissions. If you love what you do it will shine through in your writing.

    Start your own grassroots campaign to promote med/surg nursing.
  10. by   st4wb3rr33sh0rtc4k3
    No bad rep for the floor I was on, just that my hospital is union, and they don't help much. I said when I graduated that I would never go into a union hospital, but I thought it would be a good idea to get my year of medical surgical nursing. My floor closed at the hospital and I lost too many hours, resulting in my leaving. They weren't too happy about it, but what was I suppose to do to pay my bills.

    I must say it was an excellent experience while I was there.
  11. by   nursynurseRN
    Where I work, the max for a nurse is 5 patients......... what are the ratios elsewhere? I too am a new grad and feel a little overwhelmed at times, but I like the challenge. My feet and back hurt at the end of the day, everytime I work.
  12. by   kellyskitties
    Our hospital sets a max goal of 8 pts per nurse. Due to short staffing this winter there was one night I had 13 - just one night and our manager did stay almost the entire night to help us get through that. It wasn't as bad as it sounds like. At times we have 10 and at others we may have 3 or 4 - during the summer and currently we are running at about 6 per nurse.

    I've learned the trick to the heavier loads is to work smarter not harder. I make a note on my assessment lap at the beginning of my night next to each pt what they ask for - then a take those things as I pass my meds or I delegate a few items to a CNA if possible. A lot of times the pt is just glad you didn't forget the blanket or snack they asked for. A lot of the time everything doesn't have to be right now. That's helped me be more efficient.

    I also try to make a list of what I need to do that night and what time I expect to do it. Helps me organize and plan my night a little. Even when I get off plan - I have a clear list. That helps when I know I need to follow up on pain for a pt at say 0200, but I also know from this list they asked for blanket and they are due an Iv antibiotic at 0300 - well, one trip at 0230 will suffice for all three and save some running.

    I just thought maybe I could help a few folks frustrated with med surg with my tips for how I'm doing it.

    Keep the input coming. I enjoy the responses and read every one of them.
  13. by   st4wb3rr33sh0rtc4k3
    Quote from sabrosura98
    Where I work, the max for a nurse is 5 patients......... what are the ratios elsewhere? I too am a new grad and feel a little overwhelmed at times, but I like the challenge. My feet and back hurt at the end of the day, everytime I work.
    I have had up to 7 in Med/Surg and up to 60 in Long Term Care.

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