Bad Rep for Med Surg - page 5

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   Lady_Bing
    i am a new nurse and i just started on a busy med-surg floor. i find myself perpetually overwhelmed by the pt's acuity levels and the number of patients that i get (typically 6, but has been higher on several occasions). i am constantly running from one room to another, i am lucky if i get 15 minutes of break (management believes that if you schedule your lunch at a specific time and you didn't go, that it is your problem, not theirs). there's really no time to sit down and read the pt's history/chart to get a clear idea of what's going on with your patients, it's also hard to stay on top of all the labs/procedures/new orders. i do my very best to listen to the patient's fears/anxieties/concerns and advocating for them, but most of the time i feel that my patients deserve more. before getting this position, i did my externship on oncology floor and i loved being able to sit down, talk to my patients, get to know them, provide comfort and support. i walked away every day from that oncology floor feeling like a made a difference, i built bonds with my patients, they remembered my name and missed me if they didn't see me for a couple of days. to this day, i remember most of their names and their medical diagnoses! and that was almost a year ago. the patients were more acute than the pts i have right now, but i only had 3 and i had ample time to stay on top of the labs and new orders, i was even present for doctors' rounds every morning so i had a clear idea what the plan of care was. on this floor, i have to look on my sheets to remember the pt's name and medical history. at the end of the day i feel tired and mediocre. i think this floor provides a good learning experience and a solid med-surg background, but i don't think i will be staying past my 1 year commitment.
  2. by   military girl
    Med/Surg nursing is hard work. Physically hard and mentally hard at times. Too many patients and not enough staff. Multiple orders and nurses feeling overwhelmed.
    In the military, if you don't come in certified in a nursing speciality, you have to do a year of med/surg before they will let you go to a specialty course. I think that this is good because really med/surg is the foundation of nursing.
    A brand new nurse should not be given 6 patients right off of orientation. They should be in somewhat of a "protected' status for the first month until they gain confidence in taking more patients. We will usually have a resource nurse available to help this new nurse if the census is low and the resource nurse does not have to take patients.
  3. by   Super Nurse JoshuA
    Hi. During my last semester of nursing school I thought I wanted to work ICU. I had worked in the float pool as an aid for three years on the floors and really didn't have a clue where I wanted to work. I interviewed and recieved a position in the ICU at my hospital. About three weeks before I was supposed to start I decided I wasn't ready/ stressed about not knowing anyone down there so I talked to a floor I enjoyed floating to (Med/Surg). I stayed there for a year, it was stressful at times. I also really enjoyed it at times. Towards the end of the year I felt ready for the switch to ICU and thought it would be a lot better because staffing at the time on the floor sucked badly. I been in the ICU for two months and I think I'm getting ready to transfer back to the floor! I have to admitt, my general stress is probably lower in the ICU than on the floor (alot more setting around time) but not nearly as enjoyable as a good day on the floor. Also, I've had a pitful (read: hardly any) orientation to the ICU.
  4. by   bluefabian
    Ok, maybe I am late to this discussion.

    But hear this: I am thinking of going into Med/Surg. This after two years of ER/Dialysis.

    Why? I miss bedside nursing, one that I experienced in nursing school aeons ago. While I knew that the pace, load and stress is huge... I also know the excitement of everyday being a different and interesting one. Gosh, my years in dialysis is so boring, albeit being a highly (and it really is so) specialized field. You got to see same faces every week doing exactly the same thing. Repeat X1000.

    And for the record, I should think that Med/Surg should be recognized as a specialty. Even when I was working in ER, I discovered that there is so much that I don't know about a case as I transfer the cases to the ward. Really guys (or girls?!) I see you all with highest respect.

    Thinking about this, doing masters in Medical Surgical is not that bad.
  5. by   TX_ICU_RN
    Quote from SarahK73
    As a nurse manager in a med-surg unit I am saying AMEN to all of the above. I find it hard to entice new nurses who are seeking the glory and thrill of ICU and the warm fuzzies of Maternal-child. We do absolutely need to reflect our ratios to give the nurses the time they need to care for their patients. I admently disagree with one post that you do not use your critical thinking. You are using it constantly. You could have anything and everything in one day! I am amazed when we have a ICU nurse who "HAS TO" float down, and is shell shocked at what we do. Sometimes I get the impression they think our patients are not that hard (or we are not that smart), when in reality we have some very sick patients and have to juggle multiple things at once. They are usually ready to run back to their one or two patients.
    Med-Surg is a speciality!
    As an ICU RN, I have the highest respect for med-surg nurses. I am one of those who is ready to RUN back to my one or two patients because I am completely overwhelmed. Med-surg is an integral nursing specialty and I think anyone who does med-surg is an AWESOME NURSE!!!
  6. by   rn/writer
    I have tremendous respect for med/surg nurses.

    Here's an observation. We all have different learning and thinking styles, and it's generally a wise thing to take that into account when deciding where to work. Med/surg is a great specialty for those who like breadth and variety. Your focus is spread wide and there is always something new on the radar. Critical care, by contrast, is more suited to people who prefer depth. The focus is much narrower (fewer patients) and the things that pop up on the radar tend to require you to dig the same spot deeper.

    From that standpoint, med/surg was not a good fit for me. I felt scattered when I wanted to concentrate. From what I know about critical care, that would have been a much better match, and if I were just starting my nursing career, that is where I'd head.

    Seems like extroverted people who are energized by activity and interaction with others would thrive in med/surg, while hermits like me would be better off in the closer confines of 1:1 or 1:2 care.

    I realize these are generalizations, but I think we ignore this aspect of our personal make-up to our detriment and then think something is wrong with us when we find ourselves struggling in an environment that runs counter to our design.

    Wouldn't it be nice if somewhere along the way, we were all tested to determine our personality types, learning styles, and other attributes to give us some idea of what we are best suited for? For one thing, it would give us permission to decide if a particular kind of job fits like a glove, fits like a mitten, or fits like mousetrap. Then we could make choices based on our own mental health and inner needs rather than guilt and confusion.

    It's probably a pipe dream to hope for this to become a normal part of nursing education, but individuals can gather some of this information on their own. For every square peg trying to jam herself into a round hole, there is a square hole going empty and a round peg looking for a home.
  7. by   imanedrn
    Quote from rn/writer
    I have tremendous respect for med/surg nurses.

    Here's an observation. We all have different learning and thinking styles, and it's generally a wise thing to take that into account when deciding where to work. Med/surg is a great specialty for those who like breadth and variety. Your focus is spread wide and there is always something new on the radar. Critical care, by contrast, is more suited to people who prefer depth. The focus is much narrower (fewer patients) and the things that pop up on the radar tend to require you to dig the same spot deeper.

    From that standpoint, med/surg was not a good fit for me. I felt scattered when I wanted to concentrate. From what I know about critical care, that would have been a much better match, and if I were just starting my nursing career, that is where I'd head.

    Seems like extroverted people who are energized by activity and interaction with others would thrive in med/surg, while hermits like me would be better off in the closer confines of 1:1 or 1:2 care.

    I realize these are generalizations, but I think we ignore this aspect of our personal make-up to our detriment and then think something is wrong with us when we find ourselves struggling in an environment that runs counter to our design.
    Such a great point! I think MANY people don't think about this, esp. new grads, esp. when they post things on here thinking that they're "horrible" nurses or nursing is the wrong fit.

    So many people start in med/surg because they assume they have no other choice. But it's such a horrible fit for SO many people. I know med/surg isn't my ultimate home, but I chose to start there specifically because I wanted the broad experience to move on with. (I'd prefer to have too much information and go narrower than have to work backwards and learn more.)

    I'm an extroverted introvert. Although I love working with people, at the end of the day, I need to close off from the world. Even on my days off, it's a stretch for me to talk to my friends vs. just texting them!

    The best part (for me) about nursing, though, is knowing that I have such a wide range of possibilities. Although m/s is too much for me on some days, I know it's going to give me the experience I need to get where I want eventually.
  8. by   queenjean
    Quote from rn/writer
    Seems like extroverted people who are energized by activity and interaction with others would thrive in med/surg, while hermits like me would be better off in the closer confines of 1:1 or 1:2 care.
    Hmm; interesting thought.

    I've worked on a medical floor, an OB/peds floor, and in a birth center. I will tell you that the ones that worked best for me are the ones that were more stressful. I recently left OB to go back to the medical floor. Everyone was like "No one transfers TO medical, everyone transfers FROM them!" But I missed the energy and the challenge, and I think my sense of humor is definitely best suited for night shift on the medical floor.

    I'm an extrovert.
  9. by   jjjoy
    Quote from rn/writer
    Med/surg is a great specialty for those who like breadth and variety. Your focus is spread wide and there is always something new on the radar. Critical care, by contrast, is more suited to people who prefer depth. The focus is much narrower (fewer patients) and the things that pop up on the radar tend to require you to dig the same spot deeper.

    From that standpoint, med/surg was not a good fit for me. I felt scattered when I wanted to concentrate. From what I know about critical care, that would have been a much better match, and if I were just starting my nursing career, that is where I'd head.

    For every square peg trying to jam herself into a round hole, there is a square hole going empty and a round peg looking for a home.
    I think I agree with you. I'm more of an introvert (not extremely so, just energize with quiet and solitude and need to recouperate from lots of interaction) and prefer to be able to concentrate in depth on a few things rather than just a little on a lot of things. So I relate to your description of feeling scattered. I enjoyed critical care more as a student but we had just one short rotation in it and instructors were pushing hard that med/surg was THE place to start.

    The saying is that if you can make it in med-surg, you can make it anywhere. It may be true, but what if you CAN'T make in med-surg? Does that mean that you can't make it in nursing at all? I hope not!! We need to nurses too badly in so many different capacities to toss out all of those who find today's med-surg environment overwhelming and/or dissatisfying.
  10. by   imanedrn
    Quote from jjjoy
    The saying is that if you can make it in med-surg, you can make it anywhere. It may be true, but what if you CAN'T make in med-surg? Does that mean that you can't make it in nursing at all? I hope not!! We need to nurses too badly in so many different capacities to toss out all of those who find today's med-surg environment overwhelming and/or dissatisfying.
    I don't think it's one of those hard and fast laws of nature, no. I do not believe the old saying. I think some people in m/s could never make it in ICU. But the opposite is also true. M/S may be demanding and cover a broad base of nursing skill, but it doesn't mean that skill is applicable to every other area of nursing. If I go to ICU, I still have to learn ALL the equipment they use that's NEVER used in M/S. But an ICU nurse would have to take a step back & spend time passing tons of meds & giving teaching, etc. etc. for 6-10 pts. There are so many differences. Yes, they're all fruit, but some are apples, oranges, bananas / some art tropical, some are prickly... Yeah, they all contain fructose, but they're still all different. Or something like that
  11. by   grantyRN06
    Quote from ranaazha
    I don't think it's one of those hard and fast laws of nature, no. I do not believe the old saying. I think some people in m/s could never make it in ICU. But the opposite is also true. M/S may be demanding and cover a broad base of nursing skill, but it doesn't mean that skill is applicable to every other area of nursing. If I go to ICU, I still have to learn ALL the equipment they use that's NEVER used in M/S. But an ICU nurse would have to take a step back & spend time passing tons of meds & giving teaching, etc. etc. for 6-10 pts. There are so many differences. Yes, they're all fruit, but some are apples, oranges, bananas / some art tropical, some are prickly... Yeah, they all contain fructose, but they're still all different. Or something like that
    I agree nursing is nursing no specialty better than the other, some different than the other, but when it all boils down to it, it is still nursing at the end of the day.
  12. by   CrispyRN
    I agree with several of the above posts including: the ratios are too high, med-surg IS a specialty in itself!

    We are also in a crunch with our nurses on med-surg. They want to get that experience and move on. I started off on surgical-pedi went to Neuro ICU and then back to medical oncology. I don't need the daily stress at work that ICU provides. My motto is "let's get them upstairs before they crash!" It is hard work and the patient's attitudes sometimes don't help at all. However, you get the one's that are super sweet and make you so glad you are in nursing.

    ADN's can take the cert exam-so do it and show your support of your specialty!!
  13. by   RiverNurse
    Quote from 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.
    < disclaimer> I'm in an esoteric frame of mind today.

    I've been working in Tele/Med-Surg for six months now. I've encountered a lot - both from patients and staff (rudeness and disrespect). I don't want to leave the floor - I intend (to the best of my ability) to hang in for a year. Most of the nurses on this site have said that things don't really begin to "fit" until about a year (sometimes two) on the floor.

    The reality is that - nursing is much more that what you learned in school. What was taught in school is the 'idealistic version' of nursing. There's a compendium of factors that influence everyday life on the floor - the conglomeration of staff with each person's culture, history and work ethic... the patients' illnesses, coping mechanisms and family hx... the hospital culture itself - all of these combined can be a source of harmony or chaos - depending on the factors of any given moment. What a way to learn how to detach and live in the moment... Hm...

    I struggle with it every day - sometimes it wears me down the point where the worst of me is revealed - those are the days when I want to quit - when there is more of my "shadow" side than there is of my "compassionate" side. That's not the way I want to live my life. I prefer to live my life in a way that brings joy and encouragement to others. My 'job' is to try to maintain the compassionate side when the chaos strikes and I am worn to a frazzle - getting grumpy, cranky and "dark".

    I have had to re-learn what it is to "care" for patients. Yes, I'd prefer to get to know the patients on deeper levels - and still think that, holistically, that would contribute to their healing processes, but right now, it doesn't always work that way... so - I have to focus on the priority of this environment - the labs, the charts, the physicians, the staff, the paperwork... It seems that in my environment, the priority is at the physical layer of the person - ensuring their physical healing, ensuring the outer wounds are healed, the medications are distributed... taking care of the body in hopes of reaching the spirit.

    Take care,

    Shawna

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