Bad Rep for Med Surg

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.

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.

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.

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.

I have worked med-surg for a very long time, (somedays it feels longer than others), but it is the place I want to work. I have seen a lot of changes in our unit over time. We have gone from one aide on each hall to total of five. Our equipement is getting better all the time. All that said and done the work is hard, and the acuity is very high, our patients no longer have only one or two things wrong with them. Our patient load on days is 4 to 5 and we really try to keep it at that. In the winter our population doubles and our beds are full all the time with peiple waiting to get into them. I might add that we are the only hospital for at a 250 mile radius. Our aides do all the lab work, ekgs, and accu checks. I agree that the work load is hard and the morale is not what it should be. Our schedule is for a 4 week period, and most of the nurses have chosen the days that they want to work and it is set that way. A few work 3 days one week and 2 the next, for an example. Being one of the two day charge nurses, I am always trying to think of ways to keep the moral up. A bag of candy for the nurse with the first discharge, because odds are they will get the first admit. One day I brought a flower in a vase with a note that said the flower was to brighten your day for one hour and then to pass it on. That flower went around for a couple of days. Nice to see the smiles on the faces of the nurses as well as some doctors. We have also had drawings, everybody who wants to donates thier change and thier name is entered in a cup. Who evers name is drawn get all the change for the day.
Do any of you have any good ideas of little things that can be done to help keep the moral up? I might add that the candy doesn't just go to a nurse, if the person cleaning the room gets the room done right a way a bag of candy goes to them, the CA who helps get the room set up for a new patient or gets a hard lab draw, gets a bag of candy. I am open to ideas that you come up with.

Hey yumaRN1990,

I love your suggestions for boosting morale! So much so, I just created a new thread (http://allnurses.com/forums/f8/boost...ml#post2236308) in the general nurse discussion area in hopes it would generate more responses.

I'm new to the hospital environment and am working in med-surg in a small rural hospital. So far, it's been pretty good, one of the best things about it is the team approach that I see there that I didn't see @ the bigger hospitals where I did my clinicals.

In med-surg, I'm thinkin' "it takes a village," ya know?

Anyways, as far as addtl. suggestions - today, one of the nurse aides brought healthy snacks for the staff that she had prepared b/c for some reason Tuesdays can be particularly busy there and lunch is hit or miss.

Well, in addtn. to already having told her thank you, I've got a funny thank you card that I know she'd like that I can have the nurses sign and give to her tomorrow.

Seems simple - a thank card but, honestly, I probably wouldn't have thought of it before your post.

Thanks!

I work in med/surg on a floor that has a max of 48 beds.
We have a very low turnover. We lose nurses when they move away from the area, retire, or decide to be stay at home Moms. We have not lost a single nurse in 1 1/2 years. None of our new grads quit. One is moving to another unit to get off of night shifts, but she would have stayed if a day shift was available on our unit.
Here are the perks that retain nurses where I work.
Max of 5 pts per nurse every shift. Days and evening have CNA assistance, Night shift has no CNAs.
A nurse manager that allows creative scheduling. For example: If I decide or need to work Tuesday instead of Wednesday and the number of nurses scheduled is above 8 I don't need permission to change my shift. This only applies to weekdays of course.
Full benefits at 24 hours per week.
No mandatory overtime.
A good hourly rate. We have 2 former computer engineers on our unit that switched to nursing because the pay is better.
A positive environment on the unit. Nurses actually help each other and are kind to each other as well as the pts.
An overlap nurse that works from 1000 am to 7 pm who does the admission and initial assessment on ER admits and fresh post ops before handing the pt over to regular staff.
I am the lowest in seniority with only 1 year and 7 months on my shift (days). Many nurses on my shift have been there 15 years or more.
The solution is simple.
Pay people a competitive wage for the city they live in with regard to all professions.
Give people flexibility and choices for scheduling and number of hours worked.
Provide benefits at a lower number of hours to retain mothers and older nurses who need to spend less time at work.
Work on creating an atmosphere of team work and kindness toward other nurses as well as pts. A helping hand can make the worst shift bearable.
Provide an overlap nurse for high census days when regular staff are too busy to admit new pts.
I know that this is shooting for the stars in many hospitals, but why not try?
I love med/surg, but I don't know if I could handle some of the conditions that many nurses have to deal with.
I used to have to take 8 pts and "cover" for the pts of LVNs and it was hell.
I am a firm advocate of "voting with your feet" if you are able to. A hospital that loses its staff to a better run facility is quicker to change.

You know, here's the thing... I'm currently doing psych nursing. I miss certain things about Med/Surge. I miss doing dressing changes. I miss placing foley catheters. I miss educating patients on how to care for themselves. I miss placing IV's. I miss being on my feet all of the time, and being busy. I have considered going back to M/S many times in the past eleven months that I've been in psych because I miss all of those things.

Here are the reasons why I have not done that:

--Disrespectful doctors.
--OVERWHELMINGLY acute patient loads.
--"Feast or famine". Very rarely STEADY, like I like it. Either overwhelmingly busy, or nerve-racking-ly NOT busy... in other words, waiting until the storm is going to hit!
--Overall terribly stress filled ATMOSPHERE.
--Cattiness of coworkers.
--No diversity in med/surge. I've found that med surge is about 99 percent white women, at least where I live. Drives me nuts.

Which leads to the things I love about the psych hospital where I work. First of all, doctors are employed by the same agency that we nurses, MHT's are all employed by; and therefore they must be respectful of us or face the consequences. VERY diverse employee population... blacks, whites, Mexican's, Jamaicans, Indians, etc.., and lots of men as well as women. Laid back atmosphere.

So... VERY hard for me to want to go back to med surge. I actually miss that type of nursing though, as far as practicing those skills... and I miss those patients enough.. that I'm thinking about going back and doing it about one shift a week, or every two weeks. Full time though? Ehhhhh... no.