med-surg..the "trailer trash" area of nursing??

[nightengalegoddess]

Hi. This is a wierd philisophical question. Tonight, after a particularly crazy night on med-surg tele; the kind of night where you feel as if you are just tasking all night, putting out fires, admininstering pain meds q 2, and don't get to charting until 0400.......a tech who is a nursing student said something very thought provoking to me. "You are really smart. Why in the $%*& would you work in a med surg unit if you have the smarts to work in the ICU? ". I think he was referring also to the fact that he was completely flustered all night as well......not even a moment for him to find out why many of his charges were even there!

Usually, especially with the nursing student techs, I try and take time out to quiz and question them regarding issues and body systems and clinical judgement so that they can sort of get some learning while they are doing the endless tasks. But tonight, there was absolutely no time for that except once. I understand the frustration from him. But his comment got me thinking. WHY AM I just content to work in Med-Surg? Yes, I have higher aspirations and am starting my BA....dreaming of holistic nursing if I can get my masters before I'm dead...( I am almost 50 and didin't start nursing till I was 45). I haven't been moving on much since then because I've been raising my son who is now almost 18...I was thrilled that I could just start working nights as I've always wanted since my boy is now very self sufficient! That alone was a big boon for me!

I guess my question is.....how come med-surg is so much less respected than the other specialties in nursing? It seems to me that it is equally important, and if the job is done right; demands a great amount of critical thinking, organization/prioritization, and really the highest degree of nursing process utilization because you are managing 6 patients at the same time. I tried to explain this to the tech, but he still felt that med-surg is the "trailer trash" area of nursing. I am even thinking of getting certified in Med Surg Tele while working through my BSN because it seems to me that everywhere needs med-surg nurses!

Hope my question is clear. What do you all think???

[RN-Ella]

i started as a new grad in the er, and it is not boring at all. Med/surg is the same type of pt, telemetry is the same type of pt, icu is the same type of pt, in the er we get ALL those pts, so i take offense when someone says "i dont just stabilize the pt, but i get them better" actually we get the pt stabilized in the er and get them better, we do everything, the pt is all ready for you when it goes to the floor, all blood work, tests, iv access, critical meds, etc have already been done or started.

On the other hand, i do admire the nurses on the floor bc they do have 5-6pts and they are usually the pts that although not critically ill are the ones who take the most time cause they are walkie talkies, and demand a lot of attention. ICU nursing is completely different, there is a reason why those pts are going to icu, they need to be monitored all the time, yes not all of them are on vents, but the majority are, or they are on all these cardiac drips that well...usually were started down in the er....lol...just had to add that in.

Bu

[wooh, BSN, RN]

dh07..

Of course it's an ICU bashing session. It's M/S nurses venting about the ICU "snobs" that think we obviously have never been to your side if we don't see how obvious it is that ICU nurses are smarter and work harder than we do. (Guess what, some of us HAVE been there, and decided we like working elsewhere better!)

I'm glad you found your niche. If the floor isn't for you, get off the floor. But if you can't handle one thread of ICU bashing, imagine what it's like for us on the floor. Constantly having people say stuff like, "You need to start on a floor before you go somewhere more acute" or "to a specialty." I'm sure you think your world is exciting and fun. I think if you can get to where you're actually a good m/s nurse instead of one that's just doing their time until they can go where they really want to go, it can also be exciting and fun. Frustrating as hedoublehockeysticks, but still exciting and fun.

So if you can't handle the heat of some floor nurses sticking up for each other, go hide behind your locked ICU doors, and we won't be able to get ya. But let us have our vent.

[xtxrn, ASN, RN]

why isn't it good if the pts have 'croaked'?

at least they can't fill out the surveys.

but i could.

leslie;)

Yeah- but their families will

[Always_Learning, BSN, RN]

Although I love working in my area (ICU), I don't feel the need to diminish other areas of nursing just because I don't happen to work there. Because the fact of the matter is, I would probably drown in med-surg - with 6, 7, 8 patients, and would probably drown in ER as well.

All specialties have a unique and varied skill set, but I have seen darn good nurses in all of them. I am particularly envious of the organization and time management that great med-surg nurses have; I have learned a lot from them.

[Penelope_Pitstop, BSN, RN]

It was the same, boring, repetitive routine every shift.

Come and hang out on my floor. I have never had two shifts alike, even if my patients were all the same. I have a "boring" shift maybe six times per year! All kinds of ages, races, medical histories...the other night I had pts with: spina bifida (freshly extubated, too), a change in mental status of unknown origin, end stage bladdder cancer, acute on chronic renal failure, and hypoxia secondary to alcohol withdrawal.

That's quite the variety of diagnoses, no? I was a busy bee!

[amarilla, RN]

so i take offense when someone says "i dont just stabilize the pt, but i get them better" actually we get the pt stabilized in the er and get them better, we do everything, the pt is all ready for you when it goes to the floor, all blood work, tests, iv access, critical meds, etc have already been done or started. Bu

What area of the country do you work? I work in an east coast level one and our ED sends anything and everything, appropriate or not, to the floor. Blown IVs, dry drips, uncleared spines, open wounds, missing meds, blood orders 9+ hours old, abnormal EKGs (but no tele and no recent rhythm strip) etc. The patient isn't 'all ready' when they come to me; they are momentarily stabilized and now are (likely) going to be seen by surgery, get their testing and go to the OR....now. I'm not sure what lovely unit gets all 'walkie talkies'; most patients I get are in pain, vomiting, diarrhea, bleeding, bedbound, disabled, obese, or elderly. Add fresh post-ops - vascular, ortho, gastro, GYN and onc - into that mix along with trauma, psych and medical overflow.

If you missed the point of this thread, it's exactly this type of assumption - hey, we specialty nurses do all the work and your patients are all stable, what's the biggie? - that infuriates MS nurses.

Please come to the floor and take my 8+ ER messes / postops /overflow pts and we'll talk afterwards. Until then, kindly don't step on OP's vent.

OP, hold your head up. Other people may not understand but you know if this warzone is for you! Other MS nurses feel your pain, (but we don't take the @*@&, either. ).

[brandy1017, ASN, RN]

I don't like ICU because of the constant alarms, noise, chaos and also they tend to get mandated more than the rest of the hospital because they are so "special and important".

I don't think I could do OR or cath lab because I find it difficult to stand for long periods of time, my legs and feet start hurting if I'm standing still, also hot, have to pee, or you have an itch what do you do?

I've thought long and hard about what else I can do in nursing and I still haven't come up with another option than what I'm doing. I have friends in insurance and they say it is so much better, decent working conditions, weekends, holidays off, etc ie your treated like a human being not a robot! But I didn't want to work for some insurance company that was trying to deny care to its people.

Now even if I was willing to reconsider, I figure if the health reforms go thru insurance will be once again cutting costs and nurses will be laid off to save them money.

Going back to school is too costly and I'm not young enough to be able to pay the loans off before I would retire.

All I want to do is to pay my house off, have a little money in the bank, and find a job with decent working conditions. I was on light duty once and was a "helper" It was a nice job, real breaks, real lunch, not all stressed out because you weren't responsible for any patient, just helping out. Of course they would only let you do that for light duty if work related, otherwise your out of luck.

I just wish work was like that, but as so many of you know it is totally the opposite. They understaff to save money and your lucky to be able to eat, let alone take a break and just feel rushed, stressed and exhausted all the time. Everyone is pulling at you at once and your expected to do everything that everyone else refuses to do.

I don't LOVE my job. I'm not going to say how its so hard and terrible, but I really love it. That is insane. I think if staffing were better I could like my job. I enjoyed that time on light duty when I wasn't being worked to death.

Frankly I'm really surprised we don't have lots of nurses out on stress disability!

[whereslilly]

I had the fortune like most nurses from my era to cut my teeth in med-surg. I loved it because I learned so much! I guess I just really liked it?? I moved on to critical care because I moved on to another hospital that offered housing in NYC. The recruiter encouraged me to take the job in critical care as I had 2 yrs med surg experience. So I did..I liked that too. Yes, it was different but I definitely still learned a lot and worked very hard. As far as my experiences with Nurses judging one another: I have seen this going on since I looked good in a mini skirt.. ER nurse think they are better than Med-Surg nurses and ICU nurses. ICU nurses think they are better than ALL floor nurse and ER nurses. OR nurses think they are better than Med-Surg nurses, ICU nurses, ER nurses. Med-Surg nurses, ER nurses, ICU nurses hate same day Surgery nurses..(they have the best hours).:rolleyes: :yawn:

[healthstar, BSN, RN]

I just read so many negative posts about med surge and how some of you are saying that dumb nurses work in med surge, not true at all. I have met so many intelligent med surge nurses, someone who is dumb can't finish college and have 5 different degrees from RN bsn- DNP etc. I don't know where you guys work, but I work in med surge and the nurses are so smart, they never sit, they care so much about the patients, and they all are going to school for higher education. We never have a call light on, and thats bc we are in the patients room 24/7. Our floor is like a seven star hotel. Quiet, relaxing, everything under control, everybody gets along, we are like a family. No one talks smack about other coworkers. So yeah, med surge nurses are not dumb. Not everybody likes OB, OR, peds etc. Med surge is freaking awesome and nurses are respected on my floor :)

[Anna Flaxis, BSN, RN]

Med/Surg *is* a specialty! It is tough, demanding, and only SMART nurses need apply!

[StrwbryblndRN]

All nurses of all forms have something to contribute to pt's. Pt's need them all, and we need each other.

We have fantastic ICU, ER, and med-surg nurses. And we have just the opposite.

We need to accept and work with the limitations/attributes bound by our dept. We all have them but are just very different amongst us.

[anotherone, BSN, RN]

What area of the country do you work? I work in an east coast level one and our ED sends anything and everything, appropriate or not, to the floor. Blown IVs, dry drips, uncleared spines, open wounds, missing meds, blood orders 9+ hours old, abnormal EKGs (but no tele and no recent rhythm strip) etc. The patient isn't 'all ready' when they come to me; they are momentarily stabilized and now are (likely) going to be seen by surgery, get their testing and go to the OR....now. I'm not sure what lovely unit gets all 'walkie talkies'; most patients I get are in pain, vomiting, diarrhea, bleeding, bedbound, disabled, obese, or elderly. Add fresh post-ops - vascular, ortho, gastro, GYN and onc - into that mix along with trauma, psych and medical overflow.

If you missed the point of this thread, it's exactly this type of assumption - hey, we specialty nurses do all the work and your patients are all stable, what's the biggie? - that infuriates MS nurses.

Please come to the floor and take my 8+ ER messes / postops /overflow pts and we'll talk afterwards. Until then, kindly don't step on OP's vent.

OP, hold your head up. Other people may not understand but you know if this warzone is for you! Other MS nurses feel your pain, (but we don't take the @*@&, either. ).

EXACTLY. this is how we get pts from ER also and plenty of fresh post ops. Stat orders not done because, " they can be done when the pt gets to the floor" (nurse determined this, not a qualified MD/DO...........)..