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

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    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???
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  3. 57 Comments so far...

  4. 15
    Med/surg has and always will be, IMO disrepected. I think it has to do with new grads starting out in Med/Surg. Every other 'specialty' requires you to have a med/surg background.
    Med/Surg is the nursing home of the hospital. Only dumb nurses work there is the feeling I get from other speciality nurses.
    Get's old, doesn't it? I too am becoming certified in Med/Surg and the studying is labor intensive.
    I could work ICU, but frankly, I would be bored out of my mind.

    Wouldn't it be interesting to say someone needed 2 yrs of another speciality before working med/surg? Would that change the mindset?

    too bad your tech feels that way.
    JoanKayRNBSN, prettymica, ChristaRN, and 12 others like this.
  5. 10
    I don't understand it either. I work med-surg tele and I love it. I plan on becoming Cardiac vascular certified and to me med-surg is so much more holistic than ICU. How can I take care of an entire patient I'd the pt is sedated and intubated? I love pt teaching, and I love seeing me surgical pt' s progress from barely able to sit on the side of the bed to doing laps around the nurses station. I know that just good IS usage can drive postop fever down. Even if a pt is dying, I can help them have a good death, and ease air hunger and provide comfort to the family. Not to knock the ICU,there are those who love it, but my heart is med-surg.
    Aurora77, JoanKayRNBSN, iloveny68, and 7 others like this.
  6. 19
    Med surg is TOUGH. It was the hardest and most challenging job I have ever had. The most challenging aspect of the job is the patients are NOT monitored. The toolbox is your assessment and your gut instincts. You constantly prioritize and lets face it when a patient goes bad you still have your other eight to nine patients to followup on after completing the transfer to ICU. I wish it would get the respect it deserves.
    Aurora77, CUMC rn,bsn, JoanKayRNBSN, and 16 others like this.
  7. 7
    I think nurses feel that anyone who stays in med-surg must not have any aspirations, because med-surg is so hard to work. Because of high patient loads, the focus often seems task oriented, so I think people think med-surg nurses don't know as much as say an ICU nurse who is calculating CO and monitoring critically ill patients. This is all BS of course, and if I were to return to the hospital (I work hospice), I would go back to med surg. It is diverse, interesting, challenging, and I owe my entire career to my time I spent there.
    Mrs. SnowStormRN, wooh, leslie :-D, and 4 others like this.
  8. 3
    Ive always thought nurses start in med surge to learn a lot. You have a lot of different types of patients there so you can gain experience. I dont think med surg is the "trailer trash" of nursing, I have a lot of respect for them, and although I havent worked as a nurse there, during clinicals in school I thought the nurses there were very knowledgable and helpful, as opposed to the very snooty nurse I got in ICU who didnt wash his hands one the whole shift, just used that stupid hand sanitizer like it was so important. (Nothing against ICU nurses, the next day I was assigned to a very wonderful nurse in ICU who went out of her way to teach me everything she could)
  9. 11
    Quote from elthia
    How can I take care of an entire patient I'd the pt is sedated and intubated?
    Easily when they cant talk back or hit the call light

    When I reflect back I really like medical. It is making me comfortable as a nurse but I dont see myself there forever. It really is teaching me a lot and wakes me up to a lot of other things. I dont mind being called names from other floors. These are usually the people that have an elitist complex anyways. Just the other night we had a fall and me and the other nurse spine boarded the person, with more help obviously and had her strapped in just fine. ICU nurse ***** walks in the room and says "wow you strapped her in horribly" not hey how is the pt or what happened. Anyways she redid everything and when the ER doc got up there, he said "man these straps are all wrong, good thing she doesnt have a head/neck injury". Yeah suck it ICU nurse *****.
  10. 6
    The ICU isn't all sedated and intubated patients believe me. You'll get the 27 yo woman with 3 kids and a very complex family, who's dying and knows it but who get's the kids? (and more) So you're dealing with the physical problems, psychological, religious, family dynamics, juggling MD's, consults, social services ... and don't let those drips run dry! Plenty to keep you busy just in that one patient plus it doesn't get more holistic than that.
    ChristaRN, ~*Stargazer*~, kessadawn, and 3 others like this.
  11. 9
    Well, here I am, 30 years in healthcare (RN for 15, got an MBA, did alot of consulting, and now run a practice, which I love doing), and I would like to offer some support about this med/surg thing. I am almost thinking that perhaps the TECH feels med/surg is trailer trash. We as nurses know better than that. There is no experience to start us off any better than med/surg. We see so much. We feel the pace. We feel the shortages. We come in on an off shift to help out. We work HARD on med surg. We learn, every day we learn. And we begin to understand the clinical culture. We learn documentation. We learn how to work well with the pharmacy and we learn what we need to do to be prepared for our doctors. We study labs. We monitor med effectiveness. We learn the importance of changing statuses and how to best respond to them. We learn how to prioritize patient care needs. And boy do we learn how to organize our work. And we build our clinical qualifications very well in med/surg. Getting certified in tele is a great idea. The point being, that all great nurses started out on med/surg so keep the focus. Branch out after 3 years or so into a specialty. Now, we won't get much support in med/surg from any other places in the hospital, but the fact of the matter is all those floors who don't support us have about 90% of their nurses who started there. Always be humble. Always feel it is a privilege to be a nurse on a med/surg floor. We can build strong, meaningful relationships with the docs we work with. Learn what they want from us, and deliver. That's my advice, and I wish you well!
    yshell12, whereslilly, NurseB_, and 6 others like this.
  12. 4
    I've worked in hospitals where each body system besides dermatology had its own floor, and in small hospitals where it was whittled down to ICU, tele/medical, and med-surg (heavy emphasis on ortho...retirement community- half of them had metal body parts )

    I loved that small hospital with the "who-knows-what-will-show-up-next" population. It was a great place to learn, and even though it was a small hospital, we had Pyxis years before the larger hospitals in MUCH bigger cities in the area. It's sad that "basics" are looked down on, when every other specialty still needs them to do their jobs. Sure, they focus on specific areas- but every specialty needs med-surg knowledge. And in a small hospital, you have to know enough of the specialty areas, because that's the only show in town. I learned more about equipment there than in a city literally 25 x larger. And, the docs were wonderful about talking to the nurses about anything weird that came in.

    I've worked neuro/neurosurg- I liked it a lot. But it was sometimes too focused, and the tunnel vision could be limiting. I'm incredibly glad I worked there, and learned a lot (first hospital job out of school- 6 months after graduating)...but a stronger med-surg background would have gone a long way

    It's sad that fundamentals are seen as inferior. Without them patients croak. Not good for satisfaction scores either
    Mrs. SnowStormRN, tokmom, leslie :-D, and 1 other like this.


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