Tips On How To Be An Extraordinary Med-Surg Nurse

Medical-Surgical nursing is the largest specialty area in nursing. Many nurses start their nursing career in Med-Surg, acquire excellent clinical skills, and then move on to other specialized areas. Others, like myself, enjoy the myriad of medical conditions on the Med-Surg floor and thrive in that environment. Specialties Med-Surg Article

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Tips On How To Be An Extraordinary Med-Surg Nurse

What are the advantages of being a Med-Surg nurse?

Med-Surg nurses develop a broad knowledge base of many different medical diseases and conditions. They are able to execute excellent patient teaching based on this knowledge. They are often highly skilled in assessing small changes in a patient's condition that can prevent more serious problems from developing.

What are the disadvantages of being a Med-Surg nurse?

The Med-Surg floor is sometimes insanely busy. The floor is often short-staffed and the turn-over rate is high. Long hours, high acuity patients and hospital politics can lead to burn out if you do not pace yourself.

What qualities should a Med-Surg nurse have?

The ability to leap tall buildings in a single bound! OOPS, Sorry! That is SuperNurse, 'er...umm...Superman. Seriously though, the most important quality a Med-Surg nurse should have is a sense of humor. You will face things that will be much easier to stomach if you can laugh about it. Secondly, a sense of confidence can put your patients at ease and let them feel as if they are in excellent hands (which they are, of course!). The ability to prioritize and manage your time wisely is also important. Remaining professional and courteous even in times of high stress is a must for any nurse, but especially in Med-Surg.

What types of patients are admitted to Med-Surg units?

Your patient load can vary from simple 23-hour observations to chronic (frequent flyer) patients with multiple medical issues. Common medical conditions that patients are admitted with are the following:

  • CHF
  • COPD
  • Diabetes
  • Pneumonia
  • UTI
  • Pancreatitis
  • Mental status changes
  • Abdominal pain
  • Fever
  • CVA/TIA
  • Cellulitis
  • Falls/Fractures
  • Drug overdose
  • Alcohol Withdrawal
  • Chest pain
  • MVA's
  • Cancer

What essential supplies should a Med-Surg nurse have in her pocket at all times?

  • Black ink pens
  • Something to write on
  • Scissors
  • Tape
  • Pen light
  • Chapstick
  • Alcohol wipes
  • A lucky charm

How can a Med-Surg nurse stay focused and organized throughout their shift?

I find that the acronym ADPIE helps me stay on top of everything I need to do.

  • A: Assess my patients
  • D: Determine what I need to do for each patient to keep them safe, comfortable and content while they are in my care.
  • P: Plan HOW I will do this for each patient.
  • I: Implement my plan for each patient, and share with each patient what the plan will be.
  • E: Evaluate that plan periodically throughout the shift.

A lot of times, things will not go according to plan, but at least if I am dealing with a critical issue with one patient that takes a lot of time, I know that I can get back on track quickly with the rest of them when the crisis is over.

What are the signs of burnout in a Med-Surg nurse?

Burnout is always a risk when you are dealing with both acute and chronically ill patients. Recognizing the signs of burnout are very important. If you start to experience any of these symptoms, deal with them right away by scheduling vacation time, avoiding overtime shifts and getting adequate rest.

  • An overwhelming sense of anxiety
  • Uncharacteristic negativity
  • Nausea, diarrhea and stomach cramps
  • Exhaustion and fatigue
  • Lack of motivation and focus
  • Being short-tempered
  • Being sarcastic and critical
  • Having trouble sleeping
  • Dreading coming back to work on your days off
  • Obsessing over work even on your days off
  • Frequent headaches
  • Body aches and pains from tension

How can Med-Surg nurses avoid burnout?

First and foremost, leave work at work. Try not to worry about patients when you are not at work. On your days off, schedule "me" time, if at all possible. Play with your kids, spend time with your family, pursue a hobby, get a massage. By nature, nurses are passionate people. Nursing is physically, mentally and emotionally draining. The days we spend away from our job should be spent fulfilling our needs and the needs of those we love. We must reserve some of our passion for something besides caring for the needs of our patients. Once you do that, it becomes easier to find a work/home balance that works for you.

Registered Nurse

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This article is great,i see my job in whole new light now. Good advice too. Thanks

I have to laugh as a nursing instructor. ADPIE is the Nursing Process; Assessment, Diagnosis, Planning, Implentation and Evaluation. Everyone laughs and says "I'll never use this". You have proven my point, we don't take the time to teach you something, "just because". There is truely a method to our madness. Thanks for your article.:redbeathe

well said. i'l try to put in mind what you've said. it will be of help to me. thanks

Thanks for the great lessons and tips I learn from this article.

Specializes in Med/Surg Unit, ICU,OR.

thnx for your article. I'm also a MS nurse

Hi, I really enjoyed reading your thread. I have worked in Med/Surg for almost 9 years. I loved it except when telemetry became mandatory! One class does not make a med/surg nurse a competent cardiac nurse. You might have a patient on tele once a month and your supposed to remember all that you learned in that class?

I need advice and I think you may be the right person to ask but I'll take it where ever I can get it! I haven't worked since 7/07 except for a job from hell in 9/07 until 10/07. I don't like to just quit but the job was NOT what was presented to me. The floor was understaffed, my preceptor was Charge Nurse so she couldn't help me, and they had me covering LPN's on orientation! Now if I worked in a hospital and was off orientation I would have no problem covering an LPN. I've done it in the past. But I didn't know the computer system neither did the staff because it was new! All the medications were on the computer and your tasks. No kardex's and everything about the patient was verbal so if you had an incompetent nurse that gave you report you were screwed.

The reason I left my job in 7/07 was because the commute was horrible and it had been 5 years and I wanted to get something closer to home. Also my Grandmother was not feeling well and I lived with her so I wanted to be there for her. My job from hell was close to home but not worth it. My Grandmother passed away in 10/07 so that was also the last straw for me to leave that job. I was so depressed as she was one of my best friends. So I live with my fiance and he is very supportive. He's a doctor and makes a great salary and I also received a nice inheritance from my Grandmother. So financially I'm great but I'm worried because I am starting to dread going back to working. I know I have to because I don't want to depend on my fiance or waste my education. But my motivation is just not there. I have thought about working in a Same Day Surgery setting or Endoscopy. I'm really thinking about working with a Plastic Surgeon. I love before and afters and seeing people happy. Whether it's elective or not for example a burn patient.

I don't know what happened to me. I became really depressed after loosing my grandmother and then I just lost most of my drive for nursing. I'm not depressed as I used to be anymore but I don't exercise as much as I used to and I sometimes sleep more than usual. Yes, I know these are signs of depression but they don't occur on a daily basis. Has anyone ever felt this way and what did they do about it?

How can I get my love for nursing and my confidence back? I don't like going to shrinks, been there done that. I watched Oprah Friday about people that hate their jobs and how they achieved what they wanted. So maybe I need to focus on my strengths and make a list like they did. The advice was NOT to focus on the weakness areas but only the strengths.

Anyone out there have anything to say??????

Specializes in Med-Surg, HH, Tele, Geriatrics, Psych.

Pantheon, It takes a long time to get over the death of a loved one. I lost my mom 20 years ago when I was 19 years old. My grandpa died in 1999 and my uncle in 2005. My grandpa and I were extremely close, and his death was and still is hard on me. I miss him each and every single day. Luckily, my grandma lives with us (she has an apartment in our lower level and is still independent). Please check with your primary doctor and ask if you could be clinically depressed. A mild antidepressant might help.

You are lucky that you have a caring guy in your life. That is very important. I understand the feeling of dreading going back to work. Nursing is stressful. There are many times that we put our licenses on the line because of the administration we work under. I know a lot of nurses that feel the same way you do. I try very hard to stay positive, as well.

Honestly, I am not sure that I will still be a nurse in 20 years. I may go back to school for something else if something is not done to reform health care. I have not decided yet, but it has crossed my mind several times over the past few years. I enjoy nursing. I enjoy the flexibility, and the opportunities, but sometimes the risks outweigh the good things about the job, ya know? I feel very torn, and have for some time. :confused: You could read some of my other articles and tell that, I'm sure. :wink2:

Feel free to IM me anytime. Bugaloo

Hey Bugaloo,

You are so kind! Thanks so much for writing back to me so quickly. Also thanks for making me feel like I'm not a freak!

It just seems like my brother, sister, and my parents are fine and went back to their normal lives. My dad was her only child. She always used to say she could remember the pain from his birth and she closed down her reproductive factory after that!

I guess it's different for me because we were so close and I lived with her since I graduated nursing school in 1998. I moved in on the first floor as she and my grandfather were on the second. My grandfather had diabetes and his health was failing so that's why I initially moved in. I will never regret it. He died a year later and my grandmother said if it wasn't for me living with her she didn't think she would have made it. I'm starting to cry as I'm writing this to you. I think your right I should see my primary and go on an anti-depressant.

I look forward to reading more of your threads. I'm not sure how to IM you but I'll look into it. I always get a message on my AOL that I had a reply. Thanks again. You must be an awesome nurse! I hear you though it is difficult being a nurse and I think of a career change sometimes too.

It's my mother that's always building me up to go back to it. She's gotten positive feedback from people she knows that have been my patients. I also took care of her mother when she lived with us. I was only 12 years old and I cleaned out my Nana's brown crusty mouth because I couldn't take seeing her like that. I never got grossed out ever. So I know I have it in me. It's just not showing right now. Please feel free to offer me advice or anything anytime! You made my night!

I like med/surg also. There is only one problem with it and it has nothing to do with the staff, patients or families. It is the fact that managment thinks the patients are more stable than on the critical units. This may have been true 30 years ago but it is no longer true. The people are so ill, they need at least a 1 nurse to 4 patient ratio WITH support staff. IF the nurse has four patients it is OK to give one admission on that shift but NO MORE. If for some reason the nurse has 5 patient or more already then there should be no admissions assigned to that nurse. I know it sounds like a pie in the sky dream but the truth is if they ever want to get this infection control problem, these bedsore problems, these failure to rescue problems under control that is what they have to do.

Thank you. Highly appreciate it!