Why is Med-Surg so hated?

Specialties Med-Surg

Updated:   Published

Whenever I have told a fellow newer grad that I want to work in a hospital, they ask 'where?' And I say 'probably Med-Surg' and then they crinkle their nose. I just want to get my start in acute care and heard that's a good place to start. One of this area's hospital groups seems to have such a hard time hanging on to RNs willing to work in Med-Surg, that they will pay *experienced* RNs several dollars more per hour than in more sought after specialties. Is Med -Surg really so terrible or different from other acute care floors?

Specializes in ICU / PCU / Telemetry / Oncology.

I dislike med-surg because the ratios are always high. Rarely do I get less than 5 patients at a time. Thank God for my training in telemetry as it is my saving grace for getting a lower ratio than for non-monitored patients. I actually enjoy seeing patients' rhythms on the screen as opposed to walking in the room to see if they are breathing (I still check on them in the room but at least that is not my only guideline). By year's end, I hope to be in a different specialty.

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I think some ppl view it as a starting point, bc it's so physical it would hard to be a retiring time job when one is older. The social aspect can be hard for some, some of these people are here so often they work the system, while management is pushing for hotel customer service. Add that to an increased acuity level, and it can be tough.

BUT

It's that toughness that will make you stronger. I've been working med-surg for about 5 years, i'm gearing up for a switch, but it def took me some time to feel comfortable managing it all. I work on a 36 bed unit, and often charge.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
isis07734 said:
I think some ppl view it as a starting point, bc it's so physical it would hard to be a retiring time job when one is older. The social aspect can be hard for some, some of these people are here so often they work the system, while management is pushing for hotel customer service. Add that to an increased acuity level, and it can be tough.

BUT

It's that toughness that will make you stronger. I've been working med-surg for about 5 years, i'm gearing up for a switch, but it def took me some time to feel comfortable managing it all. I work on a 36 bed unit, and often charge.

What's a "ppl"? What does "bc" mean? "Def"?

Med/Surg is a great starting point. You see a lot, and you can learn a lot. It's a great place to learn time management, to see a lot of different disease processes and it's a wonderful place for a new nurse to learn what aspects of the job she loves, which she hates and which she barely tolerates.

I started in Med/Surg and found out that oncology fascinated me, so my next job was on an Oncology/Hematology floor. When I burned out on Oncology, I remembered my second love -- cardiology -- from my days on Med/Surg and spent the rest of my career in CCU and CTICU. I don't regret for a moment the time I spent learning the basics on Med/Surg. As you say, it makes you stronger -- as a nurse, as a time manager and as a person.

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Not sure if your serious..

People, because, definitely.

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*You're

(phone typing)

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Specializes in Emergency Department.

Amen to that!

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Specializes in Cardiology.

I like my cardiac stepdown but it can get crazy at times, especially on days. You can blame upper hospital management and the government for making med/surg so miserable.

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I'm an NA, currently in nursing school, and I work on a med-surg floor. The nurses have 4-5 patients until 2300, then have 5-6 patients until 0700 (meanwhile the NAs end up having 11 patients from 2300 until 0700.) The acuity of our patients seems to be going up and up, with no more staffing. Most of our patients require some significant medical care, as well as moderate assistance with ADLs. A lot of our patients probably would benefit from being in an ICU step down unit instead of med-surg. I have learned a ton being on med-surg, but I will be looking at other departments once I become an RN.

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Specializes in ED, med-surg, peri op.

So in America do you only have med/surg floors? Not seperate floors for surgical and medical.

In my country medical is a seperate floor, which is very similar to what you guys med/surg seems like. High turn over of staff. Always short staff. High pt load. Like of basic nursing care. Dumping ground of the hospital. Which I will never work in.

Where as surgical is much much nicer. More staff. 5 pt load max, Sometimes less that that too! Pt are post op and often requires acute nursing. You learn so many technical skills as well as knowledge. This is what I'm passionate about. Always busy, lots of variety, constant learning. But you get to know you pts too and see there journey of just having surgery to starting to recovery and able to go home. You often get to see there health improve and what a difference the surgery will make to them. It's a rewarding feeling when you've had a pt for 2-4 days go home happy and in good health, plus they are normally very appreciative of you.

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The US system is mostly about ship 'em in/ship 'em out to minimize the cost of care, therefore even ostensibly specialized areas like cardiac telemetry get a lot of "junk drawer" med-surg overflow (the frequent-flying CHF/COPD exacerbations, LOLs with dementia admitted for altered mental status/UTIs, etc.) because the top priority for administration is to find a bed, any bed.

My previous employer had three units that were designated med-surg. The unit I worked on got the most surgical patients of the three, and we were designated the surgical/ortho-neuro floor, but we still got overflow.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Nzrnsoontobe said:
So in America do you only have med/surg floors? Not seperate floors for surgical and medical.

In my country medical is a seperate floor, which is very similar to what you guys med/surg seems like. High turn over of staff. Always short staff. High pt load. Like of basic nursing care. Dumping ground of the hospital. Which I will never work in.

Where as surgical is much much nicer. More staff. 5 pt load max, Sometimes less that that too! Pt are post op and often requires acute nursing. You learn so many technical skills as well as knowledge. This is what I'm passionate about. Always busy, lots of variety, constant learning. But you get to know you pts too and see there journey of just having surgery to starting to recovery and able to go home. You often get to see there health improve and what a difference the surgery will make to them. It's a rewarding feeling when you've had a pt for 2-4 days go home happy and in good health, plus they are normally very appreciative of you.

In America, it depends a lot upon the size of the hospital. Smaller hospitals have Med/Surg floors; larger hospitals have Medical Oncology and Surgical Oncology, CCU Step-down, Cardiac Surgery step-down, General Med and General Surg, and various specialized medical and surgical floors. Staffing is more or less dependent upon which specialty makes the most money. In one hospital CCU and Cardiac Surgery were the profit centers -- they got the latest equipment and the best staffing. The next hospital was well known for oncology and CCU and Cardiac Surgery were crammed together. I suspect that even in your country, there is some variation of that going on. In the next city, Medical may be nicer and better staffed.

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Specializes in ED, med-surg, peri op.
Ruby Vee said:
In America, it depends a lot upon the size of the hospital. Smaller hospitals have Med/Surg floors; larger hospitals have Medical Oncology and Surgical Oncology, CCU Step-down, Cardiac Surgery step-down, General Med and General Surg, and various specialized medical and surgical floors. Staffing is more or less dependent upon which specialty makes the most money. In one hospital CCU and Cardiac Surgery were the profit centers -- they got the latest equipment and the best staffing. The next hospital was well known for oncology and CCU and Cardiac Surgery were crammed together. I suspect that even in your country, there is some variation of that going on. In the next city, Medical may be nicer and better staffed.

in my country we have general med, general surgical, A&E, peads, maternity, Operating theatre, pacu, dosa are in all hospitals and then speciality area are dependant on the skills of the doctors. We have free health care, so isn't about what area makes money. But we do have a doctors shortage. So each hospital has to have enough doctors trained in certain areas to be able to offer services. So our wards like mapu, Sapu, Hdu, Ccu, gynaecology, oncology, orthopaedics ect are dependant on them. And if a hospital loses to many doctors in a certain area than aren't replace the ward sometimes gets close down. But yeah it does vary from hospital to hospital. Big cities get more funding and attract more staff. So more wards. But medical will always be the worst ward to work in.

But the doctors shortage is really good thing for nurses though. We get used to full the shortage, so lots of oppurtunities. For example nurses recently are able to get prescribing rights after taking only 1 post grad paper in pharmacology and completing a few hours of observed prescribing. No long just for nurse practitioners.

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