Anyone come back to Med Surg?

Geeg · Mar 10, 2006

Acuity has increased in all pt care areas. Pt that are in today's ICU's used to be dead, and the old ICU pts are the new med surg pts. I would demand a long orientation/refresher period. Hospitals are desperate for med surg nurses, so negooootiate.

AC439 · Mar 11, 2006

I don't think Med/Surg get the same respect from the hospitals as the other units. It is always understaff. If other units need extra staff, M/S is the first to sacrifice. If there is a sudden inflood of PTs, no problem, give the PTs to M/S so nurses will have 15 PTs each.

When I was a brand new GPN, I was only given 2 days of orientation. The day I've got my license, they "upgraded" me to full PT load. I remember I always stayed till 9am after night shifts just for the fact to complete charting. When I made a mistake, they blamed and yelled at me. I personally will not reconsider M/S. Unless the hospitals seriously admit that the patient ratio for M/S has to be fixed (no more than 1:6) and they are indeed going to fix it, M/S is still a setup for failure. Sorry, this is not an advice.

Long Term Care Columnist / Guide · Mar 11, 2006

I worked in Med Surg when I first got out of school and have been in LTC for the last 3 yrs. I am thinking about going back to the hospital (med surg) for more experience ---I am also in FNP school, for the flexibility etc. I AM SCARED :uhoh21: !!!!!!! What if I can't do it? I remember how stressed I was in Med Surg when I worked there last time and I am scared of that again. I left MS mainly b/c of the hospital and they were giving us 13-14 patients a piece and I could not give the patients the care they deserved...Advice PLEASE

I hate to tell you this, but it's only gotten worse in the past few years. Patient acuity has gone through the roof---those who would have been in critical care units only six months to a year ago, are now on M/S floors, and the staffing has NOT increased to meet the demands. I left my M/S job nine days before Christmas last year............too much stress, too many physical and mental demands, too much risk to my license and my livelihood. Not worth it, IMHO.

Thunderwolf, MSN, RN · Mar 11, 2006

Ratios...acuity...my head hurts sometimes because of it.

pattchez · Mar 11, 2006

Yes, I did. I worked in acute hemodialysis and the call-back was terrible -- working 24 hours non-stop. Not all M/S units have nurse to patient ratios of 1 to 12. Where I work the nurse to patient ratios are usually 1 to 6 or 1 to 5 on days and usually 1 to 6 or 1 to 7 on nights. I know there are places where staffing is awful but thre are place were staffing is okay. With patient safety being an important issue in hospitals, I believe changes are happening to address this issue -- including increasing staffing on med-surg units. I am sorry to learn that so many nurses were treated badly on M/S as that is where I learned by excellent assessment, critical thinking skills as I had not monitors to help me diagnosis. If you are thinking about working on M/S ask questions during your interview -- interview them Ask: what are the nurse/patient ratios and what kind of patients do you usually have on this floor. Ask to talk with staff nurses and ask them how they like working on that floor. Walk around the nursing unit -- see what the staff look like ---are they smiling, rushed, ??? Good Luck and best wishes.

Goodby5 · Mar 11, 2006

I returned to Med/Surg several years ago ( RN for 24 yrs) and with each new position I take, I add to my list of things to look for if I ever interview for a new position. I have had the good fortune to work at facilities that have 1:5 or 6 ratio, and that sounds great, BUT you have to look beyond the question of the acuity of those patients ( which always high). It is often the support, or lack of it, from various departments within the hospital that can make or break your day. Ask about the pharmacy. How quickly do they respond when new orders are submitted or missing meds are requested. How accessible are they? Consider transport, dietary, housekeeping, social services/discharge planning. Do they function well? They all influence your day. Look at the assessment flow sheets. Are they efficient, concise, visually easy to access info at a glance, or are they 9 pages long requiring your full signature/date/time to be written on each page? Very time consuming. Same with policy/procedure manuals. Accessibility. How many doors do you have to unlock to access supplies, ice, paper for the printer. Are there clerks on every shift? Ask to look at the staffing schedule. Do they put patients in the hall (can't believe hospitals still do this-mine does) Teaching hospitals are more chaotic. Is the hospital working on attaining magnet status? Added to JHACO visits, this combo can challenge your sanity. I could go on, but you get the idea. Anything that can slow you down, or take time away from the patient, your ability to provide the excellent care you intend, should be looked at, then decide what you can live with. No place is perfect. Good luck.

johnson0424 · Mar 22, 2006

thanks guys for the advice...i tried to go for the ER and ICU but wouldn't take me b/c of my lack of exp in these areas so i am slated for M/S. I want to get my skills back being I am in NP school. I am scared though.

I returned to Med/Surg several years ago ( RN for 24 yrs) and with each new position I take, I add to my list of things to look for if I ever interview for a new position. I have had the good fortune to work at facilities that have 1:5 or 6 ratio, and that sounds great, BUT you have to look beyond the question of the acuity of those patients ( which always high). It is often the support, or lack of it, from various departments within the hospital that can make or break your day. Ask about the pharmacy. How quickly do they respond when new orders are submitted or missing meds are requested. How accessible are they? Consider transport, dietary, housekeeping, social services/discharge planning. Do they function well? They all influence your day. Look at the assessment flow sheets. Are they efficient, concise, visually easy to access info at a glance, or are they 9 pages long requiring your full signature/date/time to be written on each page? Very time consuming. Same with policy/procedure manuals. Accessibility. How many doors do you have to unlock to access supplies, ice, paper for the printer. Are there clerks on every shift? Ask to look at the staffing schedule. Do they put patients in the hall (can't believe hospitals still do this-mine does) Teaching hospitals are more chaotic. Is the hospital working on attaining magnet status? Added to JHACO visits, this combo can challenge your sanity. I could go on, but you get the idea. Anything that can slow you down, or take time away from the patient, your ability to provide the excellent care you intend, should be looked at, then decide what you can live with. No place is perfect. Good luck.