Comprehensive Medical Surgical Floor

by_stander22, LPN · Feb 24, 2009

I don't know what to call it but count me in. I was previously working on that kind of med-surg floor. Well, it's a common thing. Those things that youve mentioned are interrelated in some ways. OLd and young alike get sick and the first thing they'll do is consult to a medical doctor in turn finds out that the patient needs surgery then co-manage with surgeons. Cardiac drips are common in a med-surg floor especially patients trans out form the CCU and ICU and those elderlies with terminal illnesses. And absolutely, there are also psych patients but just seldom like patients who attempted suicide, alcohol and drug addicts who needs medical attention first than psych consult. It's really a variety and that makes it hilariously exciting.

chenoaspirit, ASN, RN · Feb 24, 2009

That describes the floor I work on (minus the telemetry, but they are planning on adding that soon). We get EVERYTHING, especially the ones that no other floor wants to take. The psych floor refuses to take the withdrawal patients. We even get pregnancy on our floor, withdrawals, broken bones (even though we have another floor that is ortho), etc.

HouTx, BSN, MSN, EdD · Feb 24, 2009

Sounds like a very interesting place to work. However, it probably doesn't really make any difference what it is called or "classified". What matters, from an administrative standpoint is the CMI (case mix index) which determines reimbursement levels.... high CMI= high reimbursment.

Or, are you asking because the classification is an important consideration for a labor agreement?

hdhnurse · Feb 25, 2009

Our hospital is a critical access hospital and we only have three floors. The first floor is OB, the second is the Med-Surg and the third is geriatric psych.

But on the med-surg floor we get everything as I have mentioned. We even have ventilators but no ICU. It is not uncommon to have gtts. ( cardizem, dopamine, levaphed, insulin,etc.) and still have a load of 5 or 6 other patients.

I am curious to know how many other med-surg floors are like this and if there are a lot why do they not have a unique classification?

We are treated like the red-headed step children of the hospital. Admin. thinks it just med-surg so how hard can it be? "You know it's not like ER where there are critical patients." Hellllllooooo! Most of my critical pts. come from ER with no BP, lungs full of fluid and about 15 minutes away from coding....then I get to discover that the ER nurse didn't start an IV because it "wasn't ordered":angryfire

I guess I am looking for a way to get people to understand that not all med-surg's are the same. Therefore a different classification of the med-surg title would help.

By the way, we found out the other day that Admin. ordered pizza and drinks for the OB dept. because they had a very "busy day"

Let's see......the last time that we had a 9:1 ratio on our floor with several criticals and nurses working 16-18 hours to help out we didn't even get a thank you from admin. let alone pizza.

The ED gets little "thank yous" from admin on occasion also.......med-surg gets grief because no one has any earthly concept of what we actually go through in a 12 hours shift on that floor.