Is med/surg nursing tolerable?

TheCommuter, BSN, RN · Feb 15, 2008

One of our moderators, Tweety, has been working in med/surg for many years without the apparent burnout. Keep in mind that we handle stressful situations differently and uniquely, but I think you will find med/surg to be tolerable.

Don't be fooled about the ratios in California, as hospital administrators have found clever ways to circumvent them. Many California hospitals are beginning to adopt the concept of team nursing, where the RN will be teamed up with an LVN and a CNA. If you are paired with a 'team,' you will be legally responsible for 10 patients. You'll only get 5 patients if you are not paired with a team.

wooh, BSN, RN · Feb 15, 2008

I love med/surg. But that's why I do it. I don't recommend med/surg as a place to go to learn on your way to other specialties. Yes you learn a lot. But it's a specialty all in itself. And most that you learn isn't anymore transferable than a year in ICU or ER or wherever else.

Do med/surg if you want to. But if you're only there to "do your time" and get out, don't be surprised if it feels like "doing time."

RNBelle · Feb 15, 2008

some people are of the mindset to do med/surg just for experience, others say do what you want. i say do whatever specialty you want. if you work on an oncology floor trust me you will get plenty of med/surg to go with it. actually any type of specialized floor will give you some type of med/surg experience. i work postpartum but trust me, i get heparin drips, PCA pumps and then some to keep me entertained.

Scrubby · Feb 15, 2008

Personally i wouldn't recommend it because i absolutely hated doing med-surg. I'm the sort who doesn't appreciate unnecessary interruptions,being given too much work in too little time, loathe annoying family members so it really isn't for me. I do get flustered when i'm being bombarded with too much information about too many patients and don't like constantly working under this sort of pressure. I love theatre because at the end of the day i know that i have completed my tasks, in med-surg it is rare that you can finish everything on time (btw my time management skills are pretty good, it's the environment). I have experienced job burnout from this area and would rather work in a non-nursing profession than go back there.

Miss Mab · Feb 15, 2008

Since i never did med/surg I can't specifically offer a first hand opinion.

However, and I actually think you seem to already realize this, but the reasons you list for perhaps not wanting to:

I have huge fears and doubts about my ability to tolerate it, since I suspect the following: that ratios are too high, patient acuity has increased, documentation requirements are becoming silly, pts and families are growing more demanding, hospitals tout themselves much like hotels, seasoned nurses are in short supply to serve as mentors, workplace collegiality may also be in short supply, and mandatory overtime and scheduling woes have made med/surg nursing (indeed perhaps all of nursing) less tolerable in general.
r.

apply equally across all units I've seen, including from my sole experiece in ER. The families, acuity, redundant paperwork, scarcity of mentors and on and on? It's not med/surg...it's everywhere.....

Truthfully, from reading most of your posts, and especially if you're coming out west, you may just want to apply directly with county public health departments. They actually do hire new grads--especially if you get the PHN cert. which isn't that difficult---but it's not necessary for entry level.

november17, ASN, RN · Feb 15, 2008

I have huge fears and doubts about my ability to tolerate it, since I suspect the following: that ratios are too high, patient acuity has increased, documentation requirements are becoming silly, pts and families are growing more demanding, hospitals tout themselves much like hotels, seasoned nurses are in short supply to serve as mentors, workplace collegiality may also be in short supply, and mandatory overtime and scheduling woes have made med/surg nursing (indeed perhaps all of nursing) less tolerable in general.

All of the above are true. However, if you enjoy a challenge then med-surg may be right for you. I've been working med-surg since I graduated in May 07. I had the same thoughts, "Put my year in med-surg, move on to something else." My year is coming up very soon. I've been putting a lot of thought into transferring to a different unit, or even moving to a different area of nursing altogether. However, the more I think about it, the more I can't really imagine myself doing anything else. I like it when I get the occasional medical patient, because it changes things up a bit, but otherwise after a while the surgical issues aren't really that big of a deal once you've seen several dozen of the same exact type of post-op cases.

The only thing is the "mandatory overtime," Most hospitals worth their salt don't require that. It IS nice to accept an extra shift now and then for the incentive + the overtime (at least where I work). I make $50 an hour when I pick up a shift. Honestly, I wouldn't put up with MANDATORY overtime. Then again, I work night shift and there are literally 80 openings on the night shift for RNs at the moment where I work. So they are extra nice to us so we won't leave hehehehh...They do call me almost every single day to pick up shifts though, which is nice if you don't have plans, what the heck? An extra $500 on your paycheck? Do that once or twice a month and you've just financed yourself a nice vacation...makes the whole thing more palatable (I just got back from Cancun last week, as a matter of fact).

I don't feel that I'm any closer to burnout then I was 7 months ago. For right now I'm okay with the work that I do. I think that how you handle stress makes a big difference. I actually got hired into the unit with 3 of my classmates from nursing school, and 2 of them have left already. The 2 that left didn't handle stress or acute/emergent situations very well at all. Me personally, I'm very levelheaded. I actually had a respiratory therapist complain about me the other day because I had a patient with an SPO2 of 82%, and the RT didn't think I acted "concerned enough" (despite the fact that I stuck them on a non-rebreather and immediately paged the doc for lasix, stayed with with the patient until they got up to 92% blablabla). Nothing really surprises me and nothing really shocks me anymore. I'm not a lightspeed thinker on my feet but at the same time I don't bow down to stress either. I think it is a good balance for me.

Overall I think my goal is to eventually work in the PACU. I heard it is the happiest place in the hospital :) I'm just bidding my time until a position opens up there. I'm happy with med-surg for the time being. Lots of my coworkers have been there for years and years.

Maybe you'd be a good fit for med-surg? Who knows? You have to decide for yourself what kind of job situation you'd like the most. What are your strongpoints? What are you main interests? What gives you the most job satisfaction?

I was a carpenter apprentice and roofer before I became an RN, so I was used to physically working my butt off. If you don't like to work, then med-surg definitely is not for you. If you want a good paycheck for an honest day's work then I'd certainly recommend it.

EmmaG, RN · Feb 15, 2008

Hello - I have a question re: med/surg. Below are my question and background info as to why I'm posing it.
MY QUESTION: Do you think I will burn out quickly in the med/surg environment?
BACKGROUND: I am planning on doing a year of med/surg when I graduate from nursing school (RN), to get a good foundation of nursing skills and familiarize myself with the care of a variety of diseases.
I have a Master's of Public Health degree, and am interested in becoming an oncology nurse or Clinical Research Coordinator, or working on public health programs.

I would suggest going directly into oncology if that is what interests you. Yes it's a specialty, but oncology patients have many medical/surgical issues as well so you'll get that experience.

RNperdiem, RN · Feb 15, 2008

I second what the above poster said about trying for work on an oncology floor. There is plenty of med-surg experience there, and you will get a better idea about what oncology is all about if you want to go for further study in that area.

Real, hands-on nursing is valuable and part of your education. Unless you had exceptional clinical experience, consider your first year at work as your final year of nursing school. Most of the floors have a lot in common with med/surg. Many of the floors take "overflow" from med/surg.

jessiern, BSN, RN · Feb 15, 2008

I think medsurg is a good foundation for your career. You encounter a wide variety of disorders and patient types. But, don't stay too long. A year on the floor, and I'm already severly burnt out. But, also we have been having a record year with patient load. And a couple of nurses have moved. I love medsurg when I have a load of patients that I feel like I can provide good care for (4-5 pts), but having 6 and 7 (8 on a couple of days), and don't provide safe care imo. That's the prob with medsurg, we get shortstaffed easier than most departments.

marie-francoise · Feb 16, 2008

Thank you, everyone, for your replies. It's reassuring to know that oncology nursing would give me many med/surg skills as well. Perhaps this will be my new plan - to go into oncology nursing straight out of school, as opposed to med/surg per se.

And to the poster who made the very good point about our own innate thresholds for stress - yes, I agree; the ability to remain calm despite stressful situations is invaluable. I know a pediatric cardiac transplant surgeon who is extremely relaxed/seemingly Type B - I guess he has to be in that profession, or else the job would be too much!

Anyway, thanks for all the replies.

Daytonite, BSN, RN · Feb 17, 2008

marie-francoise. . .i have lived and worked in california for many years as a med/surg nurse as well as in telemetry and as an iv therapist. i have also read a lot of your posts. i have made no bones about the fact that i think it is not a good idea for student nurses to be listening and participating in discussions with licensed nurses about what is going on in the real nursing world because as i now see, you are scared of what you might encounter yourself. med/surg units come in all shapes and sizes. the larger the hospital, the more specialized a med/surg unit is. i recommend that you find a unit that is more specialized to a particular type of patient population such as neuro patients, gi patients, ortho patients, etc. the reason is because it gives you some kind of routine to follow. as a new grad you need to be working on a unit where there is some kind of regular routine going on. you need that routine to fall back on when things get hectic as they occassionally tend to do.

do you think i will burn out quickly in the med/surg environment? i don't know where you got the idea that you have to do a year in med/surg before moving on to a specialty, but that is old school thinking. if there is some specific field of nursing you want to go into, i would really try to look for a job in that. you'll be much happier. you should start talking to lots of nurse recruiters to get more information about jobs for new grads. looking at putting a year in on med/surg would be like doing a prison sentence and i doubt you'll be happy about it no matter how good it might turn out to be because it is not what you really want to do. today, new grads are going right in to critical care units, ob and er and other specialized units and many hospitals, particularly in areas where nurses are needed, as in los angeles, are accomodating these new grads and providing the training they need to acclimate to these units.