Is Med Surg Pre-cursor for Critical Care Success?

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Hi Guys,

Is one's success in med surge an indicator of how well one will fair in critical care? If one is not successful or not very good at med surge, will they not likely be successful in critical care?

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You edited a whole bunch out of your OP--like many paragraphs . . .

I put a long answer up there to answer all your points that you made. Now they don't make a lot of sense so I'm taking them down.

But YES I do believe that you should have some other training before ICU. Speaking from personal experience.

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Anon456,

edited my answer because I wanted a more general response. Many have their reasons for not liking med surge or liking ICU, or have their opinions on why or why not to skip med surge completely. So my detailed answer did not seem necessary. But I read yours before the edit.

Is med surg really needed? From your longer answer you talked about the emotional aspect of PICU.

On med surg I have a really good knack for separating myself from patients. Though I give great customer service, I try to make no connection to my patients and move on to the next group. Though there are those patients, even though I do my best to keep an emotional distance they pull your heart strings…those are the patients that keep me thinking in med surge…I can do this…it is not so bad.

But problem is the many needy, drug seeking, manipulative, rude, ungrateful, demanding, etc...bad ones over shadow the few good most times. So many weird, rude, and bad things come out of patient's mouths at times…I wonder why they would think it okay to tell me such things. It usually happens on the second day of caring for my patient. Part of the reason I am more inclined to work in ICU is that I won't have to have those cringing worthy, pointless, conversations, or in the ER…I may have to have those convos with patients…but I know that by the end of my shift I won't have to endure them the next day…on to the next group! We have some patients that have stayed over 5 weeks and are very demanding of staff, and non-compliant with care, some are good enough to DC but they can't because of ECF placement issues, so they like temporarily live at the hospital. And oh how they love for the nursing staff to wait on them hand and foot and when you don't they shout, yell, get rude, etc. And on top of that they have no means for paying for their hospital bill and have no intention of doing it.

PICU….I would definitely avoid. I have no desire to work with children. I know it would shake me up too much. I love kids, don't have any of my own…but seeing them sick and on the brink of death…I will have to pass. I thought I could be a peds nurse at one time till I took care of a kid in ER during student clinicals. He was so cute, but seeing the nurse repeatedly dig for a vein in his little hand without success…the kid toughed it out for a good 10min…before he started crying…made me start tearing up. I feel some kind of way when I think of it. It was a small incident…but then I knew I did not want to work with kids in hospitals. Maybe a clinic but not in a hospital.

But adults in the ICU I can handle. You cannot cure death, they say. As long as I kept alert and did everything I could and should do for my patient, I will be okay. It is hard not to get emotional but I have found ways to switch it off. My main focus on the floor in med surge is to keep my patients, stable, comfortable, and follow the plan of care and notify the doc if there are any changes, and intervene if I have to.

My main concern is med surge will teach you organization, prioritization, and multitasking…but how much does it really teach you critical thinking in terms of monitoring your patients and signs they are going down the drain…more so than going directly into ICU…where you would learn that anyway.

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Specializes in Family Nurse Practitioner.

I think they are two different beasts. I currently work med-surg, I used to work telemetry, and I hope to go into ICU someday. Define "not very good." Do you mean time management, analysis, skills, and communication? Those are all necessary for ICU, although time management in med-surg seems different than time management in ICU.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I hated Med-surg. There I have admitted it. I hated taking 22 patients with an aide and a LPN...that was the ratio in my day. I wanted more 1:1 patient contact...ICU gave me that. Med-surg helped with getting basics down for all ICU patient are sick med-surg patients. But for patient contact...I went to ICU

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Med surg does teach you how to look at a patient and rely less on a monitor in the early stages of a patient going downhill.

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Specializes in critical care, ER,ICU, CVSURG, CCU.

i started coronary care right out of nursing school, absolutly no problem, also worked ER, CV ICU, icu, neuro icu, Headnurse Er, Er Supv, director of nursing..... all very sucessful, I have lost track now maybe after my second attemp at retirement, I let the local hospital I had worked in their ER, talk me into coming back as one of those "super PRN RNs" that could work anywhere.......I HATED! YES I SAID HATE MED SURGICAL FLOOR! of course I had zero orrientation to the med surg unit. I so admire a sucessful med surg nurse, they sure have something I lack :eek:

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Wow Esme,

22:1, that is insane, that sounds more like a LTC or ECF.

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Med Surg has taught me a lot but there is so much to be undesired. I never enjoy coming to work. I am crossing my fingers and counting the days till I get on a new floor.

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Specializes in Prior military RN/current ICU RN..

I cannot and will not say anything is a guarantee. I have seen people go multiple ways and succeed. Also success is looked at totally different by different people. ME: I did 3 years med surg prior to switching to psych and I will never go back. I will say those skills I developed with assessments and just the confidence have helped me immensely. That said I have seen people "succeed" who went straight to ER or straight to CC. They may have struggled etc, but they view it as success. So for me yes 2-3 years of med surg paid off 100% and I am SO glad I did it. I am a big believer in not trying to rush the big time. However some people dive straight in.

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I dove straight in. I would not necessarily recommend it, but it worked out for me. From what I've seen, the transition for seasoned med surg nurses to work in CC is usually pretty smooth. I had to go from 0-60.

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Specializes in critical care, ER,ICU, CVSURG, CCU.
Wow Esme,

22:1, that is insane, that sounds more like a LTC or ECF.

no that was the ratio in 70s in acute care hospital.

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