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?

I felt I needed the baiscs before I could move on to a critical area (I did 5 years med surg before taking the training). And I am glad I did it. I worked ICU/CCU for 2 years, and went back to ward nursing.

I didn't like the anxiety from the families. The "YOU ARE HERE TO FIX MY MOM. WHY ARE YOU NOT WORKING HARDER TO DO SO???". And you get lots of ungrateful people in ICU. Trust me. The first patient I extubated called me an effing c word. Or the guy who had been beaten by his drug dealer- I had to put a mask over his trach so he wouldn't shoot sputum balls at me. People who are jerks on the ward are generally jerks on other units. They just can't tell you that when they're doped up on M&M.

And I learned that you need to not separate yourself from your patients in that area. Because of all the machines, it's easy to do so. You sometimes look at your patients in systems, rather than as a living, breathing, feeling individual. Maybe it's because I've been nursing a bit longer, but I found it wasn't the end all be all that some new grads think it is.

Either way, good luck.

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And by the way IT IS Med Surg….NOT Med/Surg look it up. .

Ruby told you that it's "Med Surg" and not "med surge".

The "/" is a matter of taste, but either way is correct (Med Surg or Med/Surg), though the latter option makes more sense (Medical/Surgical ward denoting medical and/or surgical versus just running the whole thing together). Some people get really crazy and go with "Med-Surg". Whoaaa!

I'd have to agree with those who have previously posted. ICU nurses (good ones, anyway) know how to assess a patient and not rely on a monitor. Med/Surg nursing teaches you how to do that...because there are no monitors (or very few by comparison).

Also, if you think managing patients and the flow of information/people on a regular floor is a lot, just wait until you get to intensive care. Sure, it's only 1 or 2 patients, but the info burden as far as getting into the specifics is much greater. If you can't cut it in Med/Surg, you will probably struggle in ICU.

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Ruby Vee, SoldierNurse22, and GrnTea…thanks Profs for the corrections…now kindly buzz off. I rather you don't respond to my posts. I have no interest in arguing about spelling errors. As I said before my auto correct automatically switches 'med surg' to 'med surge'. That is what I pointed out. But please go away. I don't have time for that. OMG seriously…kick rocks…I rather not hear your responses. I wish there was a blocking icon…I would have blocked you busy bees like yesterday.

Hey to the other posters out there sorry for the unpleasantness from these previous posters. I rather stick to the point at hand.

Lol, this is so funny. For these posters, why don't we start a spelling and auto-correct thread so they can nit pick and vent to themselves over there instead of doing it here. They are swarming like bees. In fact you bees can start a club about those who have been booted from HoneyBeGood's posts.

You can continue to post, but just know you are unwanted.

I am trying to be good. Seriously people.

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There is a blocking option. Account > Dashboard > Edit Ignore Options. I don't believe it allows you to block things "yesterday", but it's there just the same. Feel free to use it.

I won't speak for myself, but GrnTea and Ruby could probably retire twice given the years of experience between the two of them. Your loss if you choose not to heed their advice. They, more so than you, have no need for correction.

If you can't handle the feeback, don't post on a public forum.

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Specializes in Critical Care, Education.

Hmm I am sensing a disturbance in the force .... AN'ers ramping up the negativity. I hope it's tied to phases of the moon, pre-Superbowl jitters or something and dissipates quickly.

I jumped right into ICU from school (neuro-trauma) and thrived there... Critical Care is my 'home'. But, of course, I did this back when the Earth's crust was still cooling... right before AIDS reared it's ugly head. Great timing, huh?

Based on my eons as an ICU educator, I have come to believe that in order to be happy in CC, a nurse needs to be quick - able to grasp/analyze large amounts of information & make decisions very rapidly. This has NOTHING to do with intelligence. Some of the smartest people I know are deliberate thinkers who need time to reflect and mull things over before making decisions. CC is an environment that is best suited to nurses who are kind of arrogant and operate from an innate sense that they are masters of their environment. Their (our) natural tendency is to 'take charge' ..... I recall one study that concluded that (female) tenured ICU nurse personalities tended to be much more androgynous than those in other areas. A wonderful mentor once told me "you can always tell a Critical Care nurse . . . but you can't tell them much" True Dat

I am NOT saying that this type of personality is better - just that it is very common in ICU nurses. It certainly does not work well in environments and settings where you need to be more collaborative and adaptive.

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HouTx,

thanks for the post. I would say I have that type of personality. I know going into ICU will be no cake walk. It will be hard but it will it better. That was a good post.

Sorry for the negative vibes.

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As a dyed-in-the-wool critical care nurse who now uses those autonomous, decisive, androgynous tendencies in other areas where they prove useful, I can tell you that someone with little experience in the milieu coming in and telling us old bats where to get off is not going to have a lot of fun in our sandbox trying to do the work that we do.

You don't have to like it, but you will have to learn somehow. Crying "NETY, NETY, NETY" will neither make your point nor convince us of your ability to function in the environment, med/surg or no.

But alas, I am blocked from your eyes, so you will never hear me say so. Until we meet professionally. :) That will be interesting.

GO PATS! Oh, wait. They have ... gone. Well, wait'l next year.

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Specializes in Pediatrics, Emergency, Trauma.
Wow Esme 22:1, that is insane, that sounds more like a LTC or ECF.[/quote']

Indeed...I currently work in LTC, and supervise/resource 60 pts, two nurses, and 5-6 CNAs as a "new" RN.

I've sent residents out due to my assessment skills: one found new onset CA in the bowel (presented with fatigue and RLQ warmth), new onset A-Fib (Dementia patient c/o back pain, narrow BP) and intervened to help with early signs of acute illness, especially COPD exacerbation.

I have managed pts with mental health issues in crisis by using positive confrontation as therapeutic communication when one pt decided to threaten "harm" to themselves; which was born out of fear of a past narcotic addiction and new pain from surgery, including a end stage liver failure and breast CA diagnosis; this pt's prognosis has changed for the better, as well her disposition within months; it was a joy to be teary eyes with her, as well as be a voice of reason and encouragement, even on her "worst"days.

I'm glad to have honed those skills; these skills were sorely missing when I went into PICU a year ago as a new grad; I will return one day to CC with those skills well honed for the benefit of that population.

Good assessment skills cannot be lacking when you enter CC, or any area of nursing for that matter; an pt's "issues" are not separate from your patients. :no:

We treat pts HOLISTICALLY, so even our assessment skills for the out of compliance pt, or the family dynamics for an aging pt is still considered. We treat people in their most crazy, out-of-control gutter to skid row rock bottom vulnerable times; we have be sure to hone in on those areas we can assist them in dealing and healing with...we are in the "healing management" business after all-from cradle to grave.

What I suggest to you is learn those assessment skills, lean how to home those interventions with the non compliant drug addict; the crotchety brittle diabetic who is losing their leg, the bi-polar individual who had a near death experience during a mania or a depressive state, or the young person with new onset dementia, that feels that they are slowly losing their mind and also has an electrolyte imbalance and possible malnutrition. Out pt's give us the knowledge that we need to better serve our pts and our community everyday in all settings; nursing is nursing, wherever out niche is.

It is QUITE a (wonderful, at least to me :) ) learning experience, especially when one looks at a Wolf Terrier Foxtrot patient, takes a deep breath, and puts the imaginary nursing cap on, to help the pt and maintain sanity, lol. ;)

It also makes us better nurses.

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Specializes in ICU/PACU.

ICU is overrated.

It's not easier than med surg it's just different.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Ruby Vee, SoldierNurse22, and GrnTea...thanks Profs for the corrections...now kindly buzz off. I rather you don't respond to my posts. I have no interest in arguing about spelling errors. As I said before my auto correct automatically switches 'med surg' to 'med surge'. That is what I pointed out. But please go away. I don't have time for that. OMG seriously...kick rocks...I rather not hear your responses. I wish there was a blocking icon...I would have blocked you busy bees like yesterday.

Hey to the other posters out there sorry for the unpleasantness from these previous posters. I rather stick to the point at hand.

Lol, this is so funny. For these posters, why don't we start a spelling and auto-correct thread so they can nit pick and vent to themselves over there instead of doing it here. They are swarming like bees. In fact you bees can start a club about those who have been booted from HoneyBeGood's posts.

You can continue to post, but just know you are unwanted.

I am trying to be good. Seriously people.

Someone needs to grow up, learn to use the ignore option and get over themselves.

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ICU is overrated.

It's not easier than med surg it's just different.

I don't know about overrated. I always used to say I didn't mind working hard all shift, but I sure hated running up and down hallways. At least in ICU the opportunities for long walks were limited to trips to CT and OR. :)

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Mad surge, meh surg, med shuck, Moot?

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