med-surg..the "trailer trash" area of nursing??

[nightengalegoddess]

Hi. This is a wierd philisophical question. Tonight, after a particularly crazy night on med-surg tele; the kind of night where you feel as if you are just tasking all night, putting out fires, admininstering pain meds q 2, and don't get to charting until 0400.......a tech who is a nursing student said something very thought provoking to me. "You are really smart. Why in the $%*& would you work in a med surg unit if you have the smarts to work in the ICU? ". I think he was referring also to the fact that he was completely flustered all night as well......not even a moment for him to find out why many of his charges were even there!

Usually, especially with the nursing student techs, I try and take time out to quiz and question them regarding issues and body systems and clinical judgement so that they can sort of get some learning while they are doing the endless tasks. But tonight, there was absolutely no time for that except once. I understand the frustration from him. But his comment got me thinking. WHY AM I just content to work in Med-Surg? Yes, I have higher aspirations and am starting my BA....dreaming of holistic nursing if I can get my masters before I'm dead...( I am almost 50 and didin't start nursing till I was 45). I haven't been moving on much since then because I've been raising my son who is now almost 18...I was thrilled that I could just start working nights as I've always wanted since my boy is now very self sufficient! That alone was a big boon for me!

I guess my question is.....how come med-surg is so much less respected than the other specialties in nursing? It seems to me that it is equally important, and if the job is done right; demands a great amount of critical thinking, organization/prioritization, and really the highest degree of nursing process utilization because you are managing 6 patients at the same time. I tried to explain this to the tech, but he still felt that med-surg is the "trailer trash" area of nursing. I am even thinking of getting certified in Med Surg Tele while working through my BSN because it seems to me that everywhere needs med-surg nurses!

Hope my question is clear. What do you all think???

[johnny depp23]

Don't worry - all aides/techs think that way!

[Spikey9001, BSN, RN]

Don't worry - all aides/techs think that way!

Which is why I can't wait to become an RN and hopefully jump right into the ICU. I'm a tech/aide now in a stepdown/PCU unit and it just confirmed me wanting to go to ICU after graduation.

[DeLana_RN, BSN, RN]

I guess my question is.....how come med-surg is so much less respected than the other specialties in nursing?

I really don't understand why. I respect med/surg nurses (especially if they are dealing with tele as well), it's a specialty (yes, specialty) that I couldn't do!

I tried, once right out of school (med/surg/tele/PCU, ratio 1:8 on days), but I could never get my charting done until 2 or 3 hours after my 12-hour shift ended! (Yes, sometimes with discharges and admits there were 12 pts to chart on, and on those days I stayed 4 hours late....) I tried it once more, years later, thinking that now I would be able to handle it. Alas, I still couldn't do it. So as far as I'm concerned, kudos to med/surg nurses! You are obviously extremely organized and experts at time management and prioritizing, and very skilled (as a new grad, I wasted a lot of time having to get help with skills and procedures).

Don't let anyone put you down! I - and probably all nurses who've been there, done that - highly respect you.

Good luck! And yes, do get certified.

DeLana :)

[nightengalegoddess]

Awsome, De Lana. I'm glad that lots of nurses respect nurses! Of all types......yellow, black, red, brown.....oh yeh, white too : ) .......yay! And I'm gonna fly the flag. Can't wait till I see the tech nursing student who began this soul searching. I'm gonna educate! yay! Thanks ya'll for helping me and many others feel very proud and humble at the same time for what the med-surg nurse does.......oxxoxxo and blessings to ALL!

[silentRN]

.....

[tokmom, BSN, RN]

These comments that "ICU bores me" makes me realize that perhaps you've never worked in a real ICU at a level one. I've never found it "boring" when I've just spent that last 12 hours trying to save another human being, or actually being able to use your mind a little when working with the ICU Resident who's there overnight. I find it more exciting and more fulfilling than I ever did working med-surg. When I worked Med-Surg, I felt degraded on by the physicians and nursing management. I felt med-surg was ran by HR trying to push their costumer satisfaction agenda and were very picky on every little thing which seemed to have no relevance whatsoever. It wasn't till I transferred to the ICU did I see another side of nursing that I didn't even think existed. It's a different world when you work in a legit ICU. You got to realize that not every ICU is at the same level. A small town ICU isn't going to be the same as one at a level one trauma center that is a teaching hospital in some big city. As I read these posts, I feel like this has been an ICU nurse bashing session. There really is difference between the two specialities, just like an ICU nurse isn't an ER nurse. The problem is you have these nursing students who have these ideals that nursing is like some episode out of the tv show ER...until reality hits, and you realize all the BS and stupid things that our professional is put through. I think a lot of the BS comes from within, and nurses are nurse's worst enemies. I still agree and always have, that new grads should start in med-surg to get a taste of the trenches.

Nope, not bashing at all. I just like to take care of a variety of people in my 12 hr shift. For me, staring at only 1 pt the entire shift and most likely not having any verbal interaction with them does not interest me in the least. I have had more ICU nurses ask my how I can handle pt's that talk and use call lights. They would rather have them on the vent and quiet.

[msn10]

Isn't nursing care all relative anyway?

The medical community gives ICU or ER a higher level of respect because the patients have a higher acuity; So what, there are only 2 or 3 patients to take care of. That is why I liked ICU, I like to focus on one or two things at a time if possible.

A med surg nurse may have patients with lower acuity, but they have more patients so they are professional multitaskers. Not that an ICU nurse doesn't have a lot going on, but it is usually confined to one or 2 rooms.

So can we just say the acuity of 4 med surg patients = the acuity of 1 ICU patient and call ourselves equal?

[JosefVernon Hodgkins]

Medical Surgical nursing is a specialty. There may be a great deal of new grads (p.s. thanks for going to nursing school), but this is a premium area for the best of the best. What better way to mentor the new nurses than to show them the way?

[workingharder]

Thought I'd join in. I'm a rookie BSN working the 11-7 at an LTC. Guess who gets the pts. nobody else wants?

51 pts.: Alzheimers, CHFs, CVAs, MS. Hospice pts. with COPD, cancer, liver disease. Multiple anxiety and depressive pts. IVs, PICC lines, updrafts, finicky O2 concentrators, those gawd-awful crank up beds. G-tubes that have to be flushed twice a night and have the bottle changed and meds crushed. 27 diabetics-2 brittle, FSBS beginning at 0500. Med rounds at 2400, 0100, 0200, 0500, 0600, 0630 ( not all the pts.). The prima donna who has to have her call light on every ten minutes. Wheel chair assault vehicles. Dark halls, I read by holding my pen light in my mouth.

The insomniacs, the wanderers, the falls( oh I dread falls), the occasional shoving match and cat fight.

Four med carts with 400+ meds. Thirteen Medicare pts. with all the attending charting. About 450 pages of MARs checking every night. 'Lunch' and 'breaks'? Those are just words in a dictionary.

In LTC NOC we fly on a wing and a prayer. No current labs, no monitors, no MDs within easy reach. The only computer is my smart phone.

You know the drill.

I don't consider Med-Surg "trailer trash"and I expect it to be as hard as my job. I would dearly love to get into a hospital setting but, in this day and age you take what you can get.

That was quite a rambling piece. Think I'll get some sleep.

[tcvnurse, BSN, RN]

In some ways, I feel that comparing nursing specialties (ICU vs MedSurg vs ER etc,) is kind of like comparing apples to motorcycles. They are SUPPOSED to be different.

I started 10 years ago in a NYC lvl 1 teaching hospital on a medsurg floor. It was hard, it was demanding, I went home crying many mornings after report. However. It made me strong like forging raw metal into a sword. Patient load was 10-12 patients on 11-7 shift. Some fresh post ops, lots of bariatric, ortho, CBI's and garden variety CHF/COPD/DFU. AT the end of a year I could get everything done on time, including reviewing charts, rewriting the MAR by hand when the page ran out (just writing that makes me feel old btw) and making sure all the previous 24hrs of orders had been picked up and carried out.

My second job was at a community hospital in Florida, and I worked surg/onc/tele overflow. Basically med surg. The nurses I met there were some of the best I have met in my career. They had been nursing for 10 years or more, and proved a very supportive groups for a relatively new nurse.

I believe it is unreasonable to expect an ICU to be able to seamlessly do the job of a veteran med surg nurse, just as it is unreasonable to expect a medsurg nurse to float to the CCU or ER.

Apples and motorcycles.

One is not better than the other, but then that is the whole point.