Med-Surg Roll Call

Tweety, BSN, RN · Feb 19, 2005

O.K. I'll chime in. I've been in med-surg for 14 years. Currently working in trauma/med-surg (lots of ortho trauma). I like med-surg because of the variety, it's multi-system, and it's a daily challenge.

I'm a little discouraged with the ratios and the hard work. I'm moving to day shift where the ratio is 5 by yourself with no help, or 7 with a CNA. 3rd shift is 8 or 9 to one and it's wearing me down bit by bit over time.

I'm seriously considering moving on to critical care. However, my unit is going to open an intermediate trauma unit where the ratio is 4:1, so I may go into that.

Sorry to be a bummer. But we all know med-surg is tough. Only the strong survive!

UnewmeB4 · Feb 21, 2005

I'm with you, RN-PA.......I never thought I'd stay in M/S for very long, the work is hard and getting harder by the day, but I love it! I'm not as fond of medical---most of our medical pts. are either non-compliant 'frequent flyers' or nursing-home residents who get dumped on us when the facilities can't cope with them---but surgical more than makes up for it. It's such a kick to get post-ops who are really sick or injured and be a part of their recovery process, then see them walk out of the hospital well on their way to good health.
As an older nurse (46), I wonder sometimes how much longer my back and my poor abused feet are going to be able to take the daily beatings, but I'm committed enough to M/S that I sat for the AMSN certification exam last fall and am now a CMSRN.
I'm also a float nurse who has cross-trained in OB-GYN and critical care, which may be where I end up later on when I can't run the floors any more, although I may get more involved with parish nursing (another of my 'sidelines') as I get older and don't need to make as much money. That's the great thing about nursing, anyway: if you don't like what you're doing or can't handle it physically, there's always different types of nursing to try!

I have basically always worked med-surg with other areas as well. At the hospital I work, 40% of the nurses have their certification, most of them med/surg. We just received our "annual nurses report" , and I was actually surprised. I think when the nurses read this, it will be incentive for the rest of us to do the same.

The best thing about med/surg, is you must keep current in everything. It keeps you from the narrow focus as in some specialty areas. For example...was on a cardiac floor. The pt had a heart rate in the 120's. The cardiac nurses immediately wanted a Cardizem drip to slow her rate. Having "been around", my assessment was that it was the resp distress that was making her heartrate so rapid. UNFORTUNATELTY, I was new to cardiac. They got her on a Cardizem drip. The next day, I was back, and there happened to be a resp therapist on the floor who agreed with me. The poor woman finally got what she needed after almost 24hours. The good thing is, once they realize you do have experience, they are more willing to listen, and actually ask opinions.

I hate to see what has happened with DRs, happen in nursing, that we specialize so strictly, that we lose our focus of the "whole person". It happens so easily. Sometimes we get so focused on the numbers on the machine, we forget to look at the whole scenerio.

Less invasive machines is also what keeps me in med/surg.

Cewens · Feb 22, 2005

I have been working on a busy Renal unit for the last year ( I am a new grad). I find that I LOVE the mental challenges, demands and variety of situations that my floor requires but am frustrated that our staffing guidelines are requiring us to take another pt. Our ration had been 1:4, which had been managable for our acutely ill pts. Now we are required to take 5 pts, and our NACs are now also stretched thin. Just today, I lost a pt, and I am angry that I was forced into the situation of wondering whether I could have made more of a difference if I had only had more time to spend with him. In the past, even though I have had very busy days, I could always went home and say to myself that at least I kept my pts alive for my shift....today I can't say that. It may have been his time to pass, but I will always wonder.

Green_Dragon · Feb 24, 2005

I have been a Med/Surg RN for about 5 years. When I was in school still I worked as a tech on a trauma floor, then to postpartum for the experience. I learned so much as a tech, however, I still felt that I needed the experience of Med/Surg nursing in order for me to gain experience. I am happy I went into Med/Surg nursing because it does offer such a diverse group of patients. I admittedly find that Med/Surg nursing is so difficult, not only is the acuity so high within our patient population now, but nurse/patient ratios do not take that into account. I can not imagine taking care of 10 patients on our Med/Surg floor, our acuity is too high, with trachs, and "total" train wrecks we get that are unstable, many patients with isolation needs, etc... Maybe I have been spoiled with the 5-8 patients during the day shift, and 6-9 patients on the graveyard shift, I have worked all the shifts. I am now a Charge Nurse on a Med/Surg floor. I do not believe I will stay in Med/Surg after I graduate from my Graduate program; not because I do not find it a challenge, because if anything... it is a challenge, but moreover, because I will be moving into the education end of nursing. I think Med/Surg nursing provides a wonderful backbone to launch any nursing career off of, or just to stay in because of what it is. Med/Surg nurses are diverse, and amazing folks, and we do it, because we can effectively.

Lisbeth · Apr 18, 2005

I have been a med-surg nurse for 6 years, and started here because the nursing schools were still advising new grads to go into med-surg for their first one to two years. I always figured I could change/cross-train somewhere else when I got tired of med-surg. I still don't see that coming, I love my job, and I love the diversity. Some people (from other areas of nursing) say med-surg nurses are "jack of all trades, master of none" because they see a lot of different things, but not necessarily for long periods of time. But I have seen nurses from other areas float to my floor and practically drown because they don't have their time management down, or know where their resources are. I like that I still see and learn new things. Like Tweety said, it's a daily challenge; that's what keeps it from being boring.

In my hospital, I only know one person who has certification, it's not really spoken of or recognized much. I did look into it one time, because I sometimes think med-surg is overlooked as a specialty area, but the test was in a city a few hours away, and I couldn't make it. :nurse:

live4today, RN · Apr 18, 2005

I have been working on a busy Renal unit for the last year ( I am a new grad). I find that I LOVE the mental challenges, demands and variety of situations that my floor requires but am frustrated that our staffing guidelines are requiring us to take another pt. Our ration had been 1:4, which had been managable for our acutely ill pts. Now we are required to take 5 pts, and our NACs are now also stretched thin. Just today, I lost a pt, and I am angry that I was forced into the situation of wondering whether I could have made more of a difference if I had only had more time to spend with him. In the past, even though I have had very busy days, I could always went home and say to myself that at least I kept my pts alive for my shift....today I can't say that. It may have been his time to pass, but I will always wonder.

I feel what you are saying here Cewens. The demands and variety do keep us on our toes, but with all the paperwork, computer documentation, meetings, pressures to offer excellent customer service, and so forth, it has become increasingly more challenging and frustrating as you said.

Having been in med/surg nursing for eighteen years, I remember the times when I knew more about my patients, had the time to put two and two together to come up with what was going on with my patients when their condition started to decline or change from this or that. I remember when my shift was over, I left work feeling really good about what I had done for my patients that day, and when I laid my head down at night to sleep, I felt good about my job, and looked forward to another day of being able to be the best nurse I could be for my patients.

Today's hospital environment and demands no longer allow their nurses time to read charts, know what's going on at all times with their patients, knowing the course of their days physical activities, meals consumed (or not), I/Os, onset of their pain to address their pain sooner than later due to the patient load and excessive demands on the nurses to meet this deadline or that while on duty and not skipping a beat with any patient assigned to us.

Your frustration is an honest emotion. Too bad the hospitals are all into the almighty dollar instead of truly caring about each patient as more than a commodity in their wallet. :rolleyes:

I miss patient care. I do NOT miss the abuse on my person as ... first a human being, second as a nurse ... third as a potential patient if we continue to run around like chickens with our heads cut off trying to be everything the employer demands of us.

Can we PLEASE go back to the basics.........whatever happened to caring?

nbnurse95 · Apr 19, 2005

I'm an RN on a surgical unit. Been there for almost 10 years. Due to a bed shortage, we've had a lot of medicals for quite a while now. My favorite pts are the surgicals, they keep me the busiest. The medical pts are sometimes admitted for quite a long time (weeks). I did try supervising for a while but really missed the bedside care so I stopped that. I really can't imagine working on another unit.

butterflynurse03, RN · Apr 22, 2005

Hi all ... thought it was about time to have a Med-Surg roll call .... please repond by telling us if you work in med-surg .... how long you have been there and if you plan on staying in med surg .... also, please let us know if you hold certification in med-surg through ANCC or AMSN. Thanks ....
I will start ....
I am a nurse manager for a 40 bed med-surg unit. Love med-surg, but am challenged daily by how busy the unit is and how sick our patient population is. I plan on remaining in med-surg for a number of years (at least until I finish my Masters degree and start teaching). I am not currently certified, but am planning on taking the test in October throught AMSN.
I think the thing I LOVE the most about M/S is the diversity of patients we see. You really need to be a nursing generalist to be successful in med-surg.

Hi, At our hospital the medical and surgical floors are separate. I work the surgical/ortho/neuro portion. We have a pt capacity of 34. I have been there for a little over a year, straight out of school for my RN. I did not think I would like it, but I do. The work is very challenging and requires a good working knowledge of LOTS of things. I have learned a lot. However, I am not sure that this is where I will stay. I am still deciding where I want to be and what type of nursing floats my boat so to speak. I am presently looking to become PICC certified, since we just lost our IV Therapist. I love doing IV's and this may be a good fit.

blackIrish · Apr 26, 2005

I am graduating in 2 weeks- I'll start as a GN on the same Med/Surg floor that I've worked at for a year as a PCT.(like an NA/LPN)

I work steady night shifts, switching to 12hr. shifts June 1st. (I'm taking all of May off)

I love this floor- the variety keeps me on my toes but I wonder when I will feel confident.

Brandy

akemi · May 15, 2005

I'm a new-grad med-surg nurse. I've been working an a med-surg floor for about 6 months now. It is very challenging! At first I was kind of reluctant to accept this position because I really wanted OB. But I now realize that med-surg is where I will learn so much, especially being a new-grad. I'm hoping that the hands-on skills and critical thinking skills I learn on med-surg will help me become an excellent OB nurse (when I get there).

NancyJo · May 15, 2005

I have been in med-surg for 4 years now and do like it for the most part. As many have said the down side is inadequate staffing for the amount of work we are expected to do. I did my first 12 years in LTC and loved that too, enjoyed that too, but decided to leave when my back started bothering me and I was only 32-too many years to go. Then did 3 years in acute rehab but the unit closed so a friend talked me in to giving med-surg a try. I never had any desire to work in an acute setting and was scared to death, never thought I could do it. It was like starting all over, but it came to me quickly and I really enjoy it now.:rotfl:

General E. Speaking, RN, RN · May 17, 2005

I have been an LVN for 15 years. First 4 yrs, I did Med Surg then switched to the float pool for 1 yr in the same hospital (500 beds). Next, I worked for TDH Immunization/Communicable Disease Program for about 4 years. I had a transitional job at a busy pediatrician's for one year while I watched my current hospital being built. I have been at that hospital for 5 yrs doing Med Surg. I do float to pedi occasionally. Med Surg is very hard but rewarding work. I think this is especially true in a smaller facility. Our hospital only has 58 beds- 38 Med Surg, with a few saved for pediatrics. Basically, if you are not critical or crowning- you come to our floor. My Med Surg motto: Variety is the spice of life!

Three 12 hr shifts/wk is considered full-time. This works well with my part-time school schedule. Currently doing RN pre-req's.