Med-surg for all?

[bjb_wyo]

I am graduating in May. I have visited 3 hospitals and will have interviews with all 3. I am getting very different stories. My local hospital where I have done my clinicals starts all graduate nurses with at least one year in Med-Surg. They say this is the way it is always done.

The other hospital, which is working for magnet hospital status and seems very progressive, starts their graduate nurses in "career pathways" linked to what they are interested in. I am applying for critical care pathway and will interview with telemetry. They say the the med-surg idea is outdated and a new nurse is better off in the area the nurse wants to work in.

I haven't visited the third hospital yet, so don't know what they do.

Any ideas which course is best? Is my local hospital out of date?

[NephroBSN, BSN, RN]

They'll have to go somewhere no doubt.

Maybe, just maybe, if we stop making excuses as to why we continue to accept jobs with unacceptable working conditions we'll actually get somewhere.

Nurses have children, and nurses have mortgages to pay, thus they accept jobs with insane working conditions and we all simply hope that it will change without us individually having to sacrifice and walk out on our jobs.

We all want our children to be comfortable in their nice private schools and we all want a decent house to live in decent suburbs and make the mortgage payment every month.

Thus we continue to settle for less than what we are actually worth.

Sorry I'm not part of that we. My kids and I did just fine with public school.

AAMOF my son makes as much as I do and he's 28 pulling in $70,000.

Never lived in the suburbs.

Now all those things might just be what's wrong with America.

We always seem to want more than we can afford.

[Drysolong]

First of all, as a med-surg RN I really resent the idea that med-surg is "basic" nursing where new graduates learn their stuff before they go on to the real hard stuff. Med-surg is a specialty and a pretty tough one and it is not the one to park new grads while they learn so the other specialties can get seasoned nurses. Secondly, I don't like the idea that they are putting nurses into an area who have no intention of staying. How fair is that to the existing staff and people who have to staff the area to put people over there who they know do not intend to stay? If you have an idea of where you want to work, then go for it. Personally I started out in pediatrics and then went to med-surg.

I am interested in knowing what you (and others) like about med-surg that makes you want to stay. I am a new LPN grad (haven't taken boards yet) and want to work in med-surg and psych as LPN and on to RN.

[fergus51]

First of all, as a med-surg RN I really resent the idea that med-surg is "basic" nursing where new graduates learn their stuff before they go on to the real hard stuff. Med-surg is a specialty and a pretty tough one and it is not the one to park new grads while they learn so the other specialties can get seasoned nurses. Secondly, I don't like the idea that they are putting nurses into an area who have no intention of staying. How fair is that to the existing staff and people who have to staff the area to put people over there who they know do not intend to stay? If you have an idea of where you want to work, then go for it. Personally I started out in pediatrics and then went to med-surg.

AMEN!!!! I don't understand why anyone thinks med-surg is different than any other specialty.

[fergus51]

You're right, but wrong.

Can you go into say, NICU right out of school? People do it, all the time.

But it pigeon-holes you into that specialty. Let's face it, five years out of nursing school, if you haven't honed the time management and skills to do med/surg, not only med/surg, but a whole host of jobs that build upon those skills will be lost to you.

~faith,

Timothy.

That's just not true anymore. I have friends who have gone from NICU to OR, to CCU, to PICU, to peds, to L&D, etc. I've been offered adult ICU jobs. Will I be able to become a med-surg nurse? Maybe not. Would I ever want to? NO! I would quit nursing altogether before taking a job in med-surg. It just isn't for me. Those med-surg nurses I admire, but they may not have an easy time transitioning to other specialties either. A lot of NICU managers prefer new grads. You could wind up pigeonholed into adults if you start in med-surg and if a new nurse knows she wants to work with babies, then that's not a good thing. Plus trust me, looking after critically ill infants helps you develop time management skills and other skills too:) I probably see as many chest tubes, traches, ngs, vents, post ops and procedures as a med surg nurse. Those are the things that matter to me.

[cshell1964]

I always knew med-surg was not for me!!! I honestly don't think I would be a nurse if that is all there was. I always loved OB/ NICU. I worked in couplet care as a student nurse tech and as a new grad for about a year, now I have been in NICU for 19 years. If you don't like med-surg, I don't think you have to do it. Why take a job you only want for 6 months - 1 year. Orientation is expensive!!!! Go for what you love!!!

[NephroBSN, BSN, RN]

I always knew med-surg was not for me!!! I honestly don't think I would be a nurse if that is all there was. I always loved OB/ NICU. I worked in couplet care as a student nurse tech and as a new grad for about a year, now I have been in NICU for 19 years. If you don't like med-surg, I don't think you have to do it. Why take a job you only want for 6 months - 1 year. Orientation is expensive!!!! Go for what you love!!!

I know M/S is not for every one. I suppose learning about Aricept isn't important either. Or pitocin. For that matter.

M/S is the foundation for nursing. Students don't go into nursing to only study babies, or people who are asleep most of the time they are being cared for.

I came from a M/S unit to nephrology. It was probably the last place I would have ever chosen.. And when I decided to stay with it I was told "how can you stand the smell of those uremic patients" My response was that "they don't smell any worse than those cancer patients"

I guess what I'm saying is that M/S is difficult, interesting and a good foundation for any speciality. Including babies and those who are asleep.

I hate to say it cuz I sound so much like my dad but I see that many NOT ALL of the new grads don't want to work hard. Now I'm not saying any speciality is easier than others. But many in ICU or OR will tell you . "I don't know how those M/S nurses do it. They have to juggle so much." And I feel that sometimes the new grads just don't want to have to work hard. Sorry I know many are hard workers. But how many people do we all know who say I'm gonna go into a specility where I have to work my butt off every day.

I don't think you hear that very often.

Good luck on every one's choice. But don't throw out a good experience just because "You know you won't like it" The little amount of M/S you get in clinicals is certainly not a true experience. None of us will ever see it all in our careers.

[Jolie, BSN]

I see that many NOT ALL of the new grads don't want to work hard. Now I'm not saying any speciality is easier than others. But many in ICU or OR will tell you . "I don't know how those M/S nurses do it. They have to juggle so much." And I feel that sometimes the new grads just don't want to have to work hard. Sorry I know many are hard workers. But how many people do we all know who say I'm gonna go into a specility where I have to work my butt off every day.

I don't think you hear that very often.

Good luck on every one's choice. But don't throw out a good experience just because "You know you won't like it" The little amount of M/S you get in clinicals is certainly not a true experience. None of us will ever see it all in our careers.

I think we experienced nurses will just have to agree to disagree on the advice we give to new grads regarding "a year or two of med/surg first". You obviously believe it to be necessary and beneficial. I do not.

But please don't imply that those chosing to enter specialty areas do so out of a dislike of hard work. I have great admiration for med-surg nurses (and ER and psych), not because they work harder than I do, but because they have a passion and love for a type of nursing that holds absolutely NO interest for me. I can guarantee that I have spent just as many hours on my feet, gone home with an aching back just as many nights, missed just as many meals, and had to pee just as bad as any med-surg nurse. Like med-surg nurses, I also use my knowledge of the nursing process, human anatomy and physiology, pathophysiology, disease process and management, pharmacology, technical skills, teaching abilities, advocacy, organizational skills, prioritization, and political connections to provide my patients with the best possible care. When you or a loved one have a family member in labor, or deliver a sick newborn, you will be darn glad I'm there, just as I'm darn glad to have dedicated and talented med-surg nurses take care of my parents. When the time comes, I bet you won't care a whit that I didn't do a year of med-surg before going into OB/NICU.

[NephroBSN, BSN, RN]

I see that many NOT ALL of the new grads don't want to work hard. Now I'm not saying any speciality is easier than others. But many in ICU or OR will tell you . "I don't know how those M/S nurses do it. They have to juggle so much." And I feel that sometimes the new grads just don't want to have to work hard. Sorry I know many are hard workers. But how many people do we all know who say I'm gonna go into a specility where I have to work my butt off every day.

I don't think you hear that very often.

Good luck on every one's choice. But don't throw out a good experience just because "You know you won't like it" The little amount of M/S you get in clinicals is certainly not a true experience. None of us will ever see it all in our careers.

I think we experienced nurses will just have to agree to disagree on the advice we give to new grads regarding "a year or two of med/surg first". You obviously believe it to be necessary and beneficial. I do not.

But please don't imply that those chosing to enter specialty areas do so out of a dislike of hard work. I have great admiration for med-surg nurses (and ER and psych), not because they work harder than I do, but because they have a passion and love for a type of nursing that holds absolutely NO interest for me. I can guarantee that I have spent just as many hours on my feet, gone home with an aching back just as many nights, missed just as many meals, and had to pee just as bad as any med-surg nurse. Like med-surg nurses, I also use my knowledge of the nursing process, human anatomy and physiology, pathophysiology, disease process and management, pharmacology, technical skills, teaching abilities, advocacy, organizational skills, prioritization, and political connections to provide my patients with the best possible care. When you or a loved one have a family member in labor, or deliver a sick newborn, you will be darn glad I'm there, just as I'm darn glad to have dedicated and talented med-surg nurses take care of my parents. When the time comes, I bet you won't care a whit that I didn't do a year of med-surg before going into OB/NICU.

I won't care a whit. But I will always think that you missed a great opportunity. I'm not advocating every nurse go into M/S. What I am advocating is that many not by pass it by.

What I was saying also was that many don't want to go into M/S because they are afraid of hard work. What they don't realize is that other specialities are hard work too.

As some other posters here have inferred, many new grads look down on M/S and want to be in a speciality.. M/S is a speciality.

One many can't hack. Alot of times because they don't want to or don't realize they can

Whatever is difficult makes us stronger. Or something like that.

[RN34TX]

But please don't imply that those chosing to enter specialty areas do so out of a dislike of hard work.

That's the message that I got from that post as well.

I didn't leave med/surg because I'm afraid of hard work and believed that ICU and PACU would be easier jobs.

I left for many reasons but the one pertinent to this discussion is the unsafe staffing levels that I experienced at the majority of med/surg jobs I worked over the years.

Now in the PACU, the OR can scream all they want about how they've been waiting to roll out with a patient ready to wake up.

But if each nurse still has 2 patients each, no one is rolling through that door regardless.

I have 2 patients period regardless of census or how many people called in sick on a given day. Same in ICU. No excuses or sob stories from management about staffing levels and census.

Med/Surg on the other hand, in my experience, has almost always had a policy that if there is a clean room on the floor, it's going to be filled no matter how many patients each nurse already has.

I've worked way too many days of having 7 patients, and that is already too many in my opinion for one nurse.

But if my floor had a clean room, I was going to take 8 patients or be threatened by management because a patient from ER was coming up in 10 minutes and I had no say in the matter.

Never again.

I'm worth a lot more than to be treated like that.

[NephroBSN, BSN, RN]

That's the message that I got from that post as well.

I didn't leave med/surg because I'm afraid of hard work and believed that ICU and PACU would be easier jobs.

I left for many reasons but the one pertinent to this discussion is the unsafe staffing levels that I experienced at the majority of med/surg jobs I worked over the years.

Now in the PACU, the OR can scream all they want about how they've been waiting to roll out with a patient ready to wake up.

But if each nurse still has 2 patients each, no one is rolling through that door regardless.

I have 2 patients period regardless of census or how many people called in sick on a given day. Same in ICU. No excuses or sob stories from management about staffing levels and census.

Med/Surg on the other hand, in my experience, has almost always had a policy that if there is a clean room on the floor, it's going to be filled no matter how many patients each nurse already has.

I've worked way too many days of having 7 patients, and that is already too many in my opinion for one nurse.

But if my floor had a clean room, I was going to take 8 patients or be threatened by management because a patient from ER was coming up in 10 minutes and I had no say in the matter.

Never again.

I'm worth a lot more than to be treated like that.

But you do admit you don't want more than 2 patients at a time.

[RN34TX]

But you do admit you don't want more than 2 patients at a time.

Of course. That's the way it should be.

You said it yourself that ICU was just as hard of work but people think it's an easier job.

But the 2 patients that I get are not med/surg patients. Far from it.

I keep plenty busy.

The difference is that I have a safety net of only having 2 patients so that I can provide safe care for them.

The number of patients is a meaningless value if you are under the impression that the patients are the same level of acuity as med/surg and the number of patients assigned to you is the only difference between the 2 types of units.

Apples and oranges here.

[cardiacRN2006, ADN, RN]

I won't care a whit. But I will always think that you missed a great opportunity.

.

I think we've all seen from clinicals alone that we don't mind missing out on the 'great med-surg opportunity'. Also, new grads have just finished up many years of hard work just to get through nursing school, so I doubt that any of us think that hard work is something that we avoid, or something that doesn't exist in nursing. Like someone else said, if I am in ICU and not able to handle med-surg, no problem. There is nothing that will entise me to work there.