Medical-Surgical Nursing (Med-Surg)

Medical-surgical (med-surg) nursing is the basis of all nursing care. We all learn basic med-surg principles in nursing school and then most of us move on to a specialty. However, we must all have this basic knowledge in order to move to a specialty.

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Medical-Surgical Nursing (Med-Surg)

Overview

Medical-Surgical (med-surg) nursing is the basis of all nursing practice. In years past, nurses were either medical or surgical nurses because there were no specialty nursing choices. Currently, med-surg nurses make up the largest component of all nurses. Med-surg nurses care for a diverse population of patients from the young diabetic to the aging hypertensive crisis patient and everyone in between. There are many places and roles for nurses of all levels in med-surg nursing.

Med-surg nurses must have a vast knowledge of pathophysiology as it relates to the patient's diagnosis. The med-surg nurse must be proficient at succinct charting and possess the ability to prioritize care. They also must have the ability to communicate effectively as it applies to patient education.

Type of Patient Care

  • Med-surg nurses care for a variety of patients with multiple diagnoses such as:
    • renal disease
    • hypertension
    • diabetes
  • Nurses provide post-surgical care for patients who have had:
    • cholecystectomy
    • orthopedic surgery
    • appendectomy
  • Patients undergoing outpatient procedures that will likely require med-surg nurses to care for the majority of medical than surgical patients

Work Environment

  • Inpatient care units - caring for patients in a hospital
  • Clinics - patients will be seen by their primary care provider (PCP) for preventive, acute, post-op visits or for other complaints
  • HMOs - conduct insurance reviews, quality assurance or utilization review
  • Ambulatory care units - same-day surgery unit or same-day unit
  • Home health care (HH) - provide care and education for patients in their homes
  • Long-term care (LTC) - patients that are unable to provide self-care requiring temporary or long-term rehabilitation
  • Skilled nursing homes - free-standing home for patients with a specific skilled need
  • Urgent care centers - acute, non-emergent care
  • Universities - nurse educators or working in a clinic

Education / Licensure

  • Graduate from an accredited Practical Nursing (PN), Registered Nursing (RN) or Advanced Practice Nursing (APN) {NP or CNS} program with the following:
    • PN: Certificate, diploma, or degree
    • RN: Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN)
    • APN: Nurse Practitioner (NP) or Clinical Nurse Specialist (CNS) Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP)
  • Successfully pass the NCLEX-PN or NCLEX-RN
  • Current, unencumbered LPN, RN, and/or APN license in the state of practice

Med-surg nurses are usually RNs. Some facilities do hire the LPN. Many APNs are hired as the Primary Care Provider (PCP) that:

  • Conduct Pre- and post-operative visits
  • Conduct daily rounds
  • Provide Staff education
  • Arrange for and create Case management plans
  • Ensure quality/accurate Utilization review

Professional Organizations

The Academy of Medical-Surgical Nursing (AMSN) supports students in their nursing programs and throughout their professional nursing careers. This organization provides information on standards, national practices, and evidence-based nursing.

The Canadian Association of Medical and Surgical Nurses (CAMSN), an associate member of the Canadian Nurses Association (CNA), "advocates, supports and promotes the integral role of medical and surgical nurses to the health care system".

The Medical-Surgical Nursing Certification Board (MSNCB™) is a professional organization whose mission is to, "validate excellence in medical-surgical nursing and care coordination and transition management".

Certification

The MSNCB™ provides the Certified Medical-Surgical Registered Nurse (CMSRN) certification. 

Eligibility (not all-inclusive)

  • Graduate from an accredited Registered Nursing (RN) program
  • Successfully pass the NCLEX-RN
  • Current, unencumbered RN license in the U.S. state of practice
  • Practiced 2 years as an RN in a medical-surgical setting
  • Accrued 2,000 hours of practice within the past 3 years

The American Nurses Credentialing Center (ANCC) Medical-Surgical Nursing board provides the Medical-Surgical Nursing Certification (RN-BC) certification examination.

Eligibility (not all-inclusive)

  • Graduate from an accredited Registered Nursing (RN) program
  • Successfully pass the NCLEX-RN
  • Current, unencumbered RN license within a state or territory of the U.S. or the professional, legally recognized equivalent in another country
  • Practiced the equivalent of 2 years full-time as an RN
  • Minimum 2,000 hours of clinical practice in the specialty area of medical-surgical nursing within the last 3 years
  • Completed 30 hours of continuing education in medical-surgical nursing within the last 3 years

Salary (2020)

According to salary.com, the average Medical Surgical Nurse salary in the U.S. is $96,425. The range is between $87,234 and $107,416.

According to ZipRecruiter, the average annual pay for a Medical Surgical Nurse in the U.S. is $88,025 a year.

Opportunities

As the U.S. population ages, there will be more of a need for med-surg nurses who can handle complex patients with many needs. In smaller hospitals, there may only be a single med-surg "floor"; patients with many co-morbid conditions will require nurses with a wider knowledge base.

 

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Specializes in Certified Med/Surg tele, and other stuff.

Thank you for not calling med/surg a stepping stone for a 'real' nursing job and recognizing it as a specialty. :yes:

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Thank you for not calling med/surg a stepping stone for a 'real' nursing job and recognizing it as a specialty. :yes:

Well actually, the bolded part just above the post implies that it M/S is what we do before moving to a specialty (implying that M/S is not a specialty, as that would be phrased "in order to move to ANOTHER specialty."

We all learn basic med-surg principles in nursing school and then most of us move on to a specialty. However, we must all have this basic knowledge in order to move to a specialty.
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Specializes in Acute Care - Adult, Med Surg, Neuro.

It takes a strong person to be a medical-surgical nurse. I have been one for a little over a year. Many nurses are unwilling or very resistant to float to our floor. The patients we receive are complex physically as well as often have co-morbid behavioral or mental health diagnoses. We see patients who are very elderly, who are developmentally delayed, who are devastated neurologically, who are from nursing homes/long term care facilities, who have dementia, who have chemical dependency issues/acute withdrawal, who have complex endocrine diseases, who are on comfort cares/dying, those who are pregnant and have complex medical needs, and who have many co-morbities such as HTN/dialysis dependent renal failure/diabetes. We take the patients who have infectious diseases who other floors won't take (such as OB). There is so much to know, and on top of that, we often have to take 4-6 patients. And we have to have great instincts and know when someone is going downhill because we don't have the monitors to tell us. There are no doctors immediately available on our floor to help. When someone is circling the drain, we have to prioritize and advocate because things can happen slowly. Often our floor is over-looked, the doctors don't take our concerns seriously, equipment never shows up, and pharmacy takes 2-3 hours to get needed medications to the floor. We never get all the glory - that goes to the ICU nurses or ED nurses who provide immediate care. We have to work with old, beat-up equipment while other specialty floors get brand new things. So I say, utmost respect to my medical-surgical colleagues. I believe this is the complex and challenging specialty. I know that I won't be moving on for a long time, and plan to get my certificate. So to any who says we are a 'stepping stone' - I say, please take us seriously, because we work our butts off each day and get very little respect.

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Specializes in Nephrology, Cardiology, ER, ICU.

Med-surg is the basis for all our care so in essence, we are ALL med surg nurses...thanks for your comments.

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Specializes in Pediatrics, Emergency, Trauma.
Med-surg is the basis for all our care so in essence we are ALL med surg nurses...[/quote']

Agree. :yes:

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Med-surg is the basis for all our care so in essence, we are ALL med surg nurses...thanks for your comments.

And we're all responding to emergencies in patients needing critical care. We're ALL ed and icu nurses!

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Specializes in Acute Rehab, IMCU, ED, med-surg.

A very wise ICU nurse with whom I worked told me that "med-surg nurses are a bunch of dang rock stars because they have to do be able to detect critical changes in patient condition WITHOUT invasive monitoring, an intensivist handy, etc - and do that for five-six patients!"

This impressed me, and that's why I selected a med-surg preceptorship in nursing school. No matter where my nursing career takes me, I'll probably always be a med-surg nurse at heart!

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