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

Specialties Med-Surg

Published

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???

I don't particularly enjoy medical. U usually get all the dementia patients who come in thru ED there, as no-one else in the hospital wants them. We get a lot on our cardiac stepdown unit - and they're not supposed to be there. One RN I worked with said they should just re-name the CSSU to medical, as the dementia patients were not supposed to be there at all. I get bored on medical units, though surgical is better. I don't think much of medical - I don't think there is much critical thinking involved, and even though it is busy, I would tell any new grad who had done their mandatory year there to try for another specialty.

All the med/surg units I worked on had about 99% old people on them, and as I don't like nursing home work, this is all it seemed to be to me. It was the same, boring, repetitive routine every shift. Nothing new ever came up, and it annoyed me when the physios expect nurses - who obviously have nothing better to do - to get dementia/older patients up to ambulate who for the life of me did NOT want to walk, again, ever! As if we have time with two RNs to stand there and hold up an old person or a dementia to assess them. Most other health care prof's think med/surg is the end of the road ward - you go there, then you go into a nursing home and die.

Just do what makes you happy, but yes, med/surg (medical in particular) is seen as a nowhere field by the people I know, and IMO it is.

That's just too funny to comment on.

Specializes in Certified Med/Surg tele, and other stuff.
I don't particularly enjoy medical. U usually get all the dementia patients who come in thru ED there, as no-one else in the hospital wants them. We get a lot on our cardiac stepdown unit - and they're not supposed to be there. One RN I worked with said they should just re-name the CSSU to medical, as the dementia patients were not supposed to be there at all. I get bored on medical units, though surgical is better. I don't think much of medical - I don't think there is much critical thinking involved, and even though it is busy, I would tell any new grad who had done their mandatory year there to try for another specialty.

All the med/surg units I worked on had about 99% old people on them, and as I don't like nursing home work, this is all it seemed to be to me. It was the same, boring, repetitive routine every shift. Nothing new ever came up, and it annoyed me when the physios expect nurses - who obviously have nothing better to do - to get dementia/older patients up to ambulate who for the life of me did NOT want to walk, again, ever! As if we have time with two RNs to stand there and hold up an old person or a dementia to assess them. Most other health care prof's think med/surg is the end of the road ward - you go there, then you go into a nursing home and die.

Just do what makes you happy, but yes, med/surg (medical in particular) is seen as a nowhere field by the people I know, and IMO it is.

Well, if med/surg didn't exist, ED and ICU would have nowhere to put their patients. :lol2: Hospitals cannot exist without us. I don't feel like I'm in a nowhere job. I have room for growth professionally and can give that growth back to my patients in the form of education. My job is challenging and I truly love it.

Yeah, we get old people, but we also get twenty something herion addicts with multiple psych social issues. IMO, I'd rather have granny who is sweet, and thinks I'm somebody else, than some snotty twenty something who screwed himself up by skin popping.

I'm truly happy being on my Med/Surg floor. We have the most certifications than any other floor in the hospital.:yeah:

If for some reason I ever think my job isn't good enough, or I'm not a real nurse because I only work Med/Surg, I'll just look at my annual gross of 92k last year. Not bad for just a med/surg nurse. ;)

Specializes in PCCN.

it's not that M/S is trailer trash, it's that M/s is treated like trash by management.Expecting them to take 8 to 10 pts sometimes.I dont think you can compare m/s to icu- it's like apples to oranges. And it's a DAMN HARD JOB!much respect.

Specializes in PCCN.

sorry, slight derail/ot, but what is skin popping?Like self piercing?

Specializes in Certified Med/Surg tele, and other stuff.
sorry, slight derail/ot, but what is skin popping?Like self piercing?

injecting into skin because they have no veins left. Herion does nasty things if popped. Major abscess.

Well, if med/surg didn't exist, ED and ICU would have nowhere to put their patients. :lol2: Hospitals cannot exist without us. I don't feel like I'm in a nowhere job. I have room for growth professionally and can give that growth back to my patients in the form of education. My job is challenging and I truly love it.

Yeah, we get old people, but we also get twenty something herion addicts with multiple psych social issues. IMO, I'd rather have granny who is sweet, and thinks I'm somebody else, than some snotty twenty something who screwed himself up by skin popping.

I'm truly happy being on my Med/Surg floor. We have the most certifications than any other floor in the hospital.:yeah:

If for some reason I ever think my job isn't good enough, or I'm not a real nurse because I only work Med/Surg, I'll just look at my annual gross of 92k last year. Not bad for just a med/surg nurse. ;)

I wanted to say what you said, but just couldn't find the words. Thanks.

I respect ER and ICU nurses, as well as LTC and nursing home nurses, home health care and hospice (to name a few) for doing things that I can't imagine myself doing. I know this subject has probably been beaten to death, but it's too bad as nurses we can't respect each other.

Specializes in PCCN.

ewww- thanx tokmom- must say I havent seen that one yet :-(

Specializes in Flight, ER, Transport, ICU/Critical Care.

First - there is NO REASON that any nurse should treat another like TRAILER TRASH - or inferior or "less than" - those that treat others are guilty of "lateral violence" - simple enough. While there are volumes of info available her and elsewhere on the many signs/symptoms of the "lateral violence" rot that etas through our ranks - lets agree that we all know what it is - and since most all can recognize it, lets make sure it gets "treated" and resolve to work toward it's elimination from our profession. Professionals must act as professionals IF they want to be treated that way.

OP I think that while you may be "picking up" on an "assumption" by the nurse tech - and that is unfortunate and clearly shows that he does not know what he does not know - I'd make sure that he left my unit better for the time he spends there - make his take away point on MS one where he "gets it" and looks on MS with the respect it richly deserves.

However, I have seen some broad "trends" that relates to M/S nurses.

First, I would not survive ONE DAY as a nurse in a MED-SURG position. Although I am competent, maybe even good within a few narrow areas - I am not that good of a nurse. Period. I can think of several dozen M/S nurse by name that have likely forgotten more than I know. So, to all those amazing M/S nurses that "rock it" (and you know if you are one who does ;) ) -- kudos galore to you guys (and gals!). Anyone in nursing who thinks they "know everything" - well, they are wrong. I have never had a clinical experience that I did not learn something from - period. If you are going through this profession and are not learning something daily - you are missing something big. Find out what it is - the lives of your patients depends on it.

Never forget that regardless of what area any nurse practices in - we are ALL entrusted with sacred responsibilities. While schools prepares you to a minimal point - the real "tuition" that is takes to make a good nurse is not money based, it is paid by our patients and "they" pay our tuition with their very lives. Never forget that and be absolutely certain that every "lesson" a patient pays for - teaches you something precious.

As another post noted, I have seen a few have elite attitudes toward M/S colleagues - and when one is so busy acting out the intentions of being "better than" someone (anyone) else - it NEVER sets up collaborative practice and ultimately patients are not cared for as well as they deserve.

The folks that treat the MS nurse "bad" are just likely the same ones that treat anyone/everyone else bad - bullies, baddies and b^$@(!$. Call it out when you see it and when everyone calls attention to these mean girls (and guys) they will have no place to hide - these folks will NOT have silence on "their" side anymore and bad behaviors that have been "accepted" in the past will become what they should be UNACCEPTABLE.

IMHO - I think the good M/S nurse as a general specialist. I think of good critical care nurses more in terms of singular speciality. M/S is it's own speciality and has a board certification that goes with it ---- RN-C. While folks will differ on the value of board certifications - in my case and opinion - I hold myself to higher standard than any employer will ever hold me to - and I used the certification process to add personal and professional accountability to my clinical practice. Other may differ and be aware that your actual mileage may vary. :D

Some of the perception issue has to do with M/S being the "starting point" for many new nurses. But, that is less true now than it was 10 years ago IMO. There may also be some truth in the fact that when "new nurses" are weeded out -- the garden they are "pulled" from is M/S. So, the odds of finding a struggling newer nurse in a M/S position is a bit higher than in other areas. I think that orientation and new practice for the MS nurse has to be one of the most difficult things in nursing.

In another post on this thread, an incident was shared where there was some really bad behavior - IMO for me to respond to assist another nurse (in MS) and find fault with how they packaged a patient s/p a fall - would have to be one of the most isolating and unprofessional and unproductive interactions ever. While the incident as described was rotten in so many ways - it does serve as an example of why the attitude the OP details exists at all.

I have seen and although I am embarrassed and horrified by very ashamed now, I likely have been a party to highly charged situations where that certain nurse (or unintentionally intimidating paramedic) who acts in a very narrow speciality to "pick apart" another certain nurse that finds themselves in an exceptional situation and having to act in a specialized area way outside of their comfort zone. Even in situations where everything turns out okay - the certain speciality nurse imparts knowledge in a manner that is not about sharing what they know, but more about pointing out what the other non-narrow speciality nurse did wrong. When ANY nurse treats another in a disrespected and humiliating manner, a real opportunity to improve on what either know is lost forever and walls are built and judgements are made. I think those who "act up and act out" are likely somewhat insecure or lack self-awareness or may even just be miserable, hostile, angry elitist people who are living sad, empty lives and likely get joy only from stomping kittens and attacking other nurses. :eek: :eek: :eek: Those that are the latter should not be nurses - period. They do not honor all those patients (and their lives) who paid their tuition - or the profession.

Point is - if you are treated "bad", or see someone treat another "bad" - call the offenders attention to it. Maybe not in the moment and try to avoid adding fuel to any fire - but, when possible diffuse the situation and when "safe" - confront the behavior and the person behaving badly. If there is a real clinical issue and the person who was the "victim" of the attack is someone who needs assistance or additional education to improve their clinical practice and you can help them - do so or facilitate it.

Bottom Line - no one does well in this profession without the help from others along the way. And no one should be allowed to treat any other badly - it is unwelcome, unhelpful and unprofessional - regardless of where that journey takes you - you are more than where you "live".

Be kind.

Be professional.

:angel:

I always resent the "you're too smart for the floor" mentality. I've done some ED, I've done some ICU, and frankly, they bore me. IMO, M/S is nursing at it's best. I keep my patients from needing the ICU. I don't just get them "stable," I get them better. And I can do it all without knowing every second of the shift what their heart rate is. And without an MD always around to babysit.

Specializes in Acute Ortho/Neuro, Hospice, Skilled/LTC.

If a year in med-surg is considered so "mandatory," it would be great if I could just go down to my local CC and sign up for it. As it is, I've been unable to get one of these "trailer trash" nursing jobs since becoming the oldest new grad RN in June 2010. My classmates, who have been accepted to ICU internships or got jobs in the local teaching hospital, all look at me like I have some serious deficit because I haven't been hired into an acute care position. Don't get me wrong, I like med-surg and would love to have a job there but when you still can't get an interview there after completing ACLS and an RN-BSN program, one's self esteem is considerably damaged.....partially because other nurses have the views described by the OP. I've been working in LTC and I thought that was the "trailer trash" area for an 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.

All aspects of nursing are difficult and requires knowledge and critical thinking. Med/Surg nurses utilize a different skill set than an ICU nurse. That's not to say one is more difficult than the other. I know ICU nurses who can"t survive on a med/surg floor and vice versa. People let their egos get in the way and want to create some hiarchy. Regardless of what kind of nursing you do, we should all agree that it is a difficult job that requires smarts to do it well.

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