I am going to answer this question, give some advice, and vent a little...
By definition med/surg should consist of patients that are stable but require IV antibiotics, IVP pain meds, continuous pulse ox monitoring, dressing changes post procedure, and general nursing care. Telemetry floors have patients that require cardiac monitoring and more frequent vitals/assessment than a med/surg patient. You can also push different IV drugs if the patient is on the monitor. Some places have techs that watch the rhythms and others place that responsibility on the nurses. Step down units have more critical patients that are on cardiac monitoring and may even be on a ventilator, but they do not meet the criteria for a critical care bed (or the micu is full and bed placement and administration is playing who can we kick out to open beds). They may require gtts to maintain normal pressures or heart rates. These patients require much more frequent assessment and have greater care needs than a med/surg patient.
When you interview for a position, ask the nurse manager to define the unit and explain the types of care the patients require. Also ask about ratios. The more complex care each patient needs, the less patients each nurse should have.
I work on a "med/surg" unit. We have a 1:6 ratio on a good day and a 1:7 ratio typically. I call it a med/surg unit because that is what my facility calls it. We have no step-down/progressive-care unit in the hospital. We do have two other units that that have tele monitors. Every bed in my unit has bedside cardiac monitoring (that also shows up on a central monitor at the desk, although there is no tech to watch them). Every bed is also vent ready. And we are the only unit outside of the micu/sicu/cvicu that has this. Out of 40 beds about 25-30 require tele and we have anywhere from 4-12 ventilators at a time depending on admissions. So out of my 6-7 patients, at least 5 are tele monitored and you get a vent patient (who always have a ton of care needs besides the vent care). We push lots of IV cardiac drugs that other units can't. However, we cannot titrate cardiac drips because there is no way to assess a patient frequently enough to titrate when you have 6 other patients. It is unsafe. We end up having a lot of rapids, falls, and even codes because of this arrangement. I have been in a vent room doing dressings and had another nurse come in to tell me that my CIWA patient down in the other hall was found on the floor with a systolic BP I the 200's. Sometimes a patient in fluid over load with giant pleural effusions that desperately needs a chest tube placed goes south and takes up your time and you can hear a vent alarm ringing and have to wonder if it is your vent and hope a team member jumps in a suctions them while you work on getting your CHFers sats up. We are told by administration that it is all about time management, but it is completely unsafe. Time managing tasks in med/surg (real med/surg) is one thing, but when your patients are very sick time goes out the window, you need to keep them alive!
I'm thinking of applying to ICU's and step down units in other hospitals at this point. I have learned a lot at my current job but I would like to take excellent care of a few very sick people without having to basically ignore the 4 or 5 patients that appear to be more stable (the guilt is getting to me, they are admitted to the hospital because they are sick but are neglected because they are placed on a unit that has patients MUCH sicker than they are).