What is it about Med-Surg?

klj836 · May 7, 2005

I have read quite a few posts from students complaining about how much they hate med-surg and wouldn't dream of working there after graduation.
What is it about med-surg that turns so many people off exactly? I'm a med-surg nurse and believe me I know how frustrating it can be, but what area of nursing isn't these days?
It makes me sad to think that med-surg is receiving such a bad rap.

I have been a nurse for over 30 years and love med-surg nursing. Everyone wants the speciality areas because of the patient ratio and they can focus on one modality. Med-Surg nurses are the cream of the crop. They don't nurse 'machines' as many of the ICU/CCU staff do; they have to know and relate multiple disease entities and prioritize care, have to be ready for emergencies at any time (often unsuspected) so they must react quickly, and they have excelent organizational skills and time management skills. It always amazed me that a Med-Surg nurse could float to ICU but the ICU staff COULDN"T float to Med-Surg. I mean that literally - COULD NOT, because they can't manage it. Med-Surg nusres need to stand up and be proud and realize that this is a speciality in it's own and a hard one to manage. Go out there and get those certifications and be proud of where you work and know you're the best.

Fgr8Out · May 7, 2005

I have worked Med-Surg-Tele for 4 years and really love it. The constant variety is what interested me and kept me there when the other things started to get me down (like the nurse-patient ratio). I also liked the way the day was so fast that before I knew it, I was getting report ready for the night shift. ("Course, that can be a drawback, too. Not enough time to do all that you want to do...)
I won't go into all the drawbacks, because that is a whole other thread and ahs been discussed. But I like Med-Surg very much. I have recently changed jobs to Home Health only because I have ortho problems that make it tough for me to stay on my feet 12+ hrs a day running all the time. (I am having surgery next Monday )
I think Med-Surg gets a bum rap and gets looked at as the garbage floor. But truly you receive an education there like none other. And, it is a specialty: You can get Credentialed in Med-Surg (you can be an AD, diploma or BSN) and your job initials will be RN,C. I am planning to take the exam in October - just sent in my application. And my hospital will pay for the exam. I will aslo get a small raise for it if I pass (I mean, *WHEN* I pass!!)

As the premier leader in Adult Care/Med-Surg nursing, the Academy of Medical-Surgical Nurses (AMSN) offers Med-Surg Certification to ADN, Diploma and BSN nurses; those passing the exam earn their "Certification Medical-Surgical Registered Nurse" (CMSRN). It is recognized throughout nursing. Med-Surg IS, as you point out, a nursing specialty. While the client population may have a broader base, the focus is on adult health care and education.

All nursing has a med-surg facet, and med-surg nurses are able to fulfill a wide variety of roles throughout nursing. As a member now of our hospital Float Pool, I find it easy to work on any floor. This is not to say that a nurse, is a nurse, is a nurse. It also does not mean that every Med-Surg nurse has the capacity to float throughout a hospital system with ease; I simply have found this to be a venue for preventing overload from working the same scene over and over. When it comes right down to it, Med-Surg nursing provides not only specialty expertise in the clinical setting, it also is the base from where all nursing originates.

The other arguments in this spool about staffing and patient load issues are not exclusive to the Med-Surg realm. Nursing has been perenially short for quite some time. And just because the nurse/patient ratio in the critical care units is higher, does not mean their work is any easier or any less demanding. As our overall hospitalized patient population become sicker, those in the ICU/CIC are increasingly more complex as well.

To anyone interested in certification in Med-Surg nursing, you can go to the ASMN website, at http://www.medsurgnurse.org. Our annual convention is this September in New Orleans, and there are 5 days of many great speakers and presentations planned, along with the opportunity to network with other nurses, and just plain have a good time.

Fgr8Out · May 7, 2005

While it is very easy to look for 'greener pastures' as a nurse, keep in mind that as a tech/NA it is not always so. Many hospital's pay ranges for these types of jobs can vary widely, and so can the job duties. Although I work for a great hospital now, if I had to leave, I would have a heck of a time finding a hospital that could even match my pay, and the work may be the same or even worse.
What do Med-surg nurses have against new grads going right into the ICU?? Is is because the nursing shortage allows people to go right into these areas without 'paying their dues' in Med-surg?

Your last paragraph is quite a generalization about Med-Surg nurse opinions. Perhaps this is a true statement where you work, but it is certainly not a true picture of all Med-Surg nurses.

I think some of this opinion about new graduates going directly into a critical care module stems from the perception that they lack clinical experience. I believe, however, that clinical experience can be gained in every setting from the onset. If a new graduate truly believes that the critical care setting is where their heart's desire lies, then that is what they should pursue.

jl_nurse · May 7, 2005

You hit the nail on the head kjl836!!! Thank you... I love med-surg, wouldn't want to be anywhere else.!!

Luv2BAnurse · May 7, 2005

Med surg is wonderful. But then again, any job is...as long as you make it that way. Working in a small hospital on the med/surg floor allows for many diverse diagnoses, age ranges from infants to nursing home residents. Our med/surg unit even gets overflow from the maternity ward. We (day shift) often come in with 7 or 8 patients, and if a CCU nurse has to come to the unit to cover he or she takes 4 patients. And to think...."everyone" thinks they are so special? I think they are wonderful, but that's because I don't want to work CCU, just as I think OR nurses, ED nurses, and SPU nurses are great. It takes all kinds. I think a big problem with the outlook on a med surg position could be just that, it isn't really considered a "specialty" and doesn't everyone want to be special?

cardiacRN2006, ADN, RN · May 7, 2005

Your last paragraph is quite a generalization about Med-Surg nurse opinions. Perhaps this is a true statement where you work, but it is certainly not a true picture of all Med-Surg nurses.
I think some of this opinion about new graduates going directly into a critical care module stems from the perception that they lack clinical experience. I believe, however, that clinical experience can be gained in every setting from the onset. If a new graduate truly believes that the critical care setting is where their heart's desire lies, then that is what they should pursue.

I don't feel that it was a generalization, I feel that it has been my experience since I have been working as a tech for the last 10 years. I have heard it over and over. If I thought it was representative of all med-surg nurses, then I wouldn't have posted it in the med-surg forum and asked for an opinion! I have worked at many hopitals, not just one. My hospital is a specility hospital, so we don't even have a med-surg department. It's all tele and ICU. I have been personally told by many people to go to med-surg first (especially by my mother!! An ER rn). I feel that if you have never worked in a hospital before, then med-surg is the way to go. But I feel a lot of static form other nurses in my clinicals when I mention that I want to go into ICU. I get a lot of eye rolling and sighs...... :uhoh3: Why is that?

bunny722 · May 8, 2005

I worked on a very busy med-surg floor when I was a new grad. The nurse to patient ratios were too high, and the patients are very acute with IV's, tubes, pumps, post-op, epidurals, etc.. Then you have the elderly patients who are confused or combative (and in a community hospital like mine, we didn't have bed alarms- we would have to put a posey vest on them). You have the dependent patients (most of whom end up having diarrhea on your shift) who need to be turned and fluffed and buffed. Then you have the younger patients who complain all the time no matter how much pain med you give them. You've got your patients with a lot of psychosocial problems. Then you have the patients who are dying and require a lot of time keeping them and their families comfortable. Then you have the people who are really sick and need frequent monitoring or may need to be transferred to an ICU.

You could have one or more of each type of patient in your daily assignment and it really is too much. And unlike a tele floor, the patients are not on monitors, so if someone has to be checked often, you can't just look at the monitor you have to go into the room and physically assess them.

I now work in maternity and I couldn't be happier. The physical work is less demanding. The patient population is better since it is primarily healthy women and babies. We do get sick moms and babies, but they go to the SICU or NICU respectively. The OB service where I work prides itself in being all RN staffed. We don't have PCA's so we do everything. This allows us to have a better nurse to patient ratio and we are able to spend more time with the patients and provide thorough care.

I still do med-surg from time to time as an agency nurse because I do miss it, but each time I do a shift, I remember why I left it. Still, my med-surg experience is invaluble to my nursing career. The skills learned in med-surg are carried through every specialty. Med-surg is where you learn all the fundamentals of nursing. How to start IV's, put in foleys, insert NG tubes, etc.. Med-surg is where you learn how to be a nurse. It is where you put to use everything you learned in nursing school. In med-surg, you see everything.

So to all you new grads, you may not like med-surg, but once you do it and then move on to the specialty of your choice, you will see how important it was to get that experience. It will only make you a better ICU, peds, OB nurse, etc...

Thank you for reading my long posting.

JennLynn2006 · May 8, 2005

I agree that respect should be given to each individual nurse no matter what area she works in, but I am not going to criticize CCU or ICU nurses and say they only take care of machines.

And I must say that on the unit I work on as a Student Nurse Extern has some not-so-great RNs on the floor (like all units).

I definitely agree that med/surg experience is VERY important to a nurse's education. I think all nurses should work in med/surg for a while before venturing out into their field of interest.

Like I said in an earlier post, if it wasn't the patients I work with, I wouldn't be on the same unit I've been externing on for 5 months now. Its all about the patients. :)

kenni · May 9, 2005

before starting med-surg there was the fear, #1 because of how previous students and faculty had expressed how much they hated it, and #2 because this was the semester that most dropped off. my first clinical rotation was terrible, at a county-run hospital well-known for its trauma center. the second clinical rotation was quite pleasant hospital, even better than the private facility I went to in the past. the staff was wonderful & patient, and they even played a lullaby over the speakers whenever a baby was born. so for me, the worst part about med-surg was disgruntled, rude employees (nurses) who were there cuz they had to be.

sassykitkatt · May 9, 2005

I have read quite a few posts from students complaining about how much they hate med-surg and wouldn't dream of working there after graduation.
What is it about med-surg that turns so many people off exactly? I'm a med-surg nurse and believe me I know how frustrating it can be, but what area of nursing isn't these days?
It makes me sad to think that med-surg is receiving such a bad rap.

I don't know, but working med/surg is the best place to work. You can't imagine how much knowledge you can gain from working on a med/surg floor. I worked the for over 14 years before going to dialysis. And my knowledge base is outrageous. It's busy but great. Many places won't hire you without med/surg experience.

sandnw · May 9, 2005

I have nothing but the greatest respect for med/surg nurses! I went straight into critical care after I graduated in 1974. (Wow...that was a long time ago!) I have never worked med/surg other than to rarely float; so I never learned the organizational skills necessary to handle that kind of load.

The acuity of patients has really gone up on the floors, yet the nurse to patient ratio remains the same.

My hat goes off to you!

nurseangel2005 · May 11, 2005

I graduate this Saturday (May 14th) and start precepting on the 24th on a Geriatric Med/Surg floor and couldn't be more tickled! Med/surg is the only place I want to be and the geriatric patient population is an added little bonus for me!! :)