Opinions please

[Carla25]

I have a decision to make and in the end I know it is my decision, but I would like some opinions. I recieved 2 job offers today at the same hospital. I am a new grad. One floor is strictly surgical and the other strictly medical. I think most Medical surgical units are together, but when the local hospital expanded they separated them. Can you tell me some pros and cons about each?

Thanks

[BlearnRN]

Is the surgical unit more of a short stay unit? It sounds like it might be. If that is the case then the pt will stay a short time and will be discharged before the weekend. Is the unit closed down on Saturday, Sunday, Monday or holidays? If the pt has complication to surgery, will they be sent to the medical unit or will they stay right there and be managed?

[jjjoy, LPN]

Post op patients come to you still groggy from anesthesia. Perhaps nauseous. Pain control is a big issue. You've got to make sure their bowels 'wake up' and progress their food intake. You've got to get them moving as soon as possible - despite how crappy they may feel. You've got to be vigilant for signs of complications (DVT, PE, elevated temp) (there are also relevant in med patients as well, of course). Depending on the type of surgery, you may be able to see patients "get better" that is go from post-op pain and stupor to ready for discharge, alert and walking on their own. Also, if it's a predominantly elective ortho floor it will be different than predominantly gastrointestinal floor. Some places get everything.

Med patients tend to be in for acute exacerbations of chronic disease. CHF, diabetes, renal disease, etc. There are often multiple morbidities and no "cure." The hospital stay is just to get them past an acute crisis. You need to be vigilant for subtle downturns in status - edema, crackles, dropping blood pressure, etc (these are also relevant in surg patients, of course). Some nurses become especially frustrated with those who keep being readmitted due to noncompliance. On the other hand, the sometimes extended stays of some of these patients can allow one to become more familiar with their patients, as opposed to having a high turnover day to day. Again, it depends on the floor, since some may have more of a certain type of patient than another.

These are sweeping generalizations as to be taken as such... not as a definitive definition of the differences!!!!!

You can ask the unit managers about a "typical" patient (diagnosis, length of stay, trajectory of stay) to perhaps get a better feel of these two different floors. Definitely ask about shadowing a nurse or two for a few hours if at all possible!! The personalities of one's colleagues and the overall atmosphere of the unit can make a big difference for some people.

Good luck with your choice!

[YellowFinchFan]

I think you probably will learn more in the surgical unit - it's more challenging imho - you will get great skills.

[ceecel.dee, MSN, RN]

Personally, I prefer a surgical unit. Great learning and assessment skills and procedures!

[ChristineN, BSN, RN]

I prefer medical, one reason being that alot of the hospitals in my area have highly specialized surgical units, but they have more general medical units. I love variety, and don't want to be too specialized right now, so this works great for me. BTW: I'm also a GN.

[medsurgrnco, BSN, RN]

Is there any difference in the patient:nurse ratio on the units? If you work days, you might prefer the medical unit as there would be more admits & discharges on a surgical unit. Otherwise, I'd suggest going with the unit that appears to have the best manager, teamwork (charge, nurses, & CNA's), longest staff retention, etc.