Surgical vs General Medical Unit

[medsurgrnco]

Are surgical units any easier than general medical units? I've been working on medical units with the occasional surgical patient and am considering employment on a surgical unit. I have found the surgical patients typically easier - they are younger, A&Ox3, pleasant, few scheduled meds - altho some have lots of PRN needs between pain and nausea. On medical units, seems like I typically have mostly confused patients that are huge fall risks - who are on 10M meds, are slow at taking meds, want to talk endlessly, on isolation precautions, need lots of help to BSC or restroom, on restraints or bed alarms that go off continually, etc, etc.

[Penelope_Pitstop, BSN, RN]

I prefer surgical patients because that's what I enjoy. Therefore, it may be easier for me to take care of them...however sometimes on my MedSurg floor it was nice to have the medical patietns. Why? Well, surgical patients have to be monitored pretty closely post-op, plus have pain management and anesthesia recovery issues. People don't realize sometimes what anesthesia can do to a person. The "with it" older woman can be confused, the walky-talky adolescent can be green and puking, the need for oxygen can be greater, etc. Diabetics' sugars are out of whack due to being NPO before surgery and potentially after surgery as well as the stress of illness. Patients with major belly surgeries have a long road...sometimes they're NPO for so long they end up needing a PICC and TPN, even though this isn't usually the case. There was a while there when I felt like all I did was clear PCAs, check NG Tube placements, draw labs, hang TPN, push Lopressor, give nausea medicine, watch heart monitors, hang antibiotics, hang up fluids and did I mention breakthrough pain meds? And the lovely dressings! Also, sometimes there is blood loss which equates transfusions. And I don't want to get to the issues with orthopedic patients...not a fan of joint replacements!

As has been pointed out, medical patients need surgery too...appendicitis can happen even if you have a cardiac history, brittle DM and sickle cell disease.

But you know what, give me a fresh ex lap over a COPD exacerbation any old day.

[AprilCNA]

I've worked on the surgical unit for the past two years now. It's been great, and I love seeing a person get better,i.e, have a knee replacement and see them up walking and climbing stairs two days later. It's not a very heavy floor, granted there are the CPM machines, but not the constant hoyer lifts and total care patients as often the floor. Although, there are always the bathrooming, but thats a given on any floor, as with isolation percautions and bed alarms. We do get a fair share of the confused patients who fall and break a hip who need alarms, but overall it's a great floor. It's nice to have conversations with patients and see them progress. It's a constant learning enviornment with the variety of surgeries being done.There are the many drains to empty. The only downfall I see, is that the nurses sometimes get stressed with the constant adminstration of pain meds. But when the surgeries are down, we get a lot of medical patients, so there may not be much of a difference.

[november17, ASN, RN]

Wow, your unit is NOTHING like ours! Our surgical patients are frequently there for many days, and longer. Colon resections, creations of colostomies and ileostomies are there for some time. Even ortho patients (hips and knees) are there three or four nights.

The only patients we discharge that fast are the 23 hour admissions (rotator cuffs, lap cholys).

Patients lingering TOO long is one of my pet peeves; it'd be a real switch to see them leave before we could teach them enough!

In ortho it is pretty usual to have our patients leave in 2 or 3 days (depending on their age and motivation level to get through pt/ot). The turnover is nice, but it's tough on day shift because they will d/c 3 people only to turn around and have to do 3 admits. We get admits on the night shift too, but definitely not as many as days do.

the nurses sometimes get stressed with the constant adminstration of pain meds.

That's honestly my favorite part about ortho...and really the only thing that keeps me around. I guess I take a perverse pleasure in administering morphine or dilaudid to someone's grandma hahaha...One pt wrote a letter to the management calling me the "Best nurse ever" because I was always on point with her pain meds during her stay in comparison to the other RNs that happened to take care of her. I have a coworker that I call the "Queen of Narcan" because she's always so afraid her pts are ODing all the time!!! I find it more frustrating when I give pain meds and the patient is still in pain.Thankfully all the docs have pain control protocols in place as of a few months ago, so it's made our job much easier (no more phone calls at 3am asking for different pain meds).

[Nurzelady]

Are the surgical units much more easier on your backs?