The Love-Hate Relationship with Med/Surg

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Specializes in ED/trauma.

I'm only about 5 1/2 months now...but it feels like SO much longer! So here's the breakdown...

First couple months (esp. during orientation): Disliked it. Came onto this website often looking for advice and emotional support. Found tons and managed to deal with the period ok.

Month 3: Felt incredibly insecure but liked the prospect of learning SO much. Felt confident about my abilities.

Month 4: Felt like I was finally in my groove. Got my time management down better than some experienced nurses, make sure all orders are taken care of (and, if not, have a good reason to tell the night nurse), make sure all meds are reconciled (unless it's end of shift and pharmacy hasn't updated the MAR yet), etc... I was really feeling good in med/surg, like this is something I could actually see myself hanging onto after my 1 year commitment! And my evaluation was pretty darn good given my limited experience (I received all average scores which my charge nurse said was good (given that I'm a NG) and even better than some of the other NGs). I was finally feeling "it"!

Month 5: A lull... Starting to feel like it's pointless. So many gero patients transferred from LTCs that are on isolation precautions. I feel like I'm babysitting more than I'm am BEING a nurse some of the time. All my patients seem to be in for (in order) (1) chest pain, (2) COPD exacerbation (and STILL go down to smoke!), or (3) something abdominal in origin.

I'm not sure what it is. I think it might be because I'm a compulsive over-achiever, and, although I LOVE routine, I feel like the hospital routine is eating away at my soul. Also, I feel like the learning had fallen by the wayside to all the "routine" conditions and orders. I think this hurts the most because this was the primary reason I chose med/surg over a specialty!

My days have become SO mundanely routine, that I can actually spell them out for you and come darn close to reality:

  • 0620 - 0700: arrive early to review pt profiles (time for which I'm not getting paid)
  • 0700 - 0730/0745: get report, review chart for previous (briefly, just to double check...) & new orders
  • 0730/0745 - 0830: pt rounds (make sure they're SAFE) & assessments (physical & pain)
  • 0800/0830 - 1000: pass meds, perform basic teaching (particularly on new or pain meds), perform more detailed assessments (if necessary)
  • 1000 - 1200: call significant results of procedures to dr's, chart 0800 pain assessment, chart all 6 initial assessments (I used to save these to complete sporadically during the day, as many experienced nurses do, but I found this SEVERELY stressed me out, worrying that I wouldn't get them done, or I'd end up staying late to do them, so now I MUST chart my initial assessments prior to noon meds / lunch), review new orders
  • 1200 - 1400: pass meds, chart 1200 pain assessment & re-assessments, review new orders
  • 1300 - 1430: 0.5-1.0 hr lunch (I never take breaks, so I'm willing to give myself extra time to eat, breathe, and relax if I need it -- esp. if my patients are completely covered, which I make sure to tell the other nurse in detail)
  • 1400 - 1600: pass meds, perform wound care / etc., review new orders, f/u on procedures that haven't been done yet, f/u on orders that are unclear / incomplete, call significant results of procedures to dr's
  • 1600 - 1800: pass meds, chart 1600 pain assessment & re-assessments, review new orders, inform pts about change-of-shift (at 1900 hrs & inform them to ask for anything prior to 1830 hrs, unless it's VERY important, otherwise, it will have to wait for the oncoming nurse)
  • 1800 - 1830: final review of orders / paper charts, chart I&Os (if not done so already), make sure all pain assessments & re-assessments are charted, make sure med cart is stocked w/ supplies for night shift
  • 1830 - 1900: sign charts (for 12 hr chart check), make sure everything is ready for night shift (if not, have a good reason / re-fax med orders / f/u on orders, if time allows -- or have a good reason why they're not done!)
  • 1900 - 1930/1945: give report to night nurse

Yes, I actually have it down to an orderly science (well, almost) at this point. And, although I come in EVERY single day with anxiety over the unknown conditions & needs & orders of my patients (and they're acuity levels, since we don't staff by acuity!), I still have EVERY day pre-planned... and they all usually fall into this schedule pretty darn well!

So what's the deal? I'm an organizational NUT JOB -- and love being one! But I also crave excitement, stress, drama, learning, expectations, and the chance to prove myself. I guess, although "the floor" offers all these things, the packaging isn't right anymore -- or, at least, not at this time? Maybe I'm just in a rut, and I'll snap back out of it in a few weeks or a month? I sure hope so...

Any one else go through this during their first year?

Oh, and I have a per diem home health job that I love (because of the immense autonomy I have -- even more so than in the hospital), but I'm worried I'll grow bored of that eventually too -- though the autonomy really helps -- in addition to all the paperwork, which I LOVE -- yes, I know it's a sickness.

I have applications out at other facilities, but I'm afraid I'm just doing a "grass is always greener" thing with myself. I work for a GREAT hospital. Maybe it's too great?

What the heck, guys?! :confused:

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Specializes in Med/Surg, ICU, ER, Peds ER-CPEN.

Have you thought about asking to float to the ER to see what it's like there? Some people are just cut out for ER because of the pace and you still have to be super organized, I honestly think more organized in the ER than on the M/S unit, I'm the opposite, I LOVE M/S lol give me geri's with abd pain and COPD any day lol

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Specializes in ED/trauma.
Have you thought about asking to float to the ER to see what it's like there? Some people are just cut out for ER because of the pace and you still have to be super organized, I honestly think more organized in the ER than on the M/S unit, I'm the opposite, I LOVE M/S lol give me geri's with abd pain and COPD any day lol

Yes, I am actually looking forward to floating, however... I can't until after 6 months (in a few weeks) and, even then, I can only float to one of our other med/surg units.

As for floating to ER, I don't think I'm eligible to do that at my hospital just because of the nature of the hospital -- but I've thought about asking.

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Specializes in Med/Surg, ICU, ER, Peds ER-CPEN.

Never hurts to ask, tell them you want to be cross trained so you can be a more valuable asset and expand your knowledge base

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