Tips On How To Be An Extraordinary Med-Surg Nurse

[Bugaloo]

What are the advantages of being a Med-Surg nurse?

Med-Surg nurses develop a broad knowledge base of many different medical diseases and conditions. They are able to execute excellent patient teaching based on this knowledge. They are often highly skilled in assessing small changes in a patient's condition that can prevent more serious problems from developing.

What are the disadvantages of being a Med-Surg nurse?

The Med-Surg floor is sometimes insanely busy. The floor is often short-staffed and the turn-over rate is high. Long hours, high acuity patients and hospital politics can lead to burn out if you do not pace yourself.

What qualities should a Med-Surg nurse have?

The ability to leap tall buildings in a single bound! OOPS, Sorry! That is SuperNurse, 'er...umm...Superman. Seriously though, the most important quality a Med-Surg nurse should have is a sense of humor. You will face things that will be much easier to stomach if you can laugh about it. Secondly, a sense of confidence can put your patients at ease and let them feel as if they are in excellent hands (which they are, of course!). The ability to prioritize and manage your time wisely is also important. Remaining professional and courteous even in times of high stress is a must for any nurse, but especially in Med-Surg.

What types of patients are admitted to Med-Surg units?

Your patient load can vary from simple 23-hour observations to chronic (frequent flyer) patients with multiple medical issues. Common medical conditions that patients are admitted with are the following:

• CHF
• COPD
• Diabetes
• Pneumonia
• UTI
• Pancreatitis
• Mental status changes
• Abdominal pain
• Fever
• CVA/TIA
• Cellulitis
• Falls/Fractures
• Drug overdose
• Alcohol Withdrawal
• Chest pain
• MVA's
• Cancer

What essential supplies should a Med-Surg nurse have in her pocket at all times?

• Black ink pens
• Something to write on
• Scissors
• Tape
• Pen light
• Chapstick
• Alcohol wipes
• A lucky charm

How can a Med-Surg nurse stay focused and organized throughout their shift?

I find that the acronym ADPIE helps me stay on top of everything I need to do.

• A: Assess my patients
• D: Determine what I need to do for each patient to keep them safe, comfortable and content while they are in my care.
• P: Plan HOW I will do this for each patient.
• I: Implement my plan for each patient, and share with each patient what the plan will be.
• E: Evaluate that plan periodically throughout the shift.

A lot of times, things will not go according to plan, but at least if I am dealing with a critical issue with one patient that takes a lot of time, I know that I can get back on track quickly with the rest of them when the crisis is over.

What are the signs of burnout in a Med-Surg nurse?

Burnout is always a risk when you are dealing with both acute and chronically ill patients. Recognizing the signs of burnout are very important. If you start to experience any of these symptoms, deal with them right away by scheduling vacation time, avoiding overtime shifts and getting adequate rest.

• An overwhelming sense of anxiety
• Uncharacteristic negativity
• Nausea, diarrhea and stomach cramps
• Exhaustion and fatigue
• Lack of motivation and focus
• Being short-tempered
• Being sarcastic and critical
• Having trouble sleeping
• Dreading coming back to work on your days off
• Obsessing over work even on your days off
• Frequent headaches
• Body aches and pains from tension

How can Med-Surg nurses avoid burnout?

First and foremost, leave work at work. Try not to worry about patients when you are not at work. On your days off, schedule "me" time, if at all possible. Play with your kids, spend time with your family, pursue a hobby, get a massage. By nature, nurses are passionate people. Nursing is physically, mentally and emotionally draining. The days we spend away from our job should be spent fulfilling our needs and the needs of those we love. We must reserve some of our passion for something besides caring for the needs of our patients. Once you do that, it becomes easier to find a work/home balance that works for you.

[Sylvi22]

On 4/20/2008 at 7:48 PM, pantheon said:

Hi, I really enjoyed reading your thread. I have worked in Med/Surg for almost 9 years. I loved it except when telemetry became mandatory! One class does not make a med/surg nurse a competent cardiac nurse. You might have a patient on tele once a month and your supposed to remember all that you learned in that class?

I need advice and I think you may be the right person to ask but I'll take it where ever I can get it! I haven't worked since 7/07 except for a job from hell in 9/07 until 10/07. I don't like to just quit but the job was NOT what was presented to me. The floor was understaffed, my preceptor was Charge Nurse so she couldn't help me, and they had me covering LPN's on orientation! Now if I worked in a hospital and was off orientation I would have no problem covering an LPN. I've done it in the past. But I didn't know the computer system neither did the staff because it was new! All the medications were on the computer and your tasks. No kardex's and everything about the patient was verbal so if you had an incompetent nurse that gave you report you were screwed.

The reason I left my job in 7/07 was because the commute was horrible and it had been 5 years and I wanted to get something closer to home. Also my Grandmother was not feeling well and I lived with her so I wanted to be there for her. My job from hell was close to home but not worth it. My Grandmother passed away in 10/07 so that was also the last straw for me to leave that job. I was so depressed as she was one of my best friends. So I live with my fiance and he is very supportive. He's a doctor and makes a great salary and I also received a nice inheritance from my Grandmother. So financially I'm great but I'm worried because I am starting to dread going back to working. I know I have to because I don't want to depend on my fiance or waste my education. But my motivation is just not there. I have thought about working in a Same Day Surgery setting or Endoscopy. I'm really thinking about working with a Plastic Surgeon. I love before and afters and seeing people happy. Whether it's elective or not for example a burn patient.

I don't know what happened to me. I became really depressed after loosing my grandmother and then I just lost most of my drive for nursing. I'm not depressed as I used to be anymore but I don't exercise as much as I used to and I sometimes sleep more than usual. Yes, I know these are signs of depression but they don't occur on a daily basis. Has anyone ever felt this way and what did they do about it?

How can I get my love for nursing and my confidence back? I don't like going to shrinks, been there done that. I watched Oprah Friday about people that hate their jobs and how they achieved what they wanted. So maybe I need to focus on my strengths and make a list like they did. The advice was NOT to focus on the weakness areas but only the strengths.

Anyone out there have anything to say??????

Hey just read your thread. Hope you have made a decision that has worked great for you. Blessings to you and be a light.

[Kamilah Coney, ASN, BSN, RN]

Wow! This article hit EVERY point I needed to hear. I have been a MedSurg RN for 1 year and 3 months and I am already ready to hop into a new specialty. At my facility, the nurse to patient ratio is ridiculous, the turn over rate is very high, and often we have to do our jobs with barely any supplies on hand. The nurses are fed up and the patient's are complaining to deaf ears(not the nurses, the managers and CEO). I will definitely apply the advice in this article to my life since I conveniently only live 10 mins from my workplace.

[al3x117, RN, EMT-B]

On 4/21/2008 at 2:16 PM, oramar said:

I like med/surg also. There is only one problem with it and it has nothing to do with the staff, patients or families. It is the fact that managment thinks the patients are more stable than on the critical units. This may have been true 30 years ago but it is no longer true. The people are so ill, they need at least a 1 nurse to 4 patient ratio WITH support staff. IF the nurse has four patients it is OK to give one admission on that shift but NO MORE. If for some reason the nurse has 5 patient or more already then there should be no admissions assigned to that nurse. I know it sounds like a pie in the sky dream but the truth is if they ever want to get this infection control problem, these bedsore problems, these failure to rescue problems under control that is what they have to do.

SOOOOO TRUE!!!!! PATIENTS ARE GETTING MORE AND MORE CRITICAL EVERY SINGLE MONTH!!!