What exactly is so bad about Med Surg?

Nurses General Nursing

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I know it has something to do with the ratios, but other than that, what in the world is so horrible about it that makes new nurses say they would rather chew off their left foot than put in their time there?

And for those who like Med Surg, please chime in too.

I agree with the other pep. Med-Surg is a huge clump of everything. Pt may come in for knee surgery, but has uncontrolled diabetes and goes into a-fib after surgery. So you get so much info you have to learn and you have to be time oriented, task oriented and know your resources. This is why I like Med-Surg because you learn so much and you can take that knowledge anywhere. The down side is all the usuals..bad ratios like 8:1, disrespect from pt, families and docs, and unrealistic demands from management. Oh and dont forget the money. I just left a really cushy job on a postpartum floor to do med-surg but I'm doing twice the work now for the same pay. Why do you ask? Because I'm now having to relearn all my skills I lost 2 years ago when I left med-surg the first time. I'd like to be a NP one day and I feel like I need to get back into the general arena of nursing. Med-Surg is good....if you can hang!:monkeydance:

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Specializes in Telemetry, LTC, Psych.

Nurses need to realize that addiction is a chronic illness, just like any other illness. I also see a lot of judgmental attitudes toward obesity on my tele unit.

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Specializes in ED, ICU, MS/MT, PCU, CM, House Sup, Frontline mgr.

The patient to staff ratios are a JOKE! I am still a nursing student doing my clinicals on a medical surgical floor. I can honestly say that I can CARE LESS how many nurses tell me that I need the experience, I WILL NOT work a medical surgical floor!! The kind of stress associated with the demands of medical surgical nursing reminds me of another field of study to which I will not return due to high patient/client to staff ratios. Besides, I give myself 3-5 years on the floor anyway (I need the money), then I will be in management.

Off to specialize!!!....... I mean study.

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Specializes in Cardiac/Telemetry, Hospice, Home Health.

I have been offered a job on a surgical PCU. Is this much different from what I am hearing about med-surg? Is PCU (Progressive Care Unit) a new term?

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Specializes in Cardiac.

Pregressive unit is another term for step-down. The ratios should be about 4:1, and you should be able to take stable pts on stable gtts, (non titrating)

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So, I would avoid these problems by being on a specialty floor. They don't have rude docs, managers that treat you like children, bad CNA's, and bitter coworkers?

No, you have these things on other floors. It's just worse in med surge, imo.

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I did a new grad med surg float program and started on a medical transplant floor which I hated. I then worked on a trauma surgical floor and I absolutely love it. All my co-workers are great, my boss is great, and our pt load isn't too bad (4 to 6 even on nights). I really love my unit and am happy I did it. I feel I have great organizing skills and multi-tasking skills because of my job.

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Specializes in Medical/Surg/Tele.

I have been a medical/surg RN for over 20 years. I too like the variety of patients DX. I've done mostly the medical side of med/surg with simple surg(GB,appys etc). I have consitered going to like ICU several times but never have. I do Tele also now but only because I went to a hospital in a small city that the medical floor also included Tele and PEDs(that schooling has been more than 20 yrs ago) all on the same unit.

I think that new RN's don't like Med/Surg because the like the action in ER, ICU etc. They are ready(they think ) to SAVE the world. But few have the skills straight out of school to do that. I too believe a year on a med/surg area will make you so... much better prepared for the speciality units. I seen so many Rn's who say go staight to Tele units, who after a few years only know how ti deal with the heart stuff. Give them another medical DX, and they are lost. We all worked hard to learn in school. I think it's good to keep all that info on a working base. I for one will stay medical or medical tele , there I get to use a more variety of skills technical and people skills.:lol2:

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I work in Med-surg. I once worked on a specialty surgical floor and found it too boring and routine. I like the variation in Med-Surg and the challenge of it. It can be hell on earth though.

I hate the fact that our patients can be more complicated and require more care than on other floors and that we get a high number of dementia patients. Our ratios, however, are appalling. I may have 5 incontinant confused elderly patients who need to be fed at mealtime on top of 5 acutely ill patients. If one of the acutely ill patients goes bad and takes all of your time (which is a constantly occuring situation), the families of the elderly patients accuse you of leaving their loved one to rot because you don't want to be bothered with elderly people.

I like elderly people and don't mind dementia but I can't handle 5 of them and 5 acutely ill patients on my own.

Med surg nurses are very rushed with different kinds of demands and are sometimes not able to be on top of everything. People mistake this for incompetence and laziness and it leads to a huge lack of respect for med- surg nurses.

The doctors, pharmacists, transporters, physical therapists, OT, and social workers expect the nurse to work around THEIR schedule and workload and truly believe that we are there to make their life easier. I think that this causes the patients to suffer quite a bit.

Example:I was doing a drug round for 20 patients on friday evening about an hour before pharmacy shuts. Had just had 3 come back from theatre (OR).

I was the only RN on duty and was trying to get the meds done before dinner as I had 11 feeds and only myself and 2 care assistants (welcome to the UK). The pharmacist demanded that I drop what I am doing right now and be sure to order any meds that we might need over the weekend and don't have as pharmacy is only in from 0800-12 on a Saturday morning. Then they are closed for the weekend and back Monday AM.

She didn't want the pharmacy staff to get overloaded Saturday morning with med requests because they wanted to get out on time and get home for lunch. WTF? I told her no. She wasn't happy. Bottom line was that the pharmacy tech should have done it but never got around to do it. I would have done it but at that time ( overwhelming med pass) pulling away from patient care would have had a bad effect on the patients and possibly my license. :trout:

The relatives of your 6,8,10,or 20 patients want you to meet their requests on their schedule when it is convienent for them....to hell with how many other patients you have. They don't understand the whole cause and effect thing, the sheer amount of work that we have, and how important timing is with meds/labs/assesments etc.

If they want to talk to you now rather than later because they have a hair appointment you had better do it and to hell with the effect this will have on your other patients. They don't understand nor do they care. You the nurse are the one who will be accountable when a patient crashes out and you miss it because you are off trying to please another patients family who wants a 1:1 servant.

Med-surg is my specialty and I do love many aspects of it but other times I don't think I can take another day. :o

EDIT: I just wanted to add that other floors have these problems but their patients are much more

homogeneous. Our short stay surgical unit has twice the staff and the vast majority of their patients are self caring with ADL's and are on less meds. They are generally less complicated.

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In med-surg, even your interruptions get interrupted. Prioritizing among all the different demands that come up is difficult.

With a larger group of patients, there is less control. I once had a patient with AIDS dementia just wander off. Guess who is responsible for the man? Luckily an observant physical therapist brought him back.

In a speciality, nurses do not have to depend on nursing assistants. That leaves one less relationship for friction to develop.

Med-surg nurses wait longer to have doctors call them back.

Med-surg nurses have little or no control over family visitation.

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Specializes in mental health, geriatrics, MS, TELE.

It has been my experience that you are overloaded with patients. One med-surg unit I worked on in Kansas City, it was normal to have 8 to 9 patients per nurse. If we were lucky we had an aide. Most of the time it was total patient care.

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In med-surg, even your interruptions get interrupted. Prioritizing among all the different demands that come up is difficult.

With a larger group of patients, there is less control. I once had a patient with AIDS dementia just wander off. Guess who is responsible for the man? Luckily an observant physical therapist brought him back.

In a speciality, nurses do not have to depend on nursing assistants. That leaves one less relationship for friction to develop.

Med-surg nurses wait longer to have doctors call them back.

Med-surg nurses have little or no control over family visitation.

So so true about interrruptions getting interrupted. You are going around with the medicine cart and pouring some meds and someone phones, you go to the phone and on your way back someone shouts out for the commode, on your way to fetch the commode a phone call from lab comes in, on your way to take the phone call someone complains of shortness of breath. What was the first thing I was doing? It just goes on and on like this throughout drug rounds. If a wanderting confused patient wanders away during this it is your ass rather than the managers who refuse to staff the wards and hire nurses.

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