What's the issue with med surg?

Mukfay · Jul 11, 2011

Patient to Nurse ratio.

Caffeine_IV · Jul 11, 2011

Agree with the ratios and also the acuity is higher than it should be for those higher ratios.

tmartin83 · Jul 11, 2011

Agreed w/ post above... I'm a new grad, and I just had my first day and was shocked to find out that I could have anywhere between 8-13 pts.

However, if I can do that, then I know I can do anything, ya know?

On top of that, I love being able to converse to my pts (which may not be possible in ICU), and be with them to see their progression from the their admission up until they are discharged (unlike w/ ED). Also, you see almost everything! You really interact more with your pts on med-surg, in my opinion.

I love ALL specialties of nursing (but I can't do psych, lol!), but I guess med-surg is just.... med surg. :-)

Thedreamer · Jul 11, 2011

Anything over 4 patients increases your risk for a medication error by 7% PER patient. Just saying.

glutton4punishment · Jul 11, 2011

"On top of that, I love being able to converse to my pts"

:lol2:With 8 patients, good luck with the conversation :) You will wish that the pt and the family will stop talking so you can get some work done :)

dance4life · Jul 11, 2011

I like it. Just because it was in a hospital environment. Plus wew! your shift goes by really quickly.

Jenni811, RN · Jul 11, 2011

i wanted to work in med/surg. I love it. Yea a lot of beginning nurses start off in med/surg, but then again some of them end up staying because they love it. Some do go on to other specialties. Its so hard in nursing school to say exactly what you want until you really get out there.

Palliative Care, DNP · Jul 11, 2011

I agree it is the nurse to patient ratio. It can be overwhelming at times. I believe that is any unit you go though. For me I was afraid to begin in a specialty without any sort of experience. :twocents:

eriksoln, BSN, RN · Jul 11, 2011

Nurse pt. ratio is the biggest concern. But there are MANY other points that make M/S unique and difficult:

1. Everyone will tell you "acuity" is going up and up. M/S most certainly has seen an increase in pt. acuity. In the not so distant past, patients with certain treatments simply weren't accepted onto the M/S unit (Q2 hr blood glucose with insulin gtt. for example) but they are now. But the pt. ratios are not adjusted to reflect this.

2. You deal with patients from admit to D/C........the whole spectrum. Not everyone does this as much. So, you have the new patient while they are extremely sick all the way up to D/C. You're not just dealing with one facet of the patients hospital visit. You can (and often do) have: A new ER that needs admitted or was just recently admitted, someone going to OR, someone coming back from OR and someone being D/C'd all on the same team at the same time.

3. Many other units use the M/S unit as a "soon to be D/C'd" dump off. The pt. on the Cardiac Step down unit go to the M/S unit one day before D/C. Then, the next day go home, with the M/S unit being the last stop. This is VERY BAD for your PG scores. Every patient from every other unit who is unhappy with their care comes to you last, and if you can't use your 1/2 day with them to magically make everything right, the PG scores reflect it. Unfortunately, since they were on your unit last.............all those comments about rude nurses and doctors or w/e.......are accredited to your unit, even though it's plainly obvious they are talking about the other units. This leads to many emails/meetings about answering call lights and "smiling while you enter the room" that really should be directed at others.

4. People in general don't get it that when you go to M/S from another unit, it is usually because you are better and getting close to going home. So, you have this patient from the ICU who is used to having a nurse with 2 total patients come to you. They don't want to hear about doing things for themselves or about figuring out how they are going to do things at home. They want their dilaudid and pillows fluffed like on the last unit. Getting them from "enjoying the service" to taking part in their own health often is daunting.

wooh, BSN, RN · Jul 11, 2011

It's difficult and it doesn't have the "glamour" or the respect of the other specialties.

wooh, BSN, RN · Jul 11, 2011

4. People in general don't get it that when you go to M/S from another unit, it is usually because you are better and getting close to going home. So, you have this patient from the ICU who is used to having a nurse with 2 total patients come to you.

ICUitis. Other related psychosocial disorders include NICUitis, PICUitis, CVICUitis, BICUities, TICUitis... Primary symptom is overuse of call light. Other symptoms may include inability to independently pull up covers, reach tissues, or change tv channel related to an apparent loss of motor function of the arms.