Why do so many of you hate working med/surg?

Montessori Mommy · Feb 24, 2007

As a student, I don't like med/surg for a few reasons. First, I can't imagine safely caring for 8 or 9 patients at a time. I'm sure experienced nurses can do it, but it just seems like playing with fire. Second, I - personally - don't enjoy working with seniors. Thank God there are many nurses who do, but it just isn't for me.

I'm heading to labor & delivery after graduation.

Jolie, BSN · Feb 24, 2007

When I graduated from college 20 years ago, I vowed that I would never take care of a sick adult for as long as I lived (and knock on wood, I haven't had to yet!)

I don't hate med/surg, but I don't like it either, for many of the reasons others have already stated: 1. Poor ratios, 2. Demanding, self-centered patients and family members who think you are present solely for their convenience, 3. Lack of continuity with patients over the long term. 4. I also find that med/surg just doesn't interest me much. I have no fascination with the disease processes, pathophysiology, pharmacology, etc. involved in the care of these patients. 5. I also don't like being unable to "eyeball" my patients at all times. I am used to being able to watch over all of my patients at a quick glance and know immediately if they are in need of attention, even while I am working with another patient. That simply isn't possible on med/surg without x-ray vision, which I haven't developed yet :)

My specialties have been NICU and OB. In contrast to med/surg, I find the care of critically ill newborns and pregnant and post-partum women to be absolutely fascinating. I can't get enough theory and research on these topics. I love the long-term contact with NICU babies and families. And although families can become demanding at times, I just find it easier to take in the context of the NICU or OB setting.

I agree with Montessori Mommy above, and am grateful that there are others who enjoy med/surg, psych, and all of the specialties that don't interest me. And med/surg IS a specialty!

marilynmom, LPN, NP · Feb 24, 2007

I think you either love or hate med/surg. Just like any other area. It's not me. I think it takes a very special RN to work in med/surg actually, it isn't for the faint of heart and it isn't for whimps that is for sure (I'm a whimp...lol).

I work as a tech on a med/surg floor (I float all over the hospital) and I know it is not for me. The nurses there seem to either love it or hate it. It is just not the type of nursing I am interested in or enjoy, and that is ok, we all have different interests.

I think everyone should work in an area that they enjoy and have some passion about--not in an area they hate because they feel or have been told they need to put in their time in order to move on. I think the patients deserve that.

RNperdiem, RN · Feb 24, 2007

After all the running around and getting pulled in so many directions, I would leave many days feeling guilty that my patients didn't get the care I would have liked for them. There is simply too much to do.

I also like to keep a close watch on my patient. For example, once I found a patient with no pulse or respirations. When the code team asked how long she had been down, I answered "I don't know".

Larry77, RN · Feb 24, 2007

I personally loved working surgical (with some medical overflow) because we had the same patients sometimes for their whole hospital stay. You really gained a great rapport with a lot of great people, yes there were a few "bad apples" in there but nothing like the "bad apple" ratio I get in the ED. When I worked surgical I would sometimes see my patients in the community and they would strike up a conversation and tell me how they are doing etc--working in the ED I rarely get positive feedback in the community.

I do not agree that med/surg is a "specialty", I believe it is a "field". The thing about med/surg is that that is what we are geared to do in nursing school and is a field that does not require extra certs and training (like OB/psych/ICU/NICU/ED and many other fields) this is what makes these "specialties". It's like calling GP's specialists there is no extra residency for them (not to be confused with family practitioners because that is a specialty requiring residency).

DeLana_RN, BSN, RN · Feb 24, 2007

After all the running around and getting pulled in so many directions, I would leave many days feeling guilty that my patients didn't get the care I would have liked for them. There is simply too much to do.
I also like to keep a close watch on my patient. For example, once I found a patient with no pulse or respirations. When the code team asked how long she had been down, I answered "I don't know".

LOL (if It weren't so sad...) On the med/tele floor I worked right out of school, a doctor once found his pt in rigor mortis (well, not quite, but she had been dead for a while) - the best part, she was on tele :eek: The monitor tech must have been too busy reading the newspaper...

I wish I hadn't listened to my instructors who said, "You need a year of med/surg". It was the most horrible year of my life - the ratios were ridiculous (1:8 on day shift on a med/tele/PCU* floor where we had to hang Cardizem and dopamine drips, plus blood and all the other stuff), there was no support - nobody to do admit assessments, start IVs, etc. - and new grads were basically thrown to the wolves. Some experienced RNs did help when asked, otherwise I would have never made it. However, the OT I worked was ridiculous (did I mention my base pay was 13.66? In 1999? :madface: ) because I simply did not have time to chart during my 12-hour shift - of those 8 assigned beds, half the pts were usually discharged by noon and in the afternoon the admits would come rolling in... if you were lucky, not all direct admits... oh, the horror (instead of leaving after 12 hrs at 1900, I often left at 2100, sometimes 2200, and on a really bad day even 2300 - just to do it all over again the next day).

I had a great manager, but she couldn't convince upper mgmt that these ratios were ridiculous (they were later changed after most nurses quit, along with the manager).

Yes, I did learn a lot, but in retrospect I could have learned much more elsewhere. My husband, who became and RN 3 years after I did, went straight into ICU - great internship - and says he would never work med/surg. I wish I had had that wisdom (actually, he knew what I went through - I had nobody who could warn me).

DeLana

* I was hired for cardiac PCU and was supposed to have a 1:4 ratio; a few weeks later, PCU did not have enough nurses left. The for-profit hospital decided to merge PCU with med/tele; the pt acuity remained the same, but the ratio increased to 1:8! After they lost many nurses (including me) and the manager, they split the units again and hired lots of travelers.

RNsRWe, ASN, RN · Feb 24, 2007

I do not agree that med/surg is a "specialty", I believe it is a "field". The thing about med/surg is that that is what we are geared to do in nursing school and is a field that does not require extra certs and training (like OB/psych/ICU/NICU/ED and many other fields) this is what makes these "specialties". It's like calling GP's specialists there is no extra residency for them (not to be confused with family practitioners because that is a specialty requiring residency).

Interesting perspective. I disagree, however, that med-surg does not require additional training other than what is received in nursing school. Nursing school gave me the basics from which to BEGIN learning the true skills utilized on m/s. Nursing school cannot hope to teach you all that you need to know on this unit; orientation may be two months but true competency on this unit isn't achieved for a whole lot longer. Probably where the "1-2 years of med-surg first" thinking came from.

There are unit-specific competencies that my med-surg unit has to complete that other units don't. I'm sure there are requirements for OB that I don't need to be proficient in, but I'm equally sure there are skills I must be proficient in that they don't. There is also a med-surg specialty certification to be had if you qualify to sit for the exam and pass, just as there are certs in other areas. Hence, the term "specialty".

My unit is supposed to be primarily surgical with medical overflow as well, but it seems that sometimes it's more medical than surgical, and sometimes nearly all surgical. Depends on the phases of the moon, I think!

RNsRWe, ASN, RN · Feb 24, 2007

De Lana, sorry you had such a horrible experience! I think some of that must have paved the way for better orientations for my crew of graduates...nothing really prepares you for leaving orientation and going it on your own, and nothing really prepares you for high patient loads (my ONLY complaint on my unit, the ratios are usually too high). But I didn't feel thrown to the wolves, and I've never stayed anything CLOSE to as late in overtime as you've done.

I read about someone recently having had a pity-poor internship on m/s that did absolutely nothing for her but train her to be a tech, and a great one in ICU. Left her feeling that m/s was nothing but waitressing, which is unfortunate. The kind of training period you get is ENTIRELY going to affect how you do and what you think about working m/s.

Me, I'm glad I opted for this. I didn't really go to m/s because I figured I 'had' to, but the other options for me at the time just didn't look as interesting, or offer as much opportunity for growth (learning). Sometimes I feel like pulling my hair out (or someone else's!!) because of the intense demands of my shift but overall, I feel like I'm a much better nurse because of it. :)

energizer · Feb 24, 2007

I worked on a Med. Surg floor for 2 years before passing NCLEX. I am now going through RN training for ICU. I didn't want 11-14 patients on a midnight shift. I don't want to work with nursing assistants that disappear into thin air or don't do their job correctly. I prefer to be able to practice nursing precisely the way it is intended. For me, I feel like I will be albe to do that more in ICU than on a Med Surg floor.

Natkat, BSN, MSN, RN · Feb 25, 2007

I - personally - don't enjoy working with seniors. Thank God there are many nurses who do, but it just isn't for me.
I'm heading to labor & delivery after graduation.

I'm glad to hear someone else say that. When I tell people I don't enjoy working with elderly patients they try to make me feel guilty for that. I know lots of people who love working with the elderly, and I say great! More power to them. I know myself well enough to know that I feel frustrated when I work with elderly, and I know that someday I will be old too, but that doesn't mean I need to work with them now if I don't feel pulled to it.

I was a child once too, and I don't particularly enjoy children much either. Still, there are lots of people in between and that's where I'd rather be - more specifically in the OR.

cari rn · Feb 25, 2007

I personally would quit nursing before going to work on an adult med/surg floor. But like one PP said, it's just not the right fit for me, but it might be for you. I still remember how much I thought I hated nursing while in university, UNTIL I did peds and L+D rotations in 3rd/4th yrs. I fell in love with nursing then! That's because up until then, all we had done were med/surg rotations in adult hospitals.

What don't I like about med/surg? Mostly, the horrible routine. In adult settings, we were expected to sit through taped (usually) report first thing, then run around doing bed baths (nothing worse, in my opinion!! Though thank goodness there are nurses who enjoy helping patients this way!), make beds, then give ALL those PO meds, then listen to all the whining and complaining. And THEN, you got to come back the next day and do it all over again. Certainly not everyone, but enough to make me want to run away!

All I have worked in is large Peds hospitals (oncology, then Emerg), done some public health (also not my thing...too much of an "office job"), and am now going back to Emerg, as my mat leave has just ended. I love, love, love Emerg, and, other than L+D (which I would love to do AFTER I'm finished having babies...any negative outcomes would stress me out too much if I was preggo), I can't imagine doing anything else in nursing. Well, except maybe ICU - that would be good too.

Like I said, med/surg is definitely not the right fit for me. But I've met some wonderful, very experienced nurses who love it, so you should talk to people like them!

That's the absolute beauty of nursing - eventually everyone can find the right fit for them. There's nothing boring about being a nurse, just find what you love to do.

Good luck!

Gromit · Feb 25, 2007

Delana, your experience reminded me so much of my old facility (private small hospital) -I mean that could have been written by someone who worked there! I had flashbacks!

Rarely have I ever left one job for another, and had no regrets -that was one of the rare events. I've never looked back to that place. They did hire a lot of travelers -and it wasn't uncommon for a traveler to actually break a contract rather than stay there.