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

bethin · Feb 25, 2007

Even as an aide on med surg, I hate it. I love taking care of people but I hate having 10-12 pts to take care of. Most days if a pt isn't on their call light all the time they can get ignored. I'm so busy answering call lights for able bodied people who can't pour their water or touch the remote to change a station. Also, while ICU is high stress, I love the unstable pts. We don't get too many of those. I do work ICU when it's open (small rural hospital) and I flourish. New admit comes and I know the routine. I love the 1:1 pt care or the 1:2 pt care. I love being able to sit for 5 mins and talk to a pt. I also get closer to family members and they know me (an aide!) by name and ask for me. I feel much more useful in ICU. On med surg my 12 hrs are spent trying to keep my head above water answering call lights. I love love love knowing alot about a few pts than very little about alot of pts.

I am an adrenaline junkie. I thrive in high stress areas where you never know what may happen. Some people love that kind of job - stable pts. Some love not having the same pt for days and days and some like seeing their pts walk out of the ER. You really have to look at your personality to know what you love or hate. I made a list of loves and hates for each area that interests me. I've decided on NICU because it's high stress, unstable pts, few pts so I can get close to family, and I love taking care of children and babies. They always bring a smile to my face and that's the most rewarding thing for me. I love knowing I have done everything and I have done everything well.

Now, if I only could get through nsg school and get a job in the NICU.

bethin · Feb 25, 2007

They're still selling this load of crap in 2007????
don't buy it...
to the students, if you want to do _____________ type of nursing, get an externship 1 year before graduation, and get yourself 3-6 months of a new grad class/shadow time after graduating, and you'll do fine...

Yeah, they're still selling that load of crap. I don't know whether to believe it or not. I've worked med surg for 5 years as an aide and I do NOT want to work it after graduation (years away). I want to do NICU so I applied to be a volunteer cuddler and when I do get to the NICU rotation I want to make sure they remember me well - in a positive light. I think our hospital tells us this because they just want a warm body on the floor. I see so many new grads disenchanted with their jobs and question why they became a nurse. Not a good way to start off a new career.

We've had several new grads that were CNA's on our med surg floor and immediately go to work as RN's on med surg because they tell them they need at least a year experience. I think med surg is a great learning ground but you can also learn on the job on every other floor. Our hospital doesn't offer this, but larger hospitals orientation is looonng. I have a cousin that went to a large hospital and she had 2 weeks of classroom work, shadowed a nurse for 2 weeks, then worked with a nurse on the floor. And they asked her at the end of the month of classroom work, shadowing, etc if she felt prepared to work the floor. If not, they will send you back to the classroom or you can orient longer. BTW, this is a magnet hospital. Been a pt there and everyone was wonderful. The nurses knew I was studying nursing and were giving me IV pointers, how to prevent bruising after d/c'ing an IV, etc. They took the time to treat me like a person and not a number. Happy employees makes happy pts.

Jolie, BSN · Feb 25, 2007

The notion that organizational skills can only be learned in med/surg is a load of hooey.

Nurses learn best when they are caring for patients who INTEREST them. If med/surg interests a new grad, then great! If not, then the new RN will be better served to look elsewhere. Caring for 1 or 2 critically ill, total care patients will do just as much for learning prioritization, organization, critical thinking, and problem solving as caring for 6-10 semi-stable patients on med/surg. Probaby more, because the 1-2 patient assignment is realistic, while the 6-10 patient assignment is not, and the nurse ends up spending her time "putting out fires" rather than caring for her patients in an organized, well-thought-out manner.

So I second the advice given by another poster to find a lengthy new grad internship program in an area of interest to you.

nitesky83 · Feb 25, 2007

I am in my last semester of nursing school (graduating this May!) and when I first started nursing school I also hated med-surg. My classmates and I would always say we'd never work there after we graduated. Then I started working as an Extern on a Med-Surg/oncology floor, and at first I still had those same feelings. Now, 9 months later, I love it! I want to be a medsurg nurse when I graduate!

Gromit · Feb 25, 2007

I'm graduating in this semester like a couple other posters, and I also wonder what to do. I work as a tech on a surgical floor and feel I could immediately be productive there as a new grad (well, almost immediately)-but my husband says that means I'll be bored shortly thereafter. I liked the tele floor I worked on for a while, but it was disorganized and the CNAs "disappeared" all the time. I loved my ICU experience, seemed challenging and medical enough to keep me interested-but everyone says one shouldn't go right to an ICU-but I see some posters here saying otherwise.
My question, do you really think it's dangerous to go to ICU first, or a nurse will never learn organization if she goes straight to ICU?

School, go wherever you like :) -if you're interested in it, you will likely do a better job than if youre in some place just biding your time.

The answer to your question, however, depends entirely on the internship program at your chosen facility. If they have a good one, you will be able to go and do well at any department you want to start at. Typically this means a number of months with a preceptor until you are judged to be able to keep up, and usually involves at least two preceptors and your OWN self-evaluation. If you think you're ready and they think you're ready then cut loose you shall be :) I went directly to my ICU/Stepdown floor after graduating -worked as a GN and am still there as an RN. Our acuity level is such that we would be the ICU at any smaller facility (my facility is rather large -and we don't have any centralized ICU -rather we have a number of them that are specialized to one area or other like cardiac, neuro, medsurg, ortho, trauma etc etc. In the stepdown unit, we get patients with all of those characteristics, so its a good place to be if you like the variety -and the primary reason I chose it. Before I graduated, I was a tech at a smaller facility in their ICU, I enjoyed it, but they had no internship program -you were expected to put in two years in their medsurg floor before going anywhere else (and that floor was nightmarish -patients were two-to-a-room (and only one television -they would literally get into fights over the TV control -I'm talking about throwing food items at each other, or even trading punches and biting! ) and many of the patients thought they were in a cheap hotel or something. NO WAY was I going THERE! In the unit, though, our worst patient wasn't much compared to the stepdown unit I work on now. When they got bad, they transfered them to the hospital I work at (now). Anyway, the point is, go where your interests lie. I can't think of any place in my facility where newly graduated RNs don't start.

sasparilla · Feb 25, 2007

I've been struggling with where to work as well. I graduate in May and have never liked my med-surg rotations. I run around all day and when its time to go home, I can't even remember what it was I did. I agree with those that mentioned feeling like a waitress.

I've accepted a job with a new hospital in town that is a long term acute care hospital. The management says that it will be a mix of vent patients with other more stable patients that need to be in the hospital anywhere from 5-25 days, plus ratios of 4-5 to one nurse due to acuity. I hope that turns out to be true. I really like the ICU where I'm doing my clinicals and am still wondering if I ought to just go for that, but then I hear stories from a friend who just left there about how they often give newbies 3 ICU patients when they are understaffed (a common occurrence), even though they aren't supposed to. Hearing about them crying in the hall from the stress kind of scares me from going ahead and applying.

But I figure ICU is where I'll end up in the next year or so, I get so much more satisfaction from dedicating my care and full attention to a few people who really need it than I ever do caring for a bunch and then feeling like I didn't do a very good job at the end of the day because I couldn't do it all.

Myxel67 · Feb 25, 2007

=SCHOOLDAYS[/b];2084112]I'm graduating in this semester like a couple other posters, and I also wonder what to do. I work as a tech on a surgical floor and feel I could immediately be productive there as a new grad (well, almost immediately)-but my husband says that means I'll be bored shortly thereafter. I liked the tele floor I worked on for a while, but it was disorganized and the CNAs "disappeared" all the time. I loved my ICU experience, seemed challenging and medical enough to keep me interested-but everyone says one shouldn't go right to an ICU-but I see some posters here saying otherwise.
My question, do you really think it's dangerous to go to ICU first, or a nurse will never learn organization if she goes straight to ICU?

iF YOU APPLY for ICU or CCU as a new grad, the hospital will put you into their critical care training course if they have one. Ours was 2 months, but others could be shorter or longer.

Sean 91 · Feb 26, 2007

On Med-Surg one night with three of us RNs on because of a call-in, with 10-11 patients each and expecting another, the charge nurse was a young lady out of ASN-RN one year(, and two aides). (I was only out one year myself.) No one on duty was ACLS (because the hospital will send only a select few, including ICU nurses, to ACLS because it makes people too marketable. Which is why I initially refused to be charge--but it didn't work.)

She (the charge) had a patient who was full code, whose mother asked to make her daughter, one fo the charge nurse's patient, talk. The charge and I rushed over there with an aide, and the pt had obviously been dead for at least five minutes, maybe 10. But since she was full code we popped a bag on her and I started compressions--on a very dead person--while the aide pulled the blue code slider. The code team arrived and worked on the patient for about 20 minutes. We were short-staffed and the worst happened. It's nights like that you dread on med-surg. Yes, nursing students, that wouldn't happen in an ICU.

Sometimes if the charge on evening shift is continuing into 3rd shift she can stack the deck by getting more help, and we get seven patients each which is heaven. But usually we have at least nine patients overnight, as last night. The most 12 so far. How the night goes just depends on how the level of acuity such as needing pain meds, if any have N/V, if someone is recovering ETOH, new diabetic with BS checks every 1-2 hrs. We've had 12 patients each where everyone has slept, but other nights where 8-9 patients can be hell. Acuity. Unfortunately there are not the checks and balances on med-surg as there are in ICU. You usually know what to expect in ICU--a challenging 1-2 patients, but not med-surg. Every shift is different, which is scary.

This is therapy.

aakrn · Feb 26, 2007

Med - Surg is typically diffcult because of the high patient ratios....and like one nurse mentioned you are running around ALL night trying to remember a hundred things!! It is a rough area.....physically and mentally demanding! I have worked this field for five years now and I know its time to move on. The experience is great. You learn priorty quickly!!

Bella Donna · Feb 26, 2007

They're still selling this load of crap in 2007????
don't buy it...
to the students, if you want to do _____________ type of nursing, get an externship 1 year before graduation, and get yourself 3-6 months of a new grad class/shadow time after graduating, and you'll do fine...

Can you explain to me on how to accomplish this. I need all the help I can get, I am going through all this alone. I have been offered a job after I complete my first semester of NS, but any information you can share with me, I would greatly appreciate it. I start school in April.:monkeydance:

RNsRWe, ASN, RN · Feb 26, 2007

There is a "med-surg certification", but it isn't required for my department. I believe med surg nursing is a "specialty", but unfortunately it is often viewed as a "dumping ground" for nurses. While it's true that the acuity of the patients in ICU is higher, I think that there are many patients in the ICU that could have avoided being in the ICU if their med-surg nurse had been able to assess and get the doctor to focus on the problem earlier. Unfortunately this isn't possible when half of the nurses in med-surg are fresh out of nursing school almost constantly.

...and it's often not possible when the patient body count per nurse and patient acuity is so high that the nurse is more likely than not to miss something, even if he/she's not new!

RNsRWe, ASN, RN · Feb 26, 2007

I am in my last semester of nursing school (graduating this May!) and when I first started nursing school I also hated med-surg. My classmates and I would always say we'd never work there after we graduated. Then I started working as an Extern on a Med-Surg/oncology floor, and at first I still had those same feelings. Now, 9 months later, I love it! I want to be a medsurg nurse when I graduate!

Welcome!! We obviously need enthusiastic new grads who actually LIKE med/surg

For those who think that m/s nurses aren't "good enough" to go to other areas of the hospital, they've obviously never had the privilege to see some of the nurses *I* have the good fortune to be working with. Truly amazing nurses who know what's up with a patient before anyone else (yes, including the docs) and what to do about it. I see nurses with MANY years of experience in med-surg and can never forget just how GOOD they really are. Any suggestion that they aren't "good enough" for ANYTHING else is ludicrous!

I hope to be like them someday, when I grow up!