Why is Med-Surg so hated?

Ruby Vee, BSN · May 7, 2017

Nzrnsoontobe said:
in my country we have general med, general surgical, A&E, peads, maternity, Operating theatre, pacu, dosa are in all hospitals and then speciality area are dependant on the skills of the doctors. We have free health care, so isn't about what area makes money. But we do have a doctors shortage. So each hospital has to have enough doctors trained in certain areas to be able to offer services. So our wards like mapu, Sapu, Hdu, Ccu, gynaecology, oncology, orthopaedics ect are dependant on them. And if a hospital loses to many doctors in a certain area than aren't replace the ward sometimes gets close down. But yeah it does vary from hospital to hospital. Big cities get more funding and attract more staff. So more wards. But medical will always be the worst ward to work in.
But the doctors shortage is really good thing for nurses though. We get used to full the shortage, so lots of oppurtunities. For example nurses recently are able to get prescribing rights after taking only 1 post grad paper in pharmacology and completing a few hours of observed prescribing. No long just for nurse practitioners.

What is dosa, mapu, sapu? Hdu = HemoDialysis Unit? Where are you? What is your country's requirement for using education?

EDNURSE20, BSN · May 8, 2017

Ruby Vee said:
What is dosa, mapu, sapu? Hdu = HemoDialysis Unit? Where are you? What is your country's requirement for using education?

I'm from New Zealand.

All nurses have have a BSN, it's the only way to be an RN. To work in the hospital you must complete a new progeam, that includes funded post grad study. Most nurses here get there masters because the cost is funded by the government and it's also encouraged by employers (DHBs). Plus great opportunities to advance.

HDU= High dependency unit. Not quite icu, not quite a medical ward. Pt that are acutely unwell, but to well for icu. But not well enough for medical ward.

DOSA= day of surgery. People who have minor surgery or producers and don't need to be admitted. After there surgery they will recover there before being sent home the same day as surgery.

MAPU= medical assessment and planning unit. Normal people from ED, almost an extension of the ward. acutely unwell pt that need diagnostic test before a treatment plan is made. But are to unwell to be medical ward. Almost a ED, almost a ICU. They are normally there for no longer than 24 hours.

SAPU= surgical assessment and planning unit. Again like mapu, but just with pt needing surgery.

Another difference we have is not having L&D nurses. All of maternity is run only by midwives. And then we have a neonatal unit where babies go if they are unwell, which nurses work in. Kinda like NICU? But no OB nursing here in any form. After 20 weeks it's strictly all midwives. Before 20 weeks you may see pregnant women in a out pt women health clinic, but you still wouldn't do much if any thing to do with the pregnancy.

Renal unit is for dialysis.

THats all the different wards I can think of that's different to America. But I'm sure there's more. Plus our hospitals are much smaller, only one per city too. My cities hospital is considered a big hospital and only has 360 beds. Most wards only have 20-30 beds and less in acutely unwell wards like mapu.

Ruby Vee, BSN · May 8, 2017

Nzrnsoontobe said:
I'm from New Zealand.
All nurses have have a BSN, it's the only way to be an RN. To work in the hospital you must complete a new progeam, that includes funded post grad study. Most nurses here get there masters because the cost is funded by the government and it's also encouraged by employers (DHBs). Plus great opportunities to advance.
HDU= High dependency unit. Not quite icu, not quite a medical ward. Pt that are acutely unwell, but to well for icu. But not well enough for medical ward.
DOSA= day of surgery. People who have minor surgery or producers and don't need to be admitted. After there surgery they will recover there before being sent home the same day as surgery.
MAPU= medical assessment and planning unit. Normal people from ED, almost an extension of the ward. acutely unwell pt that need diagnostic test before a treatment plan is made. But are to unwell to be medical ward. Almost a ED, almost a ICU. They are normally there for no longer than 24 hours.
SAPU= surgical assessment and planning unit. Again like mapu, but just with pt needing surgery.
Another difference we have is not having L&D nurses. All of maternity is run only by midwives. And then we have a neonatal unit where babies go if they are unwell, which nurses work in. Kinda like NICU? But no OB nursing here in any form. After 20 weeks it's strictly all midwives. Before 20 weeks you may see pregnant women in a out pt women health clinic, but you still wouldn't do much if any thing to do with the pregnancy.
Renal unit is for dialysis.
THats all the different wards I can think of that's different to America. But I'm sure there's more. Plus our hospitals are much smaller, only one per city too. My cities hospital is considered a big hospital and only has 360 beds. Most wards only have 20-30 beds and less in acutely unwell wards like mapu.

Do you still have wards? In the US, that would mean 14-16 beds in a room with only curtains between them; no private rooms and no bathrooms. It's increasingly rare here now, but I've worked the wards.

I'd love to visit New Zealand! It looks beautiful in the movies.

EDNURSE20, BSN · May 8, 2017

Ruby Vee said:
Do you still have wards? In the US, that would mean 14-16 beds in a room with only curtains between them; no private rooms and no bathrooms. It's increasingly rare here now, but I've worked the wards.
I'd love to visit New Zealand! It looks beautiful in the movies.

Yes we do have wards. We have a few private rooms in each for pt that need it. like pt in isolation or mentally unstable. And then the other rooms usually have 4-6 beds each, just seperated by curtain. I've find pt normally don't mind, they get to know the others in the room and understand what they are going through. Plus they always have some to talk to instead of getting bored.

and yes! NZ is beautiful. Completely different culture to america too. Very very laid back here.

Mrmcfender · May 14, 2017

Med-surge is the best place to build your skills. The unit I work on has no CNA ,we have to pull our own labs . The ratio is 1 to 3,4 . It builds the skills that you will need to move to the icu`s of the world . If I had one negative thing to say It would be that not all Med-surge nurse are the same. Some will want the complete life hx of the pt at shift change and some just want to know the most pertinent info and will read the H&P to learn the Hx . At the end of a 13 hr shift and having a float nurse that wants the complete hx , Im not wanting to take an hour to give a report on one pt . Read the H&P.

Isakolistic · May 15, 2017

They hate us cuz they ain't us.

lilRN16, ASN, BSN, RN · Jun 22, 2017

I started as a New Grad in Med Surg. I love it; from the patients to the coworkers. I do work in California, though, so my ratio is 5:1 and 6:1 (rarely). I get paid very well and find that we do well in our earnest attempt to provide continuity of care.

I've had ortho patients, oncology patients, patients with wound care/wound vacs, have done preop and post op care. I do hear people putting down Med Surg, but that's either their perception or their experience - both things I have no control over.

Like other posters have said, I will stay in Med Surg until I retire, and in California until those federal patient ratios became law.

I enjoy the challenges and will continue to make this specialty my nursing home.

tilliealicia · Jul 3, 2018

I have worked OR , Recovery and Med Surge. I think Med Surge has been the toughest. I prefer the schedule of med surge (3 twelve hour shifts), but i find that it requires a lot wider range of knowledge. I think med surge is higher stress. In the OR after you learn the preferences of the surgeons and anesthesia providers it is really pretty low stress. Recovery was boring for me. Med surge is a lot of patient and patient family contact....exhausting.

SeasonedTech · Jul 12, 2018

TheCommuter said:
The med/surg patient loads can be uncomfortably heavy in the area where I live. A while ago I was offered a night shift position on a med surg floor with oncology overflow: 8 patients to 1 nurse with no guarantee of a CNA or tech every night. This was a 'clean floor' with neutropenic precautions.
I shall also mention that the unappealing med/surg floor RN pay rate of $26/hour left much to be desired, especially since I had been earning more money than that as an LVN in a nursing home setting. Let's just say I rejected the offer and have remained at my current workplace, a specialty hospital, for several years.
California is the only location where I would willingly work med/surg due to the legally mandated ratios of 1 nurse to 5 patients.

Omg! $26 an hour is about what hospital CNAs make in Seattle.

RN-dancer · Jul 12, 2018

I give props to my medsurg nurses. They are the epicenter of health care. Working as a tech on a medsurg floor scared me away so I'm in the ed making sure patients proper before I send them up.

retiredmednurse · Jul 20, 2018

Karou said:
I love med-surg!
I like it that every day on my unit is very different from the previous. My patients are so diverse that I am constantly learning something new. I love the mix between medical and surgical. I have to organize and prioritize my care constantly, which keeps me busy.
I enjoy being busy. I don't like being overwhelmed, but I don't like too much downtime either. It's important to me to be able to talk with my patients and get to know them, this is one of the things that I really enjoy about nursing. On med-surg I am able to do this. In other areas (ICU, ED) you may not have that length of time with your patient or they may not be alert enough to form that bond with.
Med-surg nursing doesn't always have the glamour of other more acute or specialized areas. Some view med-surg nurses as beneath other specialities, less of a "real nurse".
I just shrug at that. I am grateful that there are nurses passionate about ED, L&D, ICU, ect... Because patients in those areas deserve nurses interested in their speciality who enjoy what they do. I happen to be passionate about med-surg and at this particular point do not want to go to a different area.

I agree wholeheartedly! I also love med-surg nursing. The local hospital is small with a 100-bed capacity. Med. and surg. are actually two different floors. The surgeons didn't like their surgical patients to be admitted to our "dirty" floor. As the medical floor, we got the "dirty surgicals", hospice, in-patient oncology, and of course the med patients. Every day is different.Diagnoses go in waves with 1-2 weeks it seems everyone is admitted with pneumonia, then it will switch to GI bleeders and we're giving blood, and then something else. If we had "dirty" and "clean" patients at the same time, then assignments were tricky. You could be either a "clean" nurse or a "dirty" nurse, but if one, you couldn't go into the other rooms.

Also, medical nursing is like working on a puzzle. You need to look at everything to see what's happening with the patient. IM docs love to try to out-do each other. One day, several were giving extreme lab values of their patients, trying to out-do the others. One that comes to my mind, is a young woman with a hct of

And because most of the patients have chronic diseases, you follow their course of their disease process over the years. From COPD, rheumatoid arthritis, cancer, sickle cell anemia, and so on. As soon as you hear the name, you already know their history. They are a person you know well and not a room number and diagnosis.

Anyway, enough of my love of medical nursing. If you stayed with me til the end, I congratulate you. I get wordy on these posts.

bd2rn · Sep 6, 2018

Personally, I think Med/Surg is pretty great! Most of the patients can talk with you, move themselves around (maybe with help, but still...), and are less likely to drop dead or wig out than pts in ICU, ER, OR, Psych, Peds, etc. People seem to think that ER/ICU is harder, but I disagree. They are DIFFERENT from Med/Surg. Not all specialties suit everyone, and the important thing is to find the place that suits you. Don't worry about whether OTHER people think your specialty is "better" than another. I hope this is helpful.