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Why is Med-Surg so hated?

Med-Surg   (109,120 Views 123 Comments)
by Nola009 Nola009 (Member)

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tokmom has 30 years experience and works as a CMSRN.

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I've seen this a lot, too and it especially gets touted by some of the nurses that float to the med-surg floors I've been on. I think there's a certain degree of "flash" and status that comes with being in a specialty but with Med-Surg, you have to be all things to all people. The time management, the total care pts (i.e. you are the sole caregiver -- no PCT, no CNA, no one to help you), the range of diseases/syndromes and everything else requires someone who has a broad knowledge base and excellent organization skills. I don't really get where this idea came from, though. I can see the excitement with higher acuity and maybe the more complex med admin and assessment but you really have to be on your toes in Med-Surg just as much. At the end of the day, anywhere is a good place to start. Experience is the most valuable thing.

Med/Surg IS a specialty. Nobody seems to realize that. :)

Any floor can and will be awful, with high rates of burnout, if staffing is sub par. Again, it's NOT med/surg that is horrible, it is what management does to med/surg that is so terribly wrong.

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tokmom has 30 years experience and works as a CMSRN.

47,618 Visitors; 4,568 Posts

Ditto. I hated my med-surg rotation in nursing school and I vowed to never return there. I have been working in OB my entire career. I'll admit there are serious disadvantages to never having worked med-surg. Every once in a while we get a pregnant patient with a trach or a PICC or some disease like MS or CF and I have no idea what to do with her. That happened to me just this week actually. But those are few and far between and overall doesn't make me regret never doing med-surg. If anything I just avoid those types of assignments. I maintain to this day that had I done med-surg straight out of school I would've quit nursing all together.

It isn't for everyone :)

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PacoUSA has 7 years experience as a BSN, RN and works as a PCU Nurse.

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It isn't for everyone :)

I wish my management would come to terms with this. True, med-surg isn't for everyone, but if conditions were made so that nurses didn't feel so overworked with high patient ratios to boot, then perhaps they can keep nurses for more than a year or two. They don't seem to be interested in fixing the retention problem in any concrete or substantive way. Staff turnover is incredibly high. Two new nurses are hired and three experienced ones leave. There are no incentives to stay on for any reasonable length of time to recoup the expense of orienting new nurses. They think free food and endless thank you's are going to keep staff but that is just a Band-Aid to the real problem. The staff nurse needs to be empowered with more than that. So even if med-surg is not a nurse's thing forever, you can make it so it is for at least more than a little while. Everyone in management has at some point moved on from prior specialties into something that was a better opportunity for them, including their management roles. Why then not support the nurse who chooses the same as opposed to being mad at them for leaving and contributing to staff reduction? If staff is unhappy, do something real with working conditions to encourage people to stay more than the bare minimum.

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tokmom has 30 years experience and works as a CMSRN.

47,618 Visitors; 4,568 Posts

I wish my management would come to terms with this. True, med-surg isn't for everyone, but if conditions were made so that nurses didn't feel so overworked with high patient ratios to boot, then perhaps they can keep nurses for more than a year or two. They don't seem to be interested in fixing the retention problem in any concrete or substantive way. Staff turnover is incredibly high. Two new nurses are hired and three experienced ones leave. There are no incentives to stay on for any reasonable length of time to recoup the expense of orienting new nurses. They think free food and endless thank you's are going to keep staff but that is just a Band-Aid to the real problem. The staff nurse needs to be empowered with more than that. So even if med-surg is not a nurse's thing forever, you can make it so it is for at least more than a little while. Everyone in management has at some point moved on from prior specialties into something that was a better opportunity for them, including their management roles. Why then not support the nurse who chooses the same as opposed to being mad at them for leaving and contributing to staff reduction? If staff is unhappy, do something real with working conditions to encourage people to stay more than the bare minimum.

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True that. I had this epiphany after I returned to work after being gone for 5 years. I was totally burned out. When I finally worked in a hospital with an amazing supportive environment, I realized it wasn't med/surg I hated, but the lack of staff and poor working conditions.

I now work in a hospital that is VERY supportive of med/surg in general. We have travelers that actually stay with us. We do lose nurses who leave for their dream jobs, but that's the way it should be. That's normal behavior.

When I said that med/surg isn't for everyone, I will still say it isn't. Nurses will always leave and even if some had grand working conditions and amazing teams, they would still leave if they found med/surg not exciting enough.

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Here.I.Stand has 16 years experience as a BSN, RN and works as a RN.

1 Follower; 41,680 Visitors; 4,829 Posts

My experience as a floor nurse was on a neuro/ENT floor. During that time, when our census was low, I floated fairly frequently to other floors--ortho/bariatric, surg onc, heme onc/BMT, solid organ transplant, tele, and med surg. I honestly didn't think med surg was a worse place to work than any of the other floors. Sure there were times I felt stretched thin, but that can happen anywhere. The variety in med-surg was really interesting, and the nurses were amazing. Nurse-pt ratios were about the same as other floors too. Neuro was kind of my first love, and most people don't love floating, but otherwise I did enjoy floating to med-surg.

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Here.I.Stand has 16 years experience as a BSN, RN and works as a RN.

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Oh, and I do think it's a great place to start, because you will see close to everything.

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LadyFree28 has 10+ years experience and works as a Clinical Nurse.

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Med/Surg IS a specialty. Nobody seems to realize that. :)

Any floor can and will be awful, with high rates of burnout, if staffing is sub par. Again, it's NOT med/surg that is horrible, it is what management does to med/surg that is so terribly wrong.

THIS.

There is a certification in M/S for a reason; there are plenty if nurses I know who have their certifications in M/S.

Any specialty can be rife with issues if staffing and management is sub-par or the culture of the unit isn't a fit; once any nurse can find that fit, they may have a niche for a time until they get to another destination, or they invest their time in that specialty.

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bear14 has 2 years experience.

4,632 Visitors; 206 Posts

It may not have the sex appeal as an ER or ICU but I see it as a great learning experience. It is a great place to cut your teeth and learn time management and develop your assessment skills. I also think it is a good place to start so you can get your "stupid questions" answered. Not that I believe that questions are stupid but as a new nurse you feel that your questions are stupid at times. I wanted L&D so badly but in the few months I have been on a med/surg floor I have learned a lot and I know what has been learned will be carried over and applied extensively. I am staying humble and grateful for what I have.

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annieboo444 works as a RN.

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I work med surg and like it. But yes it is all time management! We get 6pts and if something happens to one calling a rrt or something like a doctor writing 3 pages of orders it can take up a lot of your time and put you behind! Or they give a crappy assignment like all total care pts.

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tokmom has 30 years experience and works as a CMSRN.

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Yikes, six is a lot of patients for med/surg. I remember when typical pt's were laminectomies, broken bones, and COPD. Pt's are so much sicker now than they were back in the 80's when I first started as an RN. Our max is five, but usually runs 3-4 pt's with two CNA's.

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Everyone wants to start in their speciality. Work a med-surg floor for a couple of years though and you'll be able to go anywhere!

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PacoUSA has 7 years experience as a BSN, RN and works as a PCU Nurse.

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Everyone wants to start in their speciality. Work a med-surg floor for a couple of years though and you'll be able to go anywhere!

This is starting to become antiquated advice I fear. Lots of job announcements I have seen for specialized nursing units want specific experience in the specialty and med-surg experience does not seem to necessarily equate. ER wants ER experience, L&D wants L&D experience, ICU wants ICU or critical care experience, etc. Almost feels like if you start out in med-surg you risk getting stuck there. Just saying this because I have tried several times to transition to these kind of jobs with med-surg tele experience, have a great interview only to have someone with specialty experience grab the job. Where then can I get the experience if not given the chance? I will keep trying though, cant give up.

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