Why is Med-Surg so hated?

Specialties Med-Surg

Updated:   Published

Whenever I have told a fellow newer grad that I want to work in a hospital, they ask 'where?' And I say 'probably Med-Surg' and then they crinkle their nose. I just want to get my start in acute care and heard that's a good place to start. One of this area's hospital groups seems to have such a hard time hanging on to RNs willing to work in Med-Surg, that they will pay *experienced* RNs several dollars more per hour than in more sought after specialties. Is Med -Surg really so terrible or different from other acute care floors?

Specializes in Certified Med/Surg tele, and other stuff.
Ruby Vee said:
The OP isn't the one who said she hated bedside nursing. In fact, it seems like the OP cannot understand why others seem to hate Med/Surg so much. VAnurse2010 is the one with the horrible attitude about bedside nursing.

If you've decided that you hate bedside nursing and won't even TRY to find aspects of the job that you like and enjoy, if you just concentrate on how much "it all sucks", then you're not GOING to find any positive aspects to the job, and you'll be miserable. You tend to find what you're looking for, and if all you look for is negative, that's all you'll find. It's a miserable attitude, and it's one destined to make you even more miserable.

I once hated bedside nursing, too. Then I decided that since I had to do it to support my family, until something "better" came along, then I'd make up my mind to find aspects of it that I enjoyed. And wouldn't you know it -- when something "better" did come along, I was enjoying the bedside so much I didn't want to leave.

I can't like this enough.

That was ME years ago. I had the attitude just like that and I KNOW I was toxic to the floor. Do you know what I did? I QUIT nursing. Yep, and I don't think my coworkers missed me much.

Eventually, I had to return to nursing and you can bet my attitude needed an adjustment and it was up to me to do it, not my manager, not my coworkers. I had to FIND the GOOD in nursing again and I did.

I found that passion (yes, a much hated word on AN), and I reconnected with the patient. I became involved in policy changes and the workings of the floor. Instead of whining how awful it was, I FIXED it. I negotiate our contract, and help develop policy and procedures. I'm passionate about the profession of the Med/Surg nurse and nursing in general. I do not wear rose colored glasses and I'm a true realist. My goal is to have my nurses and team members rediscover their spark and remember why they wanted to become nurses in the first place. I fight for them as a floor and encourage them to join me.

To those that hate med/surg nursing so badly...get out. It's really simple. As I have said before, you are a toxic co-worker to the environment.

While I'm on my soapbox, I totally detest nurses that come to the Med/Surg nurse thread and whine about their med/surg job and how much it sucks. I don't go to other threads on AN and bash how awful being an ICU, ED, dialysis, or another other nurse is. Do you think they want to hear it?

I think the med/surg thread should be for those actually interested in Med/Surg :grumpy:

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Specializes in Medical-Surgial, Cardiac, Pediatrics.

I think traditionally med-surg is touted as "the thing you have to slog through to get to the REAL nursing jobs", i.e., the specialities like labor and delivery, ICU, ER, OR, etc. It's not really considered a speciality, because you get everything and anything, and that doesn't really give it a place in the nursing spectrum, which sometimes makes it hard to define. I think that contributes to the negativity surrounding it. That and it's hard. You get paid the same or less than other floors with higher acuity, yet you have a higher patient load and are expected to have a broader working knowledge to anticipate whatever comes your way. And patients can be just as sick with so many co-morbidities as higher acuity floors. It's not an easy field to work in, and it can wear on people.

I've found that I love working med-surg, which given the feedback I'd gotten from other nurses, I wasn't expecting. I think a lot of people go into it as something they feel like they HAVE to do, rather than are open to WANTING to do, and that impacts their perception of the experience.

Like any other position, it's what you make of it, and people get out of it only what they put in.

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Specializes in Certified Med/Surg tele, and other stuff.

Amsn is working on defining med surg. Funny you should mention the lack of just that

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Specializes in Pediatrics, Emergency, Trauma.
tokmom said:
I can't like this enough.

That was ME years ago. I had the attitude just like that and I KNOW I was toxic to the floor. Do you know what I did? I QUIT nursing. Yep, and I don't think my coworkers missed me much.

Eventually, I had to return to nursing and you can bet my attitude needed an adjustment and it was up to me to do it, not my manager, not my coworkers. I had to FIND the GOOD in nursing again and I did.

I found that passion (yes, a much hated word on AN), and I reconnected with the patient. I became involved in policy changes and the workings of the floor. Instead of whining how awful it was, I FIXED it. I negotiate our contract, and help develop policy and procedures. I'm passionate about the profession of the Med/Surg nurse and nursing in general. I do not wear rose colored glasses and I'm a true realist. My goal is to have my nurses and team members rediscover their spark and remember why they wanted to become nurses in the first place. I fight for them as a floor and encourage them to join me.

To those that hate med/surg nursing so badly...get out. It's really simple. As I have said before, you are a toxic co-worker to the environment.

While I'm on my soapbox, I totally detest nurses that come to the Med/Surg nurse thread and whine about their med/surg job and how much it sucks. I don't go to other threads on AN and bash how awful being an ICU, ED, dialysis, or another other nurse is. Do you think they want to hear it?

I think the med/surg thread should be for those actually interested in Med/Surg :grumpy:

Well SAID! :yes:

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Med surg is definitely not an easy floor to work. Burn out is extremely high, if it werent for my amazing coworkers I don't think I would last much longer. Our patient load usually runs 1:4-5 usually with 3-4 discharges and 3-4 admits, surgeries, or transfers. We get tons of detoxing pts who can be combative. We also get a ton of confused pts who get dumped on our floor because their care center refuses to take them back. When I leave at the end of each shift if I'm not nearly in tears then it was a good day.

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I agree with many of the positive things here. Med-Surg is not just a starting point until you can get into a better specialty. For me, and for many of my passionate and amazing co-workers, med-surg is our top pick. I love my conscious patients and the opportunity to be there for them and their families for 12 hours.

I agree that there are days the patient load can be absolutely overwhelming and I worry those days about not being as safe or as thorough as I would like to be for each patient each day, but I do what I can, have a glass of wine and come back to do my best the next day.

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Specializes in Med-Surg and Neuro.
tarotale said:
...if someone wants to go to ER or ICU in first place, why not go there and learn the art of that specialty?

I applied to several ER residencies. Many wanted EMT experience, from a new grad RN! Ugh. Many stated they wanted CNA experience from their speciality. ICU's wanted new grads to have a critical-care senior preceptorship, peds wants ped preceptorship, etc. In my dozens of applications, I found acute care (especially M/S) and NICU were the only ones in the hospital that will take you with nothing but your stethoscope and RN.

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I've worked med-surg units that were well oiled machines and a joy to be in. I've worked some that are nightmares.

Overall, though, in today's working landscape, I say no way no how would I want to go back to MS. The patient, and the joy of the science of medicine is lost in rapid patient turnaround, ever expanding regulations, and patients that are way sicker and more diverse than they were even five or ten years ago. For instance I see some MS units now taking patients on vasoactive drips as "overflow" from PCU/Tele. And don't get me started on CIWA patients....

I also do not want to walk in the door, take report on five or six patients and do all of their assessments only to find out that I need to boot two or three of the five out the door within the next hour, and admit two or three more by noon all while doing morning meds, rounds with the medical team (which can take 30 or more minutes depending), calls to the MD's, answering call lights, answering the constant beeping on the Ascom phone, skin assessments, NG placements, and IV starts. Oh yes, and charting too.

Don't worry, Tokmom, I won't show up in your unit. Definitely not my gig. But I am very glad there are people out there who not only want to do it, but like it, too. :) :)

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Specializes in ICU.

I just can't stand having so many patients who can talk. I have too much polite customer service in my background to cut people off and be brief. I'm a talker. I literally cannot function with a bunch of patients and families capable of holding a conversation. I get great feedback from my patients and families, but what would that matter if I got fired because I couldn't get my work done? I am a fabulous ICU nurse. I only have to split my attention between two people and most of the time they are tubed. I would crash and burn in med/surg.

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I keep reading articles about nursing, too the point that I picture a nurse standing on a mountaintop with the wind blowing her/his hair. It's almost like a nurse is a solo act in saving a patient.

Now, reality:

You were asking about Medical Surgical nursing. I work the 3-11p shift. Most of the time when I start the shift, I check to see what the pca situation is. Most of the pca's are barely trained. They get a couple weeks training by another pca on the floor so basically they are hired without any previous medical training. There is only one pca to 14 patients so basically we are working without an aide since it takes about 2 hours for them to complete the vitals signs. The other night I had 4 of my patients that had a discharge order. All of them, of course, wanted to leave right away. One was a paraplegic so it took over an hour to get him into the lift, get him dressed and back into the chair. I had no help with the discharges. I just took it one discharge at a time. In the meantime, each time one was discharged, I got an admission as a replacement. By the time, I finished my last discharge. My other patient became unresponsive so I had to call a rapid response and travel with him to CT for a CT of the brain which took 1 1/2 hours. I then come back up to the floor at the end of the shift to give report and nobody was watching my two admissions so I then had to catch up on their meds and assess them. I then had to catch up and chart on 8 patients. I then hear the "static" from night shift about why nobody got the new admissions weight or why the admission was not completed. It's always a pleasure to end your shift with negativity from the next shift, especially from a new grad. Which is why I always go with the flow and make the best of every situation but this is why there is such a high turnover rate in med/surg. No admission/discharge person because of budget reasons and getting slammed with admissions to the point that the nurses feel it is unsafe for patients.

The acuity is also much higher now. There is a rush to transfer ICU pt's to the floor so not only are we slammed with admissions, we have to keep a close eye on pt's with a tube coming out of every orifice of his body or pt's on bed alarms with a thin staff.

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Specializes in Med-Surg Oncology.

When I was in nursing school in 2007-2008 I had the opportunity to do clinicals on a Cardiac Med Surg floor, ICU, looped into ED, Maternity, Cath-Lab, Surgery, Recovery and Pediatrics. Of all those specialities I really enjoyed ICU the most. I worked 8 hours a week on a Med-Surg unit and grew to love it. I was offered a job before I even graduated and started working on that Med-Surg Oncology Unit. Never would I have thought that I would be on an Oncology floor but I truly love what I do. I have been in med-surg now for over 5 1/2 years and have earned my certification as well as my BSN and MSN. Yes it can get hectic caring for 6 patients (we max out at 6 patients) but you learn how to prioritize, manage your time and be well organized. I enjoy the interaction with my patients and their families. I also have had the opportunity to cross train in Progressive Care Unit (Step down ICU) and also have cross trained in Ambulatory Surgery. Each I love for very different reasons. Each unit has its own dynamics, stressors and perks. Nursing is what you make of it. If you hate your job your in the wrong field/specialty. Its time for you to change ;)

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Specializes in Med-Surg and Neuro.
Grasshopper11 said:
No admission/discharge person because of budget reasons and getting slammed with admissions to the point that the nurses feel it is unsafe for patients.

Did such a thing exist back in the day? That sounds like my dream job. Get 'em in, get 'em out... My dream job! I had a clinical day with an admissions RN at a mental facility. I liked it.

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