Medical-surgical nursing (med/surg for short) is often known as a starting place for new nurses. This isn’t a rule and won’t be the experience of all nurses (myself included). Med/surg is a great specialty to begin your nursing career in because, well, you won’t truly specialize in anything. Med/surg nurses see all kinds of diseases and treat an array of patients. It’s a great environment to learn what you like and don’t like as a nurse and it allows you to hone your assessment and hands-on skills. That being said, med/surg nursing is a challenge and requires confidence under pressure. Here’s a brief, yet realistic look into the busy role of a med/surg nurse.
Med/surg nursing comes with the highest patient-to-nurse ratios in an acute care setting. It is not unusual for one nurse to care for 7 patients. Caring for 7 patients is difficult, to say the least. This is why med/surg requires nurses to have solid time management and prioritization skills. These are skills that come with time and experience. Nurses must begin prioritizing as soon as they walk on the floor. Each nurse will develop their own method that works for them. I highly recommend using brain sheets to keep yourself organized. These can be found online and printed, or you may create your own with information you feel is most pertinent. You fill in and add to your brain sheet throughout your shift so you don’t forget details or tasks. These notes also help with giving reports to the next nurse.
Med/surg nurses will care for patients from age 18-108. While some of the most common and unglamorous diagnoses encountered on a daily basis are pneumonia, dehydration, and diabetes, you’ll also care for patients with wounds, bowel obstructions, and recent surgeries. You will utilize all of your skills learned in nursing school which to me, is the best part. You’ll insert IVs, change PICC line dressings, administer tube feedings, and insert urinary catheters, just to name a few.
Unfortunately, it’s not all fun sticking people with needles or looking at intense wounds. Not only are you providing nursing-specific care, but you’re also the pharmacist, nursing assistant, physical therapist, dietician, and housekeeper. What I mean by this is that your duties include more than just nursing. You will pass medications all day, review lab work (and maybe even draw it yourself if there isn’t a lab team), help your patients ambulate safely, assist them to the bathroom or clean them up after incontinent episodes, help them bathe, provide snacks and drinks, feed them, and keep their room tidy. The tasks vary so much day to day, one time I even had to unclog my patient’s toilet!
This is another reason why time management is so important. The shift you plan to have will almost always derail. You must be able to adapt to the ever-changing condition and needs of your patients as well as manage incoming orders, delegate, answer the incessant ringing of your phone, coordinate with other disciplines, and find any spare moment to chart.
Med/surg nurses care for patients who are, for the most part, clinically stable. Med/surg units are not equipped with monitoring equipment and so certain medications are not given. Med/surg nurses do not titrate drips and usually will not perform tasks that require advanced certification such as stroke assessments or administering chemotherapy. This does not mean they are any less capable of handling urgent situations. Critical thinking is a vital skill required of all nurses. A patient that underwent a routine surgery or was cleared to discharge can suddenly deteriorate. Med/surg nurses must have strong assessment skills and confidence in their instincts to know when something isn’t right to prevent a dire situation.
While cardiac nurses must be well-versed in hearts, and pediatric nurses know exactly how to care for the tiniest patients, med/surg nurses need to know a little bit about everything. Med/surg nurses don’t have the luxury of specializing in one specific body system or patient population. You must be able to care for the patient with liver cirrhosis, walk into the next room and suction a tracheostomy then discharge another patient and educate them about how to care for their abdominal incision. Many med/surg nurses love their job for this reason. There’s never a dull moment and you never know what you’ll see next.
New nurses who start in med/surg are often well-equipped to succeed if they decide to branch out into other specialties. The fast-paced environment of medical/surgical units prepares nurses to handle anything. They have navigated high patient ratios, established impeccable time management systems, and are well-rounded in their knowledge of diseases and disorders. Med/surg nursing is a tough job and it isn’t for everyone, but it provides a solid foundation and experience that will serve you the rest of your career.