The three Bs of med-surg nursing

Once two separate disciplines, medical nursing and surgical nursing merged back in the 1960s to form the more interdisciplinary “med-surg nursing.” Today, they’re the largest group of nurses in the profession.

Some consider med-surg nursing a stepping stone: a hands-on way for new nurse grads to gain experience for a year or two before moving into a specialty like critical or emergency care. But, over the years, med-surg nursing has really come into its own and is now considered a specialty in itself. Certification in med-surg nursing is now offered by the Medical-Surgical Nursing Certification Board (CMSRN) and the American Nurses Credentialing Center (RN-BC).

The Academy of Medical-Surgical Nurses was established in 1991 to support the growing population of med-surg nurses. The specialty organization considers med-surg nurses “the solid rock and backbone of every institution” and the specialty itself, “the foundation of all nursing practice.”

That said, many have lamented that the specialty can be rather difficult to define in specific terms. These three Bs may help you gain a clearer picture of med-surg nursing.

Med-surg nursing is broad

The patient population and duties of med-surg nurses are broader than those of other specialties, which are based in specific populations or types of care. Labor and delivery nurses, for example, take care of mothers and newborns. Emergency department nurses specialize in providing urgent, sometimes critical, care. OR nurses, well, you get the picture. But med-surg nursing covers a vast patient base, and its nurses provide an extensive spectrum of care.

On the whole, med-surg nurses provide direct care to hospitalized patients. Sounds simple enough, but only in theory. The reality, clarifies former med-surg nurse Jennifer L.W. Fink, BSN, RN, is that “in one day, a med-surg nurse may care for a 30-year-old recovering from knee surgery, an elderly woman with Alzheimer's who insists it's 1963, a newly diagnosed, non-English speaking diabetic, and an alcoholic receiving blood transfusions for a GI bleed.”

In smaller, rural hospitals, Fink adds, med-surg nurses may care for pediatric patients every now and then, too.

Shared one med-surg LPN who works in a small hospital, “We only have one floor for med-surg, so we get a wide variety of patients from myocardial infarction and strokes to post-ops and chemotherapy and detox patients. We get pneumonia patients, GI bleeds, fractures, dialysis patients, diabetics. We get it all! This is what I love about this hospital. I go to work every day just wondering what I’m going to get.”

Med-surg nursing is busy

Perhaps it’s needless to say, but you will never hear a med-surg nurse complain of boredom. With today’s nursing shortage and swelling patient populations, med-surg nurses are busy.

Many manage 5-7 patients at a time. For these patients, they are responsible for a multitude of duties, which can include:

• Admission/discharge
• Ambulation
• Wound care
• Pain control
• Medication administration
• Liaison between the patient and other healthcare providers
• Patient education
• Other basic bedside care

In well-staffed hospitals, med-surg RNs sometimes delegate more basic tasks to LPNs and LVNs on staff. But after a day spent juggling the needs of a handful of patients who are sick or recovering from surgery, no med-surg nurse will tell you there was nothing to do at work.

Med-surg nursing is brimming

Because of med-surg nursing’s broad scope and busy atmosphere, many med-surg nurses find their work brimming with satisfaction. “I love med-surg because it's never boring, you never know what's going to come up to your floor from the emergency department, and sometimes you really can make a difference in someone's life,” writes a med-surg nurse in a small, city hospital.

From easing a suffering patient’s pain to teaching heart-healthy eating strategies to prevent another cardiovascular event, the differences med-surg nurses make range from profound in the here-and-now to quieter-but-mighty over the long term.  The ability to make a difference is what keeps many med-surg nurses in the field.

Med-surg nursing isn’t easy. It’s not relaxing. And it’s not exactly glamorous. But when your heart is in it, med-surg nursing can be extremely rewarding.

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