Med-Surg Nursing Evolves as a Specialty

09/06/2016

See how the role of med-surg nurses has expanded and changed

These days, med-surg nursing has evolved into a distinct specialty, and one of the most demanding. Learn more about medical-surgical nursing.

By Debra Wood, RN, contributor

Long a mainstay as the providers of bedside care, medical-surgical nursing has grown and developed over the years from a stepping stone to other units to a specialty in its own right.

“Med-surg nurses, at some point in time, will touch every adult patient,” said Jill Arzouman, DNP, RN, ACNS, BC, CMSRN, president of the Academy of Medical-Surgical Nurses and director of professional practice at Banner-University Medical Center in Tucson, Arizona.

About 650,000 nurses work in med-surg. In addition to hospital inpatient units, med-surg nurses work in clinics and urgent care centers, for insurers and home health, in long-term care and surgical centers.

“Med-surg nursing is a place for people to come and stay,” Arzouman said. “There is always something new and different.”

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In decades past, medical-surgical nurses provided nearly all care on wards. Then specialties developed, and many in the profession viewed med-surg units as a place for a new graduate nurse to gain some skills caring for patients before moving on to intensive care, emergency or other specialty units. Those were the long-gone days when an uncomplicated appendectomy patient might stay a week in the hospital.

Now, however, as acuity has increased in acute care hospitals, med-surg nursing has evolved into a distinct specialty, and one of the most demanding. These inpatient, med-surg nurses, typically, care for 5 – 7 patients, many who years ago would have received care in an intensive care unit.

“These nurses have to have a good grasp on a wide variety of diagnoses,” Arzouman said. “On any surgical floor, you are going to have patients with medical issues, given how our population is aging.”

Med-surg admissions and discharges occur in rapid succession on med-surg units.

“It’s always fast-paced,” she added. “Patients are coming and going. The turnaround time is fast, and you have to pick up on the issues and critically think and plan for this patient in a short period of time.”

When sending patients safely home and to prevent rehospitalizations, the med-surg nurses play a key role in care transitions and in preparing the patients and families in self-management of the patients’ varied conditions.

“What they need to know to go out of the hospital and stay out of the hospital is critical,” Arzouman said. “We have an opportunity to teach about self-care.”

Additionally, med-surg nurses coordinate with other members of the health care team – rehabilitation therapists, physicians, residents, and dietary and case management professionals.

“You are the hub, coordinating all of the different disciplines,” Arzouman said. “It’s prioritizing on a larger scale than in an ICU.”

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Med-surg nurses must stay abreast of the latest research and best practices, she added.

“There is always some new practice,” she said. “You have multiple patients with multiple diagnoses, and you get a greater breadth and depth of information.”

Med-surg nurses often become involved in their hospital’s shared-government councils, actually playing a part in changing policies and practices based on the latest evidence.

“We encourage that, whether it is a process improvement project or doing a literature search or a research project,” Arzouman said.

Nurses also can move up into management roles or into a clinical nurse specialty role in planning care and working with the team. Med-surg nurses also can teach the next generation in a part-time faculty position in academia.

Med-surg nurses can become certified in the specialty through the Medical-Surgical Nursing Certification Board, and earn additional recognition from their employers.

“Certification is a mark that you know your stuff,” Arzouman said.

The Academy of Medical Surgical Nurses offers opportunities for networking and staying aware of changes in the profession, both clinically and legislatively. It also offers members a discount on certification, scholarships, and certification, research and convention grants.

“Health care is moving so fast,” Arzouman said. “You always need to have your finger on the pulse of the information. We, as a professional organization, try to provide the most current information in a timely fashion for nurses.”



© 2016. AMN Healthcare, Inc. All Rights Reserved.

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