medical surgical floor has often been called a general hospital ward or
a regular nursing floor. Neither of these definitions acknowledges
medical surgical nursing as being a specialty. In fact, the
connotation is that nurses who work on the med-surg floor are
generalists with no specific knowledge. The med surg floor is often
used as a stepping stone, or a starting place, or proving ground for
new nurses. If you wanted to start a career in critical care, it was
often recommended that you get a couple of years’ experience on the
med-surg floor first. The problem with all of these definitions is
that they diminish the impact that the med-surg floor has on patient
care and diminish the value of the nurses who work on that floor.
Medical surgical nursing is a specialty area. Nurses who work on
the med-surg floor have specialized knowledge in caring for patients
with a wide variety of different conditions, in the same way that a
general ICU nurse would have a large variety of different patients in
their unit. In the document, Keeping Patients Safe, Transforming the
Work Environment for Nurses, published by the Institute of Medicine in
2004, they documented improved patient outcomes being related to the
nurse’s skill at monitoring patients and suggested that it is the
nurse’s care that is an important defense against errors.
With the majority of inpatients cared for on the med surg floors,
why is it that medical surgical nursing has gotten a reputation for
being a starting place or a proving ground? One of the reasons could
be that until recently, no one had documented the specialized knowledge
and skills that are required of med-surg nurses. With the recent push
to achieve magnet status, many hospitals are interested in having more
nurses become certified in their specialty areas. The American Nurse
Credentialing Center and the Academy for Medical Surgical Nurses have
developed curricula and criteria that define the scope and practice of
medical surgical nursing. This documentation has helped to define what
medical surgical nursing really is.
Med-surg nurses may have to care for several patients at a time and
need certain organizational skills in order to do so. These are
organizational skills that ICU nurses or OB nurses would not have.
Med-surg nurses also need to have specialized assessment skills in
order to be able to know a little bit about a large number of
patients. This differs from ICU practice where nurses must know a lot
about a few patients. In addition, medical surgical nurses often have
a wide variety of patients to care for with problems ranging from
cancer to surgery and can even care for pediatric patients on their
floors. A wide range of knowledge and skill is necessary to care for
this vast, diverse patient population.
Med-surg nurses account for the greatest number of specialty nurses
in any hospital. It is time we started giving credit where credit is
due. Medical surgical nursing is a specialty and med-surg nurses have
specialized knowledge and skills in order to be able to practice in
their environment. To find out more about medical surgical nursing,
visit the Academy of Medical Surgical Nurses at www.medsurgnurse.org.
David W. Woodruff, MSN, RN, CNS
President, Ed4Nurses, Inc.