Complete Guide to Med-Surg Nursing

What is a Medical Surgical Nurse?

The medical surgical nurse (med-surg RN) provides direct care to a variety of patients. The med-surg population is often acutely ill and suffering from a number of issues, complications, and co-morbidities. The med-surg population also includes post-surgical patients. Because of the wide variety of patient cares and needs the med-surg RN may come across, this area of nursing can often be the most difficult one to describe. It is also a widely coveted position for a new graduate RN looking to gain experience and exposure.

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The Academy of Medical-Surgical Nurses (AMSN) is working constantly to support the growing med-surg RN population. They claim that med-surg RNs are “the solid rock and backbone of every institution.” The AMSN also reports that med-surg RNs comprise 1/6^th of the nursing workforce and are the largest group of nurses in the entire profession.

Roles & Duties of a Medical Surgical Nurse

Because the work of a med-surg RN is so broad, it can be hard to compile a comprehensive list of all possible cares and duties. The following list is many of the most common roles a med-surg RN may perform, however, it is not all-inclusive.

• Admission and discharge paperwork, education, and care planning
• Monitoring of vital signs
• Medication administration
• Equipment operation and maintenance – IV tubes, feeding tubes, catheters, oxygen tubing, etc.
• Documentation of patient cares, needs, and progress
• Care team communication and collaboration
• Patient assessment and ongoing maintenance of orders and plans of care
• Family support and education
• Transportation facilitation (to home, care centers, physical therapy, etc.)
• Running and/or ordering tests and assessments
• Facility required education, reports, and charting
• Wound care (particularly if facility has no wound care RN)
• Pain control

Possible Diagnoses Encountered by a Medical Surgical Nurse

• Diabetes
• Pneumonia
• Sepsis
• Urinary tract infection (UTI)
• Chronic obstructive pulmonary disease (COPD)
• Cellulitis
• Renal failure
• Dehydration
• Falls
• Bowel obstructions
• Orthopedic complications (hip replacement, knee replacement, rotator cuff repair)
• Congestive heart failure (CHF)
• Syncope
• Hepatic encephalopathy
• MRSA/VRE/C-Diff
• Hernia repair

Associated Care Team for Med-Surg Nurses

Like most RNs, med-surg nurses have plenty of autonomy. However, there is an extensive care team often involved in med-surg patient care. This multidisciplinary model has been proven to improve patient outcomes many times, however, effective collaboration and communication are essential to these positive patient outcomes. The med-surg care team may include the primary care physician (PCP), an internist, an anesthesiologist, physical therapists, occupational therapists, technicians, and social work.

Medical Surgical Nurse Workplace

Medical surgical nurses work in a variety of care settings. While an acute care hospital is the most common place of work, you will also find med-surg RNs in inpatient clinics, health maintenance organizations (HMOs), education positions, outpatient or ambulatory care centers, nursing homes, military facilities, home health care facilities, or outpatient surgical centers. Because of the variety of institutions a med-surg RN may work at, per diem, PRN, part-time and full time (8, 10, or 12 hour days) opportunities are all available.

Medical Surgical Nurse Salary and Job Outlook

The field of nursing has been and continues to grow in a strong positive direction (12% growth per the BLS). While the income for a med-surg nurse can vary greatly (related to geography, facility, level of education, etc.), the average pay for a med-surg RN is approximately $77,000/year.

Becoming a Medical Surgical Nurse

Currently, the Institute of Medicine (IOM) has a 2020 goal that 80% of registered nurses (RN) be bachelor’s prepared professionals. Though that goal has not been achieved at this present time, the educational choices an RN makes should reflect a movement towards this hoped for national precedent.

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Med-Surg Nursing Education

Associate Degree Nurse (ADN): To practice as a professionally licensed RN, at the minimum one must achieve an ADN and pass the NCLEX-RN exam before being eligible for licensure and subsequent employment. ADN programs typically take two years to complete (after two years of the appropriate prerequisites). ADN programs are usually offered through community colleges and include coursework online, in the classroom, lab work, clinical rotations, and practicum experiences. Most students who choose to pursue an ADN degree do so understanding that they will have to back to school for a BSN.

Bachelor of Science in Nursing (BSN): To maintain competitive advantage as well as meet the IOM mandate, most RNs choose to pursue a BSN program to begin their professional practice. BSN programs usually take four years to complete. BSN programs are offered at brick and mortar campuses and online. Much like an ADN program, they are a combination of classroom work, lecture, labor work, clinical experiences, and practicums.

 There are also “bridge” programs, which take anywhere from 12-24 months, that allow a student to move from an ADN to a BSN or Master of Science in nursing (MSN). As mentioned above, most ADN professionals will need to pursue greater education, often through one of these programs.

Master of Science in Nursing: A MSN is not required for professional med-surg nursing practice. However, many nurses choose a bridge program to complete their MSN, as this will remove a lot of professional promotion barriers. An MSN also opens the door for teaching opportunities, higher pay, and greater responsibilities. Occasionally, some employers will reimburse or offer educational assistance for these academic pursuits.

Additional Credentials and Certifications for Med-Surg RNs

There are a variety of additional certifications a med-surg RN can pursue. Three of the most common are discussed below.

Medical-Surgical Nursing Certification (RN-BC): This certification is accredited by the Accreditation Board for Specialty Nursing Certification. It is a competency-based exam that assesses entry level clinical knowledge and skills of the RN in the med-surg specialty. It must be renewed every five years.

Certified Medical-Surgical Registered Nurse (CMSRN): This certification is the recognized path to prove excellence and commitment to the field of med-surg nursing. It is considered a prestigious credential, currently held by over 38,000 professionals. Recertification is necessary every five years.

Certified in Care Coordination and Transition Management (CCCTM): This credential evidences an RN’s knowledge of patient-centered assessment and care planning. It was created in collaboration with the American Academy of Ambulatory Care Nursing. New applications for the certification are currently on hold as the board of directors evaluate the program.

State-Mandated Continuing Education: Each state has different requirements for RN’s continuing education requirements. You can find your premium ANCC-certified CEUs for all 50 states here.

A career as a med-surg RN is certain to offer plenty of opportunity for a broad range of cares, professional education, growth, and collaboration. While many nurses view med-surg nursing as a stepping stone, thousands of men and women enjoy the broad range of work and patient population and choose to spend their entire career in this area of nursing.