Is Med-Surg Nursing Right for You?

A med-surg unit is a busy spot in most hospitals — you’ll see patients being wheeled off to surgery, physicians of many specialties doing their rounds, and patients with chronic illnesses getting the treatment they need. You’ll also see nurses here, working in the largest nursing specialty in the U.S.

Med-surg nursing is usually the first recommendation for new graduate nurses, because this specialty will help you build foundational nursing skills. Fast assessments, critical thinking, medication management, and great communication are all essential on medical-surgical units.

Let’s take a look at the basics of medical-surgical nursing to help you decide if it could be a great career path for you.

What Is Med-Surg Nursing?

Med-surg is short for medical-surgical nursing, which means that patients on these units have both medical and surgical problems. These patients have a wide range of needs — you might go from dressing a wound to placing an IV to evaluating new shortness of breath, all within the span of a few minutes.

Is Med-Surg Nursing Hard?

Because of the breadth of skills required, as well as what is often a heavy patient load, med-surg is considered one of the most challenging nursing fields.

Med-surg nursing is an acute care area, meaning that patients in med-surg are sick enough to warrant hospital-based interventions. Most patients on these units are not critically ill, but they can quickly progress to being very sick, so you’ll need to stay on your toes to catch changes before they worsen.

What Does a Med-Surg Nurse Do?

Med-surg nurses do a little bit of (almost) everything. As a med-surg nurse, you’ll become adept at managing patients with various illnesses, from diabetes and respiratory disorders to post-operative recovery and orthopedic issues. And this range of patient needs means that med-surg nurses build a broad range of skills, like:

• Focused and head-to-toe assessments that include physical, psychosocial, and body systems.
• Wound care management, including dressing changes, negative pressure devices, and assessments.
• Medication administration of routine daily medications, as well as IV therapy and intramuscular injections.
• Pain management for patients who are post-operative or in chronic pain.
• Cardiac monitoring, including telemetry management and identifying irregular rhythms.
• Respiratory management, such as administering oxygen therapy and post-surgical breathing devices like incentive spirometers.
• Catheter insertion and care, including sterile insertion and removal of Foley catheters.
• Gastrointestinal care for post-surgical patients, including monitoring bowel movements and providing dietary guidance.
• Diabetes management that includes blood glucose monitoring, dietary education, and insulin administration.
• Infection control for patients who need isolation precautions, as well as basic procedural hygiene for routine treatments.

A Day in the Life of a Med-Surg Nurse

If that sounds like a lot of skills, that’s because med-surg is one of the most versatile nursing areas. Med-surg units are fast-paced environments, and every day is different. Here’s an example of what you might expect from a day in the life of a med-surg nurse:

0645 – 0700: Corbin starts his day by receiving a detailed handover from the night shift nurses. He reviews his patients’ charts and diagnoses. He has six patients today, each with unique needs ranging from post-operative care to managing chronic conditions.

0700 – 0800: Corbin begins his first patient assessments and medication passes. He examines vital signs, checks wounds, and assesses pain levels. For Mr. Johnson, who had knee replacement surgery, Corbin ensures the surgical site is clean and the pain is within his goals. Mrs. Thompson has diabetes, and needs blood glucose monitoring and insulin administration with every meal. Corbin administers medications, including antibiotics for Mrs. Ramirez, who has a respiratory infection.

0800 – 1000: Corbin attends rounds on his patients with the attending physicians, providing updates on each patient’s progress. He discusses Mrs. Turner’s symptoms with the gastroenterologist and requests a different as-need medication for Mr. Johnson’s post-surgical pain. After rounds, Corbin diligently documents the communication, changes in treatment plans, and patient responses to medications and therapies.

1000 – 1200: Corbin assists the physiotherapist in helping Mr. Anderson, who had a stroke, with mobility exercises. He collaborates with the wound care nurse to change dressings for Mrs. Lewis, who underwent abdominal surgery. During this time, he educates Mrs. Patel about her medications and dietary restrictions after her gallbladder surgery. He also ensures that Mrs. Turner, who has a gastrointestinal disorder, receives her prescribed diet and medications.

1200 – 1400: Corbin takes a 30-minute break, then discharges Mrs. Thompson home with her family. He removes her IV, charts a final assessment, and educates her on her post-discharge plan. Then he check’s Mr. Johnson’s pain again and gives him his new pain medication. He checks in with Mrs. Patel, who is having her first meal after surgery. Mrs. Ramirez’s IV has stopped working, so he takes it out and replaces it with a new one.

1400 – 1800: Corbin gets discharge orders for Mr. Johnson, and gets him ready to go to a skilled rehab facility. He gives him instructions on pain management and falls safety after his knee surgery, and gives a detailed report to the nurse who will take him to rehab. The transport team comes, and Corbin waves him goodbye. He checks in with Mrs. Turner, who is reporting abdominal pain and calls the attending physician to see her. Mrs. Patel’s surgical site needs a dressing change, so Corbin gets the supplies he needs and gives her the appropriate wound care.

1800 – 1845: Corbin does his final documentation for the day and gets his reports ready for the incoming night shift nurse. He gives bedside report for each of his four patients, and ensures that they understand their care plan for the evening before leaving for the night.

How Much Does a Med-Surg Nurse Make?

The Bureau of Labor Statistics doesn’t list a distinct med-surg nursing salary, however, the average annual salary for an RN in general medical and surgical hospitals is around $96,830 per year. The annual salary for an LPN in general medical and surgical hospitals is around $55,380. The area you live in, your experience, and any certifications you have will influence what you make in med-surg.

Med-surg nursing is a stable career choice, since nearly every hospital has at least one general med-surg unit, and many have several. Nurses with med-surg skills are increasingly in demand, as the staffing crisis has impacted med-surg units more than others. Plus, you can use med-surg experience as a launch point to pursue a different specialty later on, such as pediatrics, intensive care, or ambulatory care.

The Pros and Cons of Being a Med-Surg Nurse

If you’re considering moving to this specialty, you might be wondering what med-surg nurses like and don’t like about their jobs. Here are the biggest advantages and disadvantages of working in this broad area:

The Advantages of Med-Surg Nursing

• Skill building: Because med-surg nurses see a broad range of diagnoses and patient populations, this is a fantastic area to grow your nursing skill set. Many career opportunities for nurses want a med-surg or acute care background, so this specialty will prepare you for many other paths.
• Nursing judgment: A nurse’s greatest asset is their ability to assess a patient and develop a sense of what they need. It’s normal to feel like you don’t have that nurse’s sixth sense as a new graduate, but you’ll build that confidence in med-surg.
• Interprofessional communication: Med-surg nurses work with attendings, surgeons, physical therapists, respiratory therapists, nursing staff, and more. You’ll get to work with an interprofessional team, and learn from each of the experts you work with.
• Teamwork: Because you’ll work with a range of professionals, med-surg gives you an opportunity to build relationships with other medical staff. A sense of camaraderie can keep you sane, even on the craziest shift.

The Disadvantages of Med-Surg Nursing

• Steep learning curve: Because med-surg demands so many skills, being a new grad nurse can feel overwhelming. Expect to feel out of your depth in the first year or two of practicing in med-surg.
• Heavy patient loads: Short staffing and shifting patient acuity can make med-surg stressful. You might not have much time for each patient. Working with five to seven patients at once can feel overwhelming, and even great time management skills can’t combat an unreasonable workload.
• Staff turnover: Since med-surg is sometimes viewed as a transitional specialty, staff turnover can make working on these units harder. Taking care of patients is more difficult when you don’t know your coworkers.

How to Become a Med-Surg Nurse: 3 Steps

Step 1: Nursing School

To qualify for a nursing license, you’ll need to go to nursing school first. The registered nurse (RN) license is generally preferred in acute care settings, and you’ll need to choose which nursing degree to get: a bachelor’s degree in nursing (BSN) or associates degree in nursing (ADN).

If you want to take the licensed practical nurse (LPN) route, you’ll need to attend a diploma program at a vocational or trade school. Learn the difference between RN vs LPN credentials.

Step 2: Pass the Licensure Exam

The national council licensure examination for RNs (NCLEX-RN) is the test you’ll need to take to become a registered nurse. There’s another exam, the NCLEX-PN, for practical nurses. Learn about studying for nursing exams.

Step 3: New Graduate Residency

Once you’re an RN, congratulations! You can update your med-surg nurse resume and find a job as a new graduate nurse, typically through a residency program. Unlike other specialties, you won’t need prior experience to enter this area.

Step 4: Med-Surg Certification (Optional)

Once you’ve got a few years under your belt, you can continue your education with one or more of a national med-surg certification. Note that this is not required to work in med-surg units, but it could put you in a favorable position with employers. Choose from:

• Medical-surgical nursing certification (MEDSURG-BC)
• Certified medical-surgical registered nurse (CMSRN)

Med-Surg and More

Interested in learning about med-surg nursing opportunities? Search for med-surg nurse jobs on IntelyCare to find listings for jobs in your area and specialty.