A medical-surgical (med-surg) nurse treats a wide variety of patients. From medical diagnoses like pneumonia to surgical repairs like colectomies, med-surg nurses have to know a lot. Some hospital units are devoted only to certain surgical recovery patients, but even these units will receive medical overflow from other floors.
Medical patients refer to those who have an infectious process working through their bodies. Surgical patients can refer to anyone who has had surgery. Although, in a medical-surgical unit, surgical patients mostly fall under the “general surgery” umbrella. Orthopedic, oncology, and neurosurgery usually have their own units.
A med-surg nurse may see traumas, burns, and burst appendices. They must be proficient in a vast array of nursing skills because their patients’ medical problems cover a lot of ground. Medical-surgical nursing is a great place to learn, and the learning never stops.
Where Do Medical-Surgical Nurses Work?
Medical-surgical nurses typically work in hospitals on a non-critical unit. If the hospital is smaller, they may see a wider mix of patients. In larger hospitals, med-surg nurses may be able to specialize more. For example, a massive university hospital may have an entire floor devoted to colorectal surgery patients.
Medical-surgical nurses see a huge range of diagnoses. On the medical side, a med-surg nurse can expect to treat patients with:
Cholecystitis
Crohn’s Disease
Diabetes mellitus
Diverticulitis
Hypertension
Osteoarthritis
Pneumonia
Sickle cell anemia
Ulcerative colitis
Urinary tract infection
On the surgical side, med-surg nurses treat patients before and after surgeries like:
Amputation
Appendectomy
Burn treatment
Cholecystectomy
Colectomy
Colostomy placement
Diabetic ulcers
Exploratory laparotomy
Pressure ulcers
Skin grafting
Transplants
Because their duties center around surgery and significant infections, most medical-surgical nurses work solely on hospital units. However, trained med-surg nurses can easily find work in other settings such as:
Ambulatory care
Home health care
Hospital and regulatory administration
Nursing homes
Universities
Medical-surgical nurses treat so many different types of patients that their knowledge grows vast, which makes them very employable in a lot of different roles.
What Does a Medical-Surgical Nurse Do?
Medical-surgical nurses treat patients recovering from an infection, a chronic illness flare-up, or a surgical procedure. During a shift, a med-surg nurse has four to six patients at a time, depending on the unit. To care for those patients, nurses frequently perform the following tasks:
Administering medications
Collaborating with physicians, nurse practitioners, patients, and families
Coordinating care with other departments
Collecting laboratory samples of blood and other bodily fluids
Dressing changes
Emergency resuscitation
Head-to-toe assessment
Inserting and managing foley catheters
Inserting NG tubes
Keeping patients clean and comfortable
Managing central lines like ports and PICCs
Managing tracheostomies
Monitoring and taking vital signs
Monitoring chest tubes
Patient and family education
Starting and accessing IVs
Transporting patients
For medical patients, medical-surgical nurses monitor symptoms and vital signs, administer antibiotics, and get the patient up and moving as much as possible. If a patient has pneumonia, for example, the med-surg nurse needs to listen to their lungs multiple times throughout the shift and report any changes to the physician. They also need to get that patient out of bed and moving if at all possible, as physical activity helps mobilize mucus buildup in the lungs.
For surgical patients, nurses know their wounds. Whether they treat fresh incisions, infected incisions, burns, or pressure wounds, medical-surgical nurses know how to handle them. Med-surg nurses assess wounds often and reinforce or change dressings as needed or ordered.
Mobility is also important for surgical patients, and med-surg nurses must set expectations for the day with their patients. They must also ensure adequate pain control, and time pain med delivery with expected periods of activity.
Patients on a medical-surgical unit often come and go within a few days. Because of the rapid turnover, a large part of a medical-surgical nurse’s job is managing admissions and discharges. Med-surg nursing is fast-paced and busy.
How Do I Become a Medical-Surgical Nurse?
To become a medical-surgical nurse, candidates must first graduate from an accredited nursing program with a Bachelor of Science in Nursing (BSN). A BSN can take the traditional four years to complete, but some schools offer accelerated programs that can be done in as little as a year.
After completing their education, nurses can apply to a medical-surgical unit as new graduates. New nurses pair with a preceptor–an experienced nurse on the unit–who teaches them how to treat patients on that unit.
For a graduate nurse to become a registered nurse, they must pass the NCLEX-RN. A series of multiple-choice questions, this standardized test shows a nurse’s clinical knowledge and capability to begin practicing alone.
After a medical-surgical nurse passes the NCLEX, they may need to complete their orientation. Nurses can work with their preceptors and managers to decide when they can handle their own patient assignments.
Once medical-surgical nurses have a few years of experience under their belts, they can pursue certification in this specialty. The American Nurses Credentialing Center (ANCC) offers the Medical-Surgical Nursing Certification (MEDSURG-BC). To be eligible for this certification, the ANCC requires nurses to have:
A current RN license
A minimum of 2,000 hours of clinical practice in medical-surgical nursing within the last 3 years
The equivalent of 2 years of full-time experience as a registered nurse
Thirty hours of continuing education in medical-surgical nursing within the last 3 years
The Academy of Medical-Surgical Nurses (AMSN) also offers a med-surg certification called The Certified Medical-Surgical Registered Nurse (CMSRN). The AMSN requires nurses to have the following to test for this certification:
Current RN license
Two full years in a medical-surgical setting as an RN
Proof of 2,000 practice hours within the past three years in a medical-surgical setting
How Much Does a Medical-Surgical Nurse Make Per Year?
The US Bureau of Labor Statistics (BLS) reports registered nurses (RNs) make an average of $81,220 per year as of 2022. This amount can vary depending on your work setting and the cost of living in the area. The low-end average is $61,250, and the high-end is $129,400. Depending on where you work, your employer may offer higher or lower compensation:
General Medical and Surgical Hospitals: $90,600
Home Health: $82,920
Outpatient Care Centers: $97,200
Physician Offices: $79,810
Skilled Nursing Facilities/Nursing Homes: $77,190
Salaries also vary depending on which state a medical-surgical nurse practices. The west coast generally pays nurses the best, but they also have a higher cost of living.
The west coast, New England states, Minnesota, and Alaska pay medical-surgical nurses the highest wage, but the cost of living in these areas can also be high. The lowest paying states are in the Midwest and some southeastern states.
The top paying areas for medical-surgical nurses include:
Federal Way, WA: $114,802
Santa Clara, CA: $112,774
San Francisco, CA: $112,461
Washington, DC: $110,194
Los Angeles, CA: $109,885
San Jose, CA: $109,620
Fremont, CA: $108,916
San Buenaventura, CA: $108,294
Oakland, CA: $108,215
Marysville, WA: $107,742
Certified medical-surgical nurses can be paid more than a nurse who is not certified, depending on the facility. In general, the more experience and proof of expertise, the more a medical-surgical nurse will be eligible to earn.
Are Medical-Surgical Nurses in High Demand?
Nurses in the United States are in short supply. According to the US Department of Health and Human Services, 24% of US hospitals have reported critical staffing shortages. According to the Centers for Disease Control, six out of every ten Americans have a chronic illness, and four out of every ten have more than one.
Chronic diseases like diabetes and heart disease frequently send people to the hospital for care. The American Hospital Association predicts these numbers will continue to rise through 2030. With so many chronic illnesses emerging in the numerous baby boomer generation, medical-surgical nurses should see no shortage in work availability in the near future.
Additional Resources About Becoming a Medical-Surgical Nurse
To learn more about becoming a medical-surgical nurse, these additional resources may help:
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