Med-Surg Nursing in 2021: Greater Responsibility, More Options
Medical-surgical nurses remain in high demand as they care for individual patients and are setting the bar high to improve health equity and overall health and well-being.
“It’s impressive to me what med-surg nurses are doing on units,” said Terri Hinkley, EdD, MBA, BScN, RN, CAE, CEO of the Academy of Medical-Surgical Nurses (AMSN), speaking about how current practice differs from when she was practicing as a med-surg nurse in a hospital. “It’s a busy practice setting, with a significant skill set requirement.”
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Med-surg nursing skills
From assessments to critical thinking to providing education to help patients safely transition home or to a lower level of care, med-surg nurses draw on a wide range of nursing skills to care for ever more complex and challenging patients.
“Med-surg patients of today would have been in an ICU or stepdown unit when I practiced,” Hinkley said.
Summer Bryant, DNP, RN, CMSRN, president of AMSN, agreed that patients are becoming more complex, with multiple comorbidities. But another difference she noted was how quickly patients move through the acute-care setting.
Bryant said she enjoys the variety of patients cared for by med-surg nurses.
Nurses on med-surg units must possess good communication skills and quickly establish a rapport with patients.
“There’s something about that relationships you build with patients,” Bryant said.
Bryant said that strong assessment skills are a key talent in med-surg nursing. Time management and prioritization also will prove helpful.
“You have to learn to assess without technology,” Bryant said. “You have to spot something quickly.”
Med-surg nurses care for multiple patients requiring multiple tasks during a shift.
Hinkley considers multitasking and managing competing priorities the most important skills for success as a med-surge nurse.
Med-surg nursing allows clinicians to specialize, by working on an orthopedic, pulmonary or other special unit.
Bryant encouraged med-surg nurses to become certified.
“Having the certification validates med-surg as a specialty,” she said. It also validates the nurse’s competency.
Med-surg nursing skills also are practiced in a number of settings outside of the hospital environment, including home health care and correctional nursing, Hinkley said.
“The principles of med-surg are embedded in every aspect of healthcare,” Hinkley said. “Med-surg is what you practice and not where you practice.”
Med-surg nurses advocating for equity
Health equity has become an important focus for the profession.
AMSN has taken action on improving health equity, including providing nurses with education to understand the complexity of diversity, equity and inclusivity; fostering healthy work environments, respectful of diversity, equity and inclusion; and evaluating academy policies and practices to ensure they support that work. It also is building an e-learning certification program.
“Diversity, equity, and inclusion is a competency, like many others,” said Hinkley, adding that nurses realize that social determinants of health, such as a lack of transportation, affect people’s lives and well-being.
Med-surg nurses can address some of these social determinants when discharging a patient.
Medical-surgical nurses cope with COVID-19
Many seasoned nurses have retired over the last several months, and other nurses are leaving the profession.
Some hospitals furloughed med-surg nurses and other staff when elective surgeries were paused. Nurses and physicians are reporting burnout, depression and fatigue after more than a year of caring for seriously ill COVID-19 patients.
“We recognized early on that this would have a major impact on the mental health of nurses,” Hinkley said.
ASMN advocated and pressured all government levels to ensure nurses had sufficient personal protective equipment. The academy also offered nurses resources, including how to complain about whistleblower protection; financial grants to those experiencing hardships due to the pandemic; and online Zoom meetings, so nurses could chat with their peers in other units.
“What we learned about nurses’ mental health and dealing with the stress is [nurses want] to talk with other nurses rather than a counselor,” Bryant said.
Med-surg nurses and others must care for themselves and their mental health needs to survive in the field.
“If you cannot take care of yourself, it’s really hard to take care of others,” Bryant said.
An abundance of med-surg nursing jobs
Across the country, the need for med-surg nurses remains strong, Bryant said.
“I see demand in almost all places I have worked in different states as a consultant,” she added. “The hospitals I am working with are all hiring med-surg nurses.”
Hospitals experiencing difficulty recruiting to fill enough medical-surgical nursing jobs often turn to contingency staff or travel nurses, she added. Hospitals typically require at least one year of experience for med-surg travel nurses and will set the salary for the assignment.
“Nurses are open to whoever will come in and work with them,” Bryant said.
Whether permanent or travel, medical-surgical nursing jobs are rewarding, exciting, and challenging. They offer variety and require strong nursing skills.