According to the US Bureau of Labor Statistics, RNs accounted for about 3.1% of the US workforce in 2021.1 The largest number of RNs, about 60%, work in hospitals.1 The majority of those nurses likely started out working on a medical-surgical unit. Medical-surgical nurses aren't only the backbone of the healthcare workforce, but the very soul of it, based on the complexity of nursing care provided and the role these nurses play for patients, their families, and their communities.
Competent medical-surgical nurses possess a high level of critical thinking, a broad knowledge of diseases and body systems, excellent time management skills, and the ability to remain calm under pressure. When providing patient care, these nurses not only focus on healing their patients' physical ailments but also tend to the emotional needs of patients and their families. Medical-surgical nursing deserves to be considered a specialty even if it's used as a transition to practice.
According to the Academy of Medical-Surgical Nurses (AMSN), these nurses are special because of the diverse skill set they bring to the table every day and the unique way they combine knowledge, skill, and compassion.2 Many RNs who begin their nursing career on medical-surgical units won't stay because they don't see medical-surgical nursing as a true specialty. Although personal and professional growth are encouraged, deciding to remain a medical-surgical RN shouldn't indicate a stagnant career. On the contrary, with experience and continued education, these nurses can accelerate the quality of nursing care provided to patients and the entire healthcare system, and patients would greatly benefit from this shift in mentality.
Specialized care
The concept of a specialty unit began to gain traction several decades ago, when the belief emerged that grouping patients with similar health problems on the same unit would lead to better patient outcomes and the provision of higher-quality healthcare. As this idea became mainstream across the US, medical-surgical nursing units were often considered "less special."3 The lure to critical care, obstetrics, or the ED drew many medical-surgical nurses away from the bedside in search of the glory that's associated with specialty nursing. But where else do you get to work with a diverse patient population every day and provide care to the entire patient? Medical-surgical nursing is a specialty. According to the AMSN, it's the largest nursing specialty in the US.2
Medical-surgical RNs can be found in hospitals, outpatient settings, long-term-care facilities, and telemedicine.2 These nurses provide care to a wide variety of adult patients with a range of medical issues. Their broad knowledge base allows them to interact with all types of patients. They have excellent organizational, assessment, and communication skills.2 A good medical-surgical nurse will always rely on their critical thinking skills to assess what's occurring with the patient and not simply focus on the machines attached to the patient.
The face of nursing
Medical-surgical nurses enjoy the change of pace from day to day and room to room and like working with a diverse patient population. These nurses are often the face of the hospital and the profession. They can practice, support, and educate patients. They're present throughout the patient's journey from admission to discharge to restore health.
The medical-surgical nurse is the one admitting the patient, discharging and teaching the patient, giving hope to the patient, calming the fears of the patient going to surgery, gaining the patient's trust, and holding the hand of the patient who's dying. The silent heroes of many healthcare systems, these nurses have a great deal of compassion and so much to offer to the nursing profession. They must have a full understanding of many medical issues and comorbidities to provide competent patient care.
The true spirit of Florence Nightingale and her passion for nursing lives within all medical-surgical nurses as they roam the units checking on patients and keeping them safe. Medical-surgical nurses treat the whole patient, act as a link between the patient and the community, and provide excellent patient education; they're responsible for the prevention of many readmissions. Medical-surgical nurses see the patient and family as a singular unit. It's a true specialty and calling.
They save lives through assessments and interventions, allowing them to handle any situation with grace and dignity. A good medical-surgical nurse may be hard to find, but many who have mastered this specialty and put their heart into it have found that they never want to leave and are never bored. The diversity of the patient population and myriad medical conditions, as well as the other aspects of nursing care, bring novelty to the work and keep nurses engaged and motivated to learn more. Medical-surgical nurses wear many hats and maintain multiple roles on the unit to ensure that patients receive the best possible nursing care, and they'll always go the extra mile to make the patient's stay as comfortable as possible.
Even with many tasks lined up, making the 12-hour shift not long enough, a dedicated medical-surgical nurse will always take time to listen to their patient, hold the patient's hand, and meet all of the patient's physiologic and spiritual needs. Even when all medical treatments and efforts are exhausted and the patient faces end of life, the medical-surgical nurse continues to make a difference by being present to guide the patient and their family through that difficult moment. They exude compassion and care, wearing a kind smile beneath their mask and offering healing words to help soothe the patient and the family.
Medical-surgical nurses play an integral part in maintaining the flow of patients throughout the hospital, from the ED to the OR. Like Florence, they walk the halls at night and their vigilant eyes notice things many others may miss. They may seem as if they're simply having a casual conversation with the patient or family members but, at the same time, they're assessing the patient, their support system, and the environment, already envisioning an individualized plan of care.
The COVID-19 pandemic affected every aspect of healthcare and challenged medical-surgical nurses in many ways. Driven by dedication and a desire to uphold the oath they took when they became nurses, medical-surgical nurses rose to the occasion and cared for patients with high acuity levels. During these hard times, these nurses proved once again that their skills and knowledge are comparable to any other nursing specialty, and they're a true asset to the healthcare system.
Shifting perceptions
Officially medical-surgical nursing is considered its own specialty, as evident from available certifications; namely, the certified medical-surgical registered nurse (CMSRN) from the Medical-Surgical Nursing Certification Board and the medical-surgical nursing board certification (MEDSURG-BC) from the American Nurses Credentialing Center. However, much work is still needed to change people's perception to view medical-surgical nursing as a true specialty and a desired career. Medical-surgical nursing can be extremely rewarding and provide job satisfaction to the nurse who finds the specialty a true calling. The diverse patient population served and the broad scope of nursing practice makes medical-surgical nursing a fulfilling career and a great choice for the next generation of nurses.
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