Medical-Surgical Nursing: A Foundation of Nursing Practice
Traditionally, medical-surgical nursing, or med-surg, has been viewed as an entry-level opportunity that many nurses use as a springboard into other specialty areas. Because of this scenario, med-surg nursing was often not perceived as a specialty in and of itself. Today, however, the specialty has gained prominent attention within the nursing community.
In 1991, the Academy of Medical-Surgical Nurses (AMSN) was formed to provide national exposure for the specialty and to support its nursing professionals. Since then, the AMSN has hosted an annual convention to help accelerate the careers of med-surg nurses and improve their nursing skills. This year's AMSN 20th Annual Convention featured a general session on the future of med-surg nursing. The session highlighted the Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health, which outlines recommendations for changes in the nursing profession in response to the transitioning healthcare system.
"An important take away from the IOM report is that all nurses are expected – by the public – to continue to evolve in their education and competency," said Michael R. Bleich, PhD, RN, FAAN, Dr. Carol A. Lindeman Distinguished Professor at Oregon Health & Science University in Portland. Bleich participated in the IOM study and examined its relevant recommendations for med-surg nurses at this year's AMSN convention. "Medical-surgical nurses, no doubt, acquire much of the knowledge, skills and abilities they need just by the types of patients they care for daily. But there are bigger issues at hand – there is a public demand to ensure every patient's safe passage through the health system."
med-surg nurses are well positioned to accomplish these goals by continually expanding their portfolio of knowledge, with an eye toward safety and transitional care. According to the AMSN website, "med-surg nursing is no longer viewed as a stepping-stone, but is the solid rock and backbone of every institution."
The establishment and growth of the AMSN has resulted in the national recognition of med-surg nursing as its own field. In fact, based on the Health Resources and Services Administration National Sample Survey of Registered Nurses, approximately 29.3 percent of nurses working in hospitals primarily care for medical and surgical patients. This translates to 459,315 full-time and part-time med-surg nurses nationwide.
"The AMSN has been instrumental in promoting and solidifying the specialty of med-surg nursing," said Kathleen Lattavo, MSN, RN, CNS-MS, CMSRN, RNBC, ACNSBC, President-Elect of the AMSN and med-surg Clinical Nurse at St. David's Medical Center in Austin, Texas. "We have worked with other organizations and associations to spread the word about med-surg nursing and continue to provide evidence-based practice research grants to promote the science of the specialty."
In conjunction with its mission to promote excellence in med-surg nursing, the AMSN plans to continue offering educational resources for nurses in the field, specifically as it relates to the IOM report. "We feel that education is a lifelong event. Educating our med-surg nurses inspires them to take pride in what they do and assume a leadership role of excellence in the workplace," said Lattavo. "At the same time, we know that it's equally as important to recognize the hard work and dedication that already exists in med-surg nursing."
Currently, the AMSN is developing a program to recognize exemplary med-surg nursing units nationwide. The award, scheduled to launch next year, will be called the PRISM (Premier Recognition in the Specialty of med-surg) Award. "It's simply another way for our organization to recognize and showcase how important the med-surg nursing specialty truly is."
For more information about the Academy of Medical-Surgical Nurses, visit www.amsn.org.
A Closer Look at Medical-Surgical Nursing as a Specialty
Medical-surgical nursing is a multifaceted and sophisticated area of specialization that is typically focused on adult healthcare. med-surg nursing is its own distinct specialty complete with a highly developed skill set, professional organization and certification. According to the Academy of Medical-Surgical Nurses (AMSN), these nurses not only make up the largest nursing specialty group, but they are also considered the backbone of the staff at nearly all medical facilities.
Cynthia Steinwedel, PhD(c), RN, CNE and Assistant Professor at Bradley University in Peoria, Ill. said, "It used to be the case that med-surg nursing was everything except a specialty. However, as time went on, the field became increasingly focused on taking care of patients with multiple medical conditions." For example, if someone is experiencing arthritis in his or her legs, it might limit their ability to walk, which could then result in cardiovascular problems due to the limited mobility. "A med-surg nurse must be able to assess a patient's condition quickly, and take into consideration what other ailments might result from their current situation down the road," said Steinwedel.
A majority of med-surg nurses practice in the inpatient setting. They specialize in caring for patients with acute illness, major surgery, and chronic diseases or conditions. med-surg nurses also specialize in caring for patients in settings such as home health agencies, community health clinics, private practices, hospice and schools of nursing.
The med-surg nurse manages care needs of patients admitted from the surgical recovery area and emergency department, or transferred directly from the health care provider's office, the intensive care unit or from a long-term care facility. They simultaneously care for several patients on a designated med-surg nursing unit, some who are in stable condition, some who are at high risk for a rapid deterioration in health status, and some who are not ready to return home or transfer to a long-term care setting. The med-surg nurse teaches patients and families how to best care for themselves and their loved ones and when to seek medical and nursing care upon discharge.
"med-surg nursing allows you to work in a variety of settings for a diverse group of patients who have a wide assortment of medical conditions. It is an extremely versatile specialty," said Steinwedel.
While med-surg nursing allows for a variety of exciting opportunities to work with patients affected by many different conditions, it is also one of the most demanding specialties. med-surg nurses must continue to improve upon their education to stay on top of ever-changing healthcare practices by reading newly published research and taking CE courses. "Continuing education is critical because you have to keep up with so many areas of medicine. CE courses are the keystones for med-surg safe practices," said Steinwedel.
Additionally, med-surg nursing offers the opportunity to earn an advanced certification. One source is the Academy for Medical Surgical Nursing's certification, Certified Medical-Surgical Registered Nurse (CMSRN). This is granted to a nurse after they have documented two years of experience, 2,000 hours in medical-surgical nursing care and taken a test administered by AMSN. Also, the American Nurses Credentialing Center provides certification through its program leading to an RN-BC.
The future of med-surg nursing is constantly evolving. There will be an even greater need for the expertise these nurses can offer, as the number of aging adults who may be experiencing more than one medical issue increases. Because of this, med-surg nurses are in an excellent position to apply their skills in practically every medical setting. "Medical-surgical nursing is growing up as a profession, and growing out in terms of scope as a specialty area," explained Steinwedel. "If you're interested in a bit of everything, med-surg is an excellent specialty to get into."
For more information about the specialty, visit www.discovernursing.com.
Get to Know...
Q. When did you decide to pursue a career in nursing and why?
A. I decided to pursue a career in nursing after a 12-year career as a civil engineer. I thoroughly enjoyed the engineering profession as I was able to engineer stormwater and drinking water systems to optimize and promote public health. I went into nursing because I wanted to use my critical thinking skills and problem solving skills in a clinical setting to promote healing and health in a more tangible, personal way.
Q. What inspired you to become a med-surg nurse?
A. As a student nurse, I completed the majority of my clinicals in the med-surg setting. I knew right away that the clinical setting was where I was meant to be as I was constantly introduced to endless learning opportunities. med-surg nursing was the perfect setting to implement my critical thinking and problem-solving skills in a dynamic and ever evolving setting.
The nursing unit I currently work in provides post surgical care to patients undergoing a wide variety of gastrointestinal surgeries and complex wound care to a diverse and complicated patient population. I enjoy learning something new every day I work and the unique challenge that comes along with learning creative ways to implement the practice of nursing.
Q. What is the most rewarding part of being a med-surg nurse?
A. The most rewarding part of being a med-surg nurse is the privilege of guiding a patient and their family through their hospital journey: supporting them, teaching them, celebrating their progress, being inspired by their life stories, their courage and spirit. It is such an honor to be an advocate for a patient within the nursing role as you are able to meld together critical thinking, science, compassion and persistence. I can think of no better way to be truly present for another human being.
Q. What has been one of the greatest moments of your career?
A. I have had the privilege of working on a very exciting leadership project at Oregon Health and Science University (OHSU). I am the staff lead in the pilot of the NHS Productive Ward-Releasing Time to Care program. The overall goal of Productive Ward is to increase the amount of time a nurse is able to spend at the bedside in direct patient care. This is accomplished by removing barriers to efficient workflow, implementing daily efforts to improve unit performance data, organizing a streamlined work environment, and strengthening the voice of the bedside nurse. I believe that my project management skills gained as an engineer have prepared me for this unique leadership role as a nurse.
Additionally, this leadership opportunity has given me many opportunities in both personal and professional growth. This past May, I was invited to speak at the annual ONA (Oregon Nurses Association) conference about the OHSU journey thus far with the Productive Ward pilot. Speaking in front of several hundred people is something I never thought I would be doing as a staff nurse. It was a rewarding and confidence-building experience. I believe this opportunity led to my award as the Oregon March of Dimes Nurse of the Year (Medical/Surgical specialty).
Q. What advice would you offer to nurses or nursing students interested in the med-surg specialty?
A. I think med-surg nursing is the most exciting and engaging nursing specialty! To fellow nurses and student nurses out there, I would absolutely recommend experiencing a clinical rotation in med-surg. You will be surprised by the diverse learning opportunities afforded to you and by the fact that the specialty is constantly evolving. Each day provides unique opportunities to not only practice a variety of hands on nursing skills but to also be actively engaged in patient teaching, patient advocacy, mentoring, research, and multidisciplinary engagement. med-surg nursing is a dynamic environment geared toward ensuring a safe patient journey in which you have the opportunity to influence people's lives in profound ways.
Q. How has nursing impacted your life?
A. Being a nurse has changed my outlook on life in many ways. Primarily, I have been inspired as I have witnessed people struggling with chronic illness, recovering from complex surgeries, and struggling with unfortunate complications while navigating the healthcare arena. I am humbled by the endless life stories that arise and the strength of human spirit that emerges. Additionally, as a result of my day-to-day experiences working with patients and their unique situations, my personal views on all of the following have been impacted: public health, nutrition, politics, education and healthcare reform.
BlogWorld & New Media Expo 2011, the first and only industry-wide conference, tradeshow & media event for all New Media, took place in Los Angeles, on November 3-5. For the third year, Johnson & Johnson sponsored the Social Health Track sessions that focused on how the social web can be used to positively impact society. From members of the social health community to those interested in the effective application of digital and online technologies for change, these sessions covered a multitude of topics surrounding this type of social media.
One session in particular featured top nurse bloggers Kim McAllister, RN, BSN, CEN; Jamie Davis, RN, EMT-P, B.A., A.S and Managing Director for ProMedNetwork.com; and Terri Pollick, RN, Department of Defense, who shared their tips for producing HIPAA-friendly social media content during the Social Health Track session entitled "Stop Being Afraid of HIPAA."
McAllister, author of Emergiblog, said of the event, "BlogWorld was a creative shot in the arm. I always leave the conference inspired to write and excited to be a part of the blogosphere; this year was no exception. You will leave inspired and with enough energy to blog for months. It is worth every penny."
Additionally, Davis said, "The Expo is an excellent resource and opportunity for anyone interested in the future of social media and healthcare. Partnered together, social media and healthcare provide a forum for nurses, other healthcare professionals and patients to stay focused on patient needs and to openly discuss current issues in healthcare."
Be sure to check out Davis' latest Insights in Nursing podcast episode, where he brought together McAllister, Pollick and nurse blogger "The Nerdy Nurse" Brittney Wilson to reflect on this year's BlogWorld. To listen to the podcast, visit www.insightsinnursing.com.
For more information about BlogWorld, visit BlogWorld & New Media Expo 2011 or check out the hashtag #socmedia on Twitter to see what all the chatter was about at the conference. The hashtag can be used year round to discuss all things social health.
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