Just A Medsurg Nurse

"Just a MedSurg nurse..."

How many times have you heard this?

How many times have you said this?

Sadly, it's a pretty common phrase. You hear it a lot. Maybe you've heard it from a doctor, a patient, a manager, or, another nurse. Maybe you've even said it about yourself.

It's a phrase that needs to leave our nursing language.

Because there is no "just" about it.

Let's think about what that Medsurg nurse is doing for thirteen hours.

1. More patients than almost any other practice theater in acute care.

An average of five to seven patients at one time. This is not taking into account discharges and admissions. Also, take note, that gone are the days when a charge nurse was tasked to assist with admissions or discharges, on most floors, anyway. Five to seven, is, easily, more like eight to ten throughout the day.

2. "Sicker" Patients

These patients are "sicker" than they were even ten years ago. They feel like baked roadkill and NEED a lot of care. Their disease process is frequently a poorly managed or understood (on their part) chronic condition. Many have just experienced surgical intervention.

Patients are discharged sooner. Consequently, they often seek readmission sooner.

Look at the statistics for elderly or chronically ill people who live alone. The numbers are staggering, even in our First World country. Most people have little to no home health services available to them.

Many are lonely, uncertain and somewhat frightened. Hourly rounds help. But the call light is used, not just for nursing needs, but to get someone to talk to, a sandwich, a drink, a tenth trip to the bathroom.

Let me be clear...it's not their fault. They are in a place where no one wants to be...sick and, usually, alone.

3. "But there's a nursing assistant..."

MAYBE there's a nursing assistant. Often the medsurg nurse is providing primary care, at least, for some of the patients, if not all.

How often is that nurse able to go in the patient's room to provide medications and do an assessment on the first round of the shift without getting the patient fresh water, taking them to the bathroom, assisting them to sit up, whether in bed or the chair, getting their meal set up, or a plethora of other things that need to be done?

Performing a thorough head to toe assessment takes time. It is not a passive activity for the patient. This is the time when the labs and notes that the nurse, hopefully, was afforded time to read, are reviewed with the patient. There's more that is done. But, suffice it to say, this takes time.

Checking the medications four times before administering them and performing patient teaching about the medications and their relevance to that patient is about a twenty minute process by itself. Patient teaching about the disease process and how their medications figure in to the management of their health, is only the tip of the iceberg. But that's a blog for another day...

IF your nurse has a nursing assistant, those assistants are spread thin. And, nearly every patient need they provide care for takes a lot of time. Often, even in a "no-lift" facility it takes two people to provide the needed care, whether it be re-positioning, incontinence care or "simply" walking to the bathroom. Most patients are high fall risks and are not left unattended while out of bed.

Everyone is in a patient's room. Nursing assistants aren't always able to know where another nursing assistant is. But they usually know which room their nurse is in. So the nurse is that second care provider, more often than not.

4. No time to play cards.

Okay, I know that's somewhat funny in retrospect. I've never worked anywhere that I saw nurses playing cards. Have you?

Actually, that whole thing still ticks me off.

How many other professions get no breaks and, many times, no lunch? I don't think we need to count "lunch" that is so late in the day that the nurse has already been providing care and charting for ten hours...that's not a "lunch"...that's an emotional health break.

5. Speaking of Emotional Health

I've said for years...

Nursing is an intellectual, emotional, physical and spiritual calling.

The Medsurg patient needs, and deserves, just as much of those energies as a patient in any other part of the hospital. Just like all other patients, their nurse is their lifeline for all these.

I could go on...I could talk about Covid-19. I could bring up many more subjects in relationship to the unsung heroes of the Medsurg floors across the globe. But it would be too long and no one would read to the end.

I'll end with this...

Every nurse is struggling to do the best they can. Every nurse is trying to provide that level of care that they would want their loved ones to receive.

There are good days and bad days. Sometimes, we hit the ball out of the park. Sometimes, we pull that patient back from the brink of death. Sometimes, we get them a ginger ale, when they really wanted one. Or, sneak them a cookie. Sometimes, we make them comfortable for the first time in a long time. Sometimes, we get a hug.

Sometimes, we cry in seclusion, or with the patient, or their family.

Be proud to be a nurse.

You are not "just" anything.

You are the heart and soul of healthcare.