Med/Surg Nursing in America

Med/surg stands for medical surgical nursing. The primary role of a med/surg nurse is to provide care for adults who have a broad range of illnesses. While med/surg nursing is the most common specialty in the United States, it’s also one of the most in-demand specialties. Med/surg nursing is also very popular among new nurses because the duties of a med/surg nurse are typically the foundation for many other nursing positions, and med/surg experience can prepare you for other roles. Global Nurse Partners interviewed Darius, a med/surg nurse with a variety of experience in nursing in both India and America, to look at a day in the life of a med/surg nurse in the United States.

Darius was drawn to nursing because his mother was a nurse. While he was initially looking into physical therapy, he found that nursing had a more extensive scope of practice and provided more opportunities. In 2015, he completed a Bachelor of Science degree in nursing and began his career working in an acute dialysis unit in India. In 2016, the opportunity arose to pursue a Master’s in Nursing in the US, which he completed in 2017 and passed the NCLEX in 2018. Darius made the decision to further his career in the US because “You can work in so many different fields. Healthcare in the US is very diverse. It’s not limited to a hospital setting.” After moving to the Southwest, Darius began work as a med/surg nurse, later cross-training in ICU nursing during the peak of the COVID-19 pandemic.

A Day in the Life of a Med/Surg Nurse

A day shift nurse by preference, Darius typically arrives around 15 minutes before his shift begins in order to prepare for the day. “Some places don’t want you to clock in early,” he explains, “I look at what my assignments are. In med/surg, we have a higher patient load because acuity [severity of patient illness or medical condition] is lower. I have my own SBAR sheets [Situation-Background-Assessment-Recommendation] sheets with pre-filled information to review.” SBAR technique is a critical tool in med/surg nursing because it helps healthcare providers to prioritize patient care needs.

After checking in with the previous shift nurse, Darius, and the previous shift nurse walk bed to bed visiting patients. “We involve the patient in rounds. They tell us what they need, we answer questions and concerns,” he explains. A typical patient ratio for Darius is 1:5 on a good day; 1:6 on busier days. After rounds, Darius sits down to read out labs, make sure he knows who the attending physician is for that day, and starts dispensing morning medications. “I make sure my patients have everything they need and make them comfortable.” 

Patients in the med/surg unit have a variety of medical or surgical conditions and need observation or additional support, including pain management, oxygen support, intravenous therapy, or antibiotics. “I think of med/surg as being a step away from home,” says Darius. “Discharging patients safely is my top responsibility. I’m the bridge between case managers and physicians.” His daily workload requires a lot of communication between different types of specialists and providers, including case managers, speech therapists, physical therapists, doctors, and even patient families. Med/surg nurses also work directly with dieticians, especially with feeding tube patients to ensure they’re receiving the proper nutrition, and infection control specialists to prevent hospital-acquired infections. As patients are discharged, med/surg receives new patients from the ER and ICU as they stabilize. Med/surg also monitors patients when their conditions worsen and advocate for them when they need to move to a higher level of care.

As a med/surg nurse, Darius’ shifts are 12 hours long. At his workplace, clocking out for breaks is standard. “As a new nurse, I didn’t take many breaks because breaks depend on time management and prioritization,” he notes. Darius learned to make sure he takes breaks during his shift, adding that, “You have to stand up for yourself. I make sure my patients have everything they need before I take a break, and I let them know how long I’ll be out for and who to call if they need immediate assistance.”

Advice for New Nurses Considering Med/Surg Placement

Darius considers time management and the ability to prioritize patient needs among the top skills nurses considering med/surg placement should have. Prioritizing which patient’s needs should be addressed first makes a huge difference in care when patient load is high. He recommends nurses new to med/surg take breaks when they’re supposed to because the opportunity might not come around again later in a shift. Med/surg nurses have to stay sharp and quick on their feet: as Darius warns, “Patient acuity is low, but they can go downhill fast.”

Don’t let that deter you, though! “As a new nurse, when you’re coming from international nursing to the United States, med/surg is a great place to learn,” Darius says, “You do a lot of different things; it provides foundational knowledge and skills. Some people fall in love with it because acuity is low, so you can talk to and connect with patients.” Plus, because patient loads are higher in med/surg than critical care units, “Higher-level care feels like a piece of cake after med/surg.”

Med/Surg Nursing Careers in the US

You can learn more about what a nursing career in the US could look like with our Nursing In America blog series. Interested in furthering your nursing career in the US? Global Nurse Partners brings internationally experienced nurses and US healthcare facilities together for permanent positions and supports their employment relationships throughout the process. Learn more about our partnership program and opportunities for international nurses here.