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Q&A with Med-Surg Nurse, Sandra D. Fights, MS, RN, CMSRN, CNE


BestNursingDegree.com speaks with Med-Surg nurse, Sandra D. Fights, MS, RN, CMSRN, CNE. She is the president of the Academy of Medical-Surgical Nurses (AMSN) and the Freshmen Division Coordinator at the St. Elizabeth School of Nursing in Lafayette, Indiana. She is also pursuing her PhD at Capella University.

Below she talks about what it's like to work as a med-surg nurse.



Q: What is your current position?

I teach at a school of nursing, and I've been working with freshmen, which is an entirely different experience. I feel like a background in med-surg is what sets [nursing students] up to do well in the rest of their curriculum. And, I really believe it's the foundation for a lot of nursing practice.

Q: What is med-surg nursing?

In general, in med-surg nursing, you can have anything from a pneumonia patient to someone with a very complex surgical situation [such as] colon cancer surgery. You could have a patient with renal failure, or you could be doing dialysis or changing dressings. You really have to have a strong foundation and a really broad base of knowledge. I think that's probably what I like the most [about med-surg nursing] - that you get to touch on a little bit of everything. It's not the same every day; it's different, and it makes [the job] more exciting.

Q: How did you get started in this field?

I had an aunt who was a nurse; she was a labor-delivery nurse, and I wanted to be like my Aunt Maria. Aunt Maria said, "You have to start in med-surg and spend a year there."

I wasn't sure she was right, but I did it; I have enjoyed it, and it did end up being my practice area.

Q: What is an average day like for a med-surg nurse?

We all start the day out gathering our information, gathering our reports, and hearing about where our patients have been. We make a plan, check the labs and meds, and begin the process of caring. If you're on the day shift, you know it's going to be a busy time. You've got the physicians, pharmacy, physical therapy, speech therapy, occupational therapy, and social services - everybody is there during the day.

In most med-surg units, it's very typical to start your day out with your set list of patients, but one or two of those go home and one or two more come in. That adds some challenge to your day - you think you're going to have four patients, but in actuality you have seven. You become really good at juggling.

Q: In general, are there any specific traits that work well in this career?

I would put [the ability to multitask] very high on my list. [You need to be able] to think on your feet and use good clinical decision-making. And, I think nursing programs have been working over the last several years to really hone in on how [nurses] make decisions. General organizational skills [end up being really important as well].You have to have really good communication skills. You have to be able to ask the right questions and provide really good answers. You have to be a good listener for your patients and for their families, and also when you're listening to the providers.

Q: What do you wish someone had told you about med-surg nursing?

I think what I would have wanted to know was where med-surg nursing was headed. When I started med-surg nursing, it wasn't like it is today. It's more challenging [now]. I think I had rose-colored glasses on for a while, thinking, "Well, it's not critical care, so it'll be OK." That's selling med-surg nursing way short. I think there's a fallacy that it's very simple care.

It's very challenging, and I think maybe understanding how much more I needed to know about pathophysiology, anatomy, physiology and pharmacology [would have been helpful].

Q: Med-surg is often recommended as a good place for new grads to start out. Is this a good idea?

It really lets the students or the new graduates learn their practice and learn how to care for groups and coordinate care among multiple disciplines. While many people do say that med-surg is a good foundation and a good place to start, I'm not sure that it fits all nurses. You really have to look at what you want your practice to be.

Q: What kind of changes have there been in med-surg nursing in the last few years?

Way back when, patients would come in for their testing, and we'd have time to sit and talk with them. That's not the way it is today. The patients who are there are very sick. They don't come to the hospital until they're very ill. They require a lot of care.

We have a lot of technology that helps us do what we do. And while that's fabulous, we have to, as med-surg nurses, make sure we don't let the technology stand in front of the patient because the patient is always first.

One of the biggest things right now is the electronic medical record and getting used to using that system. Our new nurses who are coming out of school are really comfortable with the whole thought of point-and-click. For some of the nurses who have been around for a while, that's a real struggle.

Q: What do you see for the future of med-surg?

I see that med-surg has an opportunity to really be one of the leaders in providing quality patient care. I think our ability to organize and coordinate is going to become even more important. We're going to have much more of an opportunity to impact the environment of the patient.

I'm very hopeful that the number of patients and the number of staff are going to balance out. We want to be connected with our patients, to show them compassion. We want to make sure that we are committed to providing the highest quality of patient care to them. Med-surg nurses are right at the core of that, and we have a real opportunity to be leaders.

Q: Any other recommendations for aspiring med-surg nurses?

This is a grand time to begin to learn nursing. I invite you to begin considering med-surg nursing as your specialty. I think it is the most rewarding of fields. But, I would also say that if med-surg isn't for you, please find that part of nursing that meets your needs. You need to be involved in the division of nursing that really speaks to your soul. If med-surg is it, I would love to welcome you into that part of our profession. If not, go find your path.