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Med-surg nursing carries a unique appeal
EDITOR'S NOTE: Lisette Hilton is a freelance writer.
After more than four decades as a med-surg nurse, Kathy Lattavo, MSN, CMSRN, said she never grew tired of the detective work the specialty offered.
“I like med-surg because there’s a wide variety of patients with complex disease processes,” said Lattavo, past president of the Academy of Medical-Surgical Nurses. She retired in 2015 to work part-time in an outpatient cardiac rehab unit, at St. David’s South Austin Medical Center in Austin, Texas. “I think you have to use very good clinical decision-making skills to figure out what’s going on with your patients because of that variety.” Many nurses see med-surg as a stepping stone in nursing, where nurses can hone their skills in preparation for work on specialty units, such as cardiac or orthopedic floors. But many others see it as a long-term career, in which there’s lots of room to grow and change, according to Lattavo.
“People like high-tech — the adrenalin run of critical care and emergency departments,” she said. “That fits a lot of people. Sometimes, they can’t find a job in those areas, so they start in med-surg.”
Med-surg nursing is a strong foundation for other areas in acute care, as well as in the community. The nursing specialty prepares nurses for a spectrum of roles and careers. Mendoza said med-surg experience is preparing her for a career as a nurse practitioner as she learns from her fellow medical and surgical team members. She listens to how the surgeons and nurse practitioners communicate with patients just out of surgery. Mendoza also learns from caring for patients, who may have come to med-surg from the emergency department. She looks at differential diagnoses, how the medical team rules out possibilities and how they ultimately decide on plans of care. “I take it all in,” Mendoza said. Med-surg nursing prepared Lattavo for the job she has today in outpatient cardiac rehab. “I have a strong knowledge base,” she said. “I had to pick up some cardiac, but I knew very well how to assess patients, how to communicate with patients, teach patients, help family members cope with a scary diagnosis. What’s interesting now is I’m looked at as the educator for our unit. They’ve asked me to do classes and prepare competencies and that came out of my med-surg background.” Mendoza, who recently published an article about a day in the life of a med/surg nurse for the University of Buffalo, admits med-surg is hectic and leaves nurses feeling exhausted at the end of a shift. “At the end of a 12-hour shift, especially on a consecutive day, you’re exhausted, you’re tired, you’re hungry and sit down at the computer to try and finish your charting,” she said. “All you can think about is how crazy it is. But taking care of a patient and knowing that you did everything that you could and that most of them are going to go home, you kind of know this is exactly what you should be doing.”
Certification is a solid step forward
Lattavo pursued higher degrees during the years she spent as a med-surg nurse and eventually became certified as a med-surg registered nurse — CMSRN. It’s one of the certifications med-surg nurses can earn to advance their career in the specialty. Another is the care coordination and transition management, or CCCTM, certification. Despite her vast experience, Lattavo said getting certified was important. “I feel as a professional, certification is a step that you should take to show people — your patients and your peers — that you have the knowledge base to do your job well,” she said. Med-surg nurses also can sub-specialize in orthopedics, cardiac, nephrology and others areas, according to Lattavo. While the CMSRN and CCCTM credentials are obtained through the Medical-Surgical Nursing Certification Board, AMSN's affiliate certification organization, other certifications can be done through other specialty organizations.
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“I think you have to use very good clinical decision-making skills to figure out what's going on with your patients because of that variety.”
— Kathy Lattavo, RN
Kathy Lattavo, RN
Isabel Mendoza, RN
At 25, Isabel Mendoza, RN, DNP student in adult geriatrics, is three years into her nursing career. She said she plans to remain a med-surg nurse at Kenmore Mercy Hospital until she graduates in December 2018 from University of Buffalo School of Nursing.

It’s the variety that keeps her interested.
“When I graduated, I saw a lot of people go into specialties: the ICU, NICU, pediatrics,” Mendoza said. “But there are a lot of young nurses on my floor in med-surg, where you kind of get everything. You can get some really acute patients or more stable patients. I think a lot of young nurses want to get the experience of getting our skills down, before we venture out into the other units. I’m getting a lot of experience here in med-surg and think, as a nurse, staying in med-surg is the best option for me.”
For Lattavo, it wasn’t the high-technology focus or the pace of critical care units or EDs that appealed to her. Rather, it was using what she thinks are her nursing talents: having keen assessment skills and being willing to think unconventionally as well.

Lattavo encourages nursing students to give med-surg a try. “I think once you get over that hurdle of learning how to be a nurse, it can be extremely rewarding to be able to take care of complex patients, working with a variety of doctors, a variety of diagnoses and watching your patients improve,” she said.
It’s that connection with patients that makes med-surg nursing in the hospital setting stand out, according to AMSN President-Elect Robin A. Hertel, MSN, EdS, RN, CMSRN.
Hertel worked on a med-surg unit at a 150-bed hospital for about 15 years before transitioning to work in the community setting. “I was a staff nurse and a charge nurse, and I loved that work,” Hertel said.
Hertel said she chose med-surg after nursing school because of the direct impact these nurses have on their patients. “We work closely with them,” she said. “We teach them. We see them progress towards becoming the healthiest that they can be.”
Med-surg nurses, according to Hertel, also excel at coordinating care for multiple patients at a time, while keeping the entire healthcare team working towards the same goals. They have high-level critical thinking skills and a wide range of clinical knowledge.
These nurses combine traditional skills with unconventional thinking
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By Lisette Hilton
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