Not ‘Just a Nurse’

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Vol. 5 •Issue 22 • Page 21
Not ‘Just a Nurse’

Med/surg nurses are at the core of adult care

Once, all nurses acted as med/surg nurses caring for adults on wards. As many nurses began to pursue various specialties, med/surg nursing evolved from an entry-level position into its own adult health specialty involving the largest group of practicing professionals. As med/surg nursing advanced, so did its level of organization.

The Academy of Medical-Surgical Nurses (AMSN) launched in 1992 “to enhance the knowledge, skills and professionalism” of these nurses in all practice settings, according to the group’s mission statement. Currently, there are more than 44 local AMSN groups across the country, including chapters in Texas (Dallas, San Antonio, Austin and Houston) and Louisiana (Lake Charles).

To commemorate Med/Surg Nurses Day Nov. 1, ADVANCE joined a roundtable discussion with AMSN Chapter 205 in Dallas. AMSN President Kathleen Reeves, MSN, RN, CNS, CMSRN, assistant professor/clinical, University of Texas Health Science Center at San Antonio, joined AMSN steering committee members.

Local chapter leaders included President Joyce Winbush, RN,C, CMSRN, Medical City Dallas Hospital; Vice President Lette Smith, MN, RN, CCRN, Baylor University Medical Center; Secretary Jeanne Seitz, RN, CMSRN, UT Southwestern-St. Paul; and Treasurer Greta Purdue, MN, RN, Medical City Dallas Hospital; along with board members Barbara Warren, MSN, RN, CS, Baylor University Medical Center; and Debra Thompson, BSN, RN, CMSRN, Medical Center of Plano.

ADVANCE: Tell us about your association and what benefits you provide to your members.

Winbush: The local chapter of the AMSN is a professional organization developed and implemented with the med/sug nurse as its focus, and to improve the number of med/surg nurses becoming certified in their own specialty. The foundation of our local chapter is based on the mission, vision and values of our national organization. The chapter has been successful in recruiting local members because nurses want to connect on a professional level to benefit their careers and share common experiences.

Many facilities now have a clinical ladder for nursing staff that encourages them to get involved in professional development activities. We meet that need perfectly with our educational programs, CEUs and certification review courses. Membership costs $84 for national and $35 for local, but comes with many professional discounts, publications, newsletters, conferences and networking opportunities.

We have nurses from a variety of hospitals and other facilities across the area. Our leadership in this room alone represents close to 200 years of nursing experience. Our national membership in the Dallas/Fort Worth area is just over 100, with about 45 local members. There are floor nurses, nurse managers, ICU nurses, educators and more in our group, but our common focus – our passion – is med/surg nursing.

ADVANCE: With so much experience in your ranks, how have you seen the practice of med/surg nursing evolve in your careers?

Smith: Med/surg is an umbrella over many other types of nursing, which are “super specialties.” Med/surg is the backbone of them all. Some might want to work in oncology or ICU, but you rarely excel in a specialty if your core knowledge and skills are weak. The specialty of med/surg was acknowledged only 16 years ago, so it’s a relatively young division of nursing from that standpoint, but everyone comes out of nursing school as a “generalist.” You learn set methods to treat fever and infection and care for patients at the bedside. Once you are a strong bedside med/surg nurse, you are better prepared to specialize in any other type of nursing.

Reeves: The value of the organization can be measured by our increased membership, which is close to meeting our national AMSN goal of “7,000 in 2007.” One of the best intangible changes, however, has been the development of a strong sense of identity, recognition and pride in nurses choosing this specialty. We urge our members to be proud of their accomplishment; it takes a great deal of skill, intelligence, organization and assessment ability to become a med/surg nurse.

Smith: This area of bedside nursing has been taken for granted. You are not “just a nurse.” This job requires critical-thinking and skillful prioritization because we are taking care of more patients, often with multiple problems. Med/surg nurses are starting to be more appreciated as the association raises awareness of the expertise needed in med/surg practice.

Seitz: Med/surg nurses have to understand the rationale behind the medicines given and the actions taken. Bedside nurses play a vital role in educating patients and caregivers about medical conditions and treatment methods.

Warren: There is a much higher level of acuity in patients these days. All patients ask for is safe passage to leave healthier and unharmed after our care. The typical scenario in ICU nationally is for a nurse to work 2-3 years in ICU, and then become certified as a CCRN. AMSN’s goal is to have nurses work the med/surg floor for 2-3 years, then become a CMSRN, and only then go on to certify in other “super specialties.”

ADVANCE: How do nurses in the field perceive med/surg certification? How important is it to them?

Warren: Not every nurse has an MSN or PhD, and not every hospital knows what to do with you if you have those degrees. They do know what to do if you are certified in your core area and in your super specialty, however.

Seitz: Pursuing further training and certification gets nurses excited about their work, connects them with what other nurses and hospitals are doing in med/surg practice, and opens up more career opportunities.

Reeves: On a national level, nurses in all areas of healthcare recognize med/surg as a meaningful certification program. Experienced med/surg nurses write our certification exam, not a generic testing service. It’s tough, clinically focused, and represents today’s practice and standards.

ADVANCE: What educational programs are most in demand by med/surg nurses today?

Winbush: We do a needs-assessment survey every year to ensure we’re covering what our members need and want to know. Popular topics now are bariatrics, national patient safety goals, research and evidence-based practice. In addition, anything related to achieving Magnet status is always good. Facilities working toward Magnet status want to know what professional organizations can do to help their nurses enhance patient care skills as well as continue to improve their knowledge basis. The association shares information in a productive way so nurses who have already gone through the Magnet program assessment can pass along tips. This becomes a valuable resource for nurses and hospitals undergoing assessment or working toward that goal.

Warren: Hospitals want us to offer CEUs, but they also ask the nurses if they can apply what they learn. If they can apply it, hospitals want it to improve patient outcomes. This metro area probably has one of the highest concentrations of Magnet hospitals in the country. We can all help each other to succeed.

Reeves: Topics like those are also seen at AMSN’s national convention, held Oct. 24-29 in Las Vegas this year. We also survey members about their educational needs each year. We do a certification review course as well as the actual exam there. Some key topics this year are nursing research, leadership skills, professional image, evidence-based practice, telemetry, diabetes, new drugs, bariatrics, patient safety, shift reporting, avoiding malpractice and a variety of disease-specific sessions.

ADVANCE: What other activities does the local chapter offer in addition to education and networking?

Reeves: Mentoring is crucial in our profession overall, but also within this specialty. This is not the era of “eating our young;” we can’t afford to do that. AMSN promotes a program called “Nurses Mentoring Nurses.”

Winbush: Our board and committee members network with contacts in area hospitals to tell them what we offer and collaborate with them on programs. We just participated in the first-ever med/surg symposium at the Dallas VA Medical Center. We assisted the VA system in developing and implementing a very successful event.

We also stay connected to the community through work with Scouts, Boys & Girls Clubs, Explorers Posts and schools to teach young adults about the field of nursing. We provide first aid stations and participate in area Special Olympics activities. Overall, we stay busy presenting a positive image of med/surg nurses to North Texas.

Lola Howle is regional editor at ADVANCE.

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