By Jeremy R. Verhines MSN, RN, PMHNP-BC
Psychiatric Mental Health Nurse Practitioner
How Much Does a Medical-Surgical Nurse Make?
Overview of Medical-Surgical (Med-Surg) Nursing
Medical Surgical or Med-Surg nursing is at the core of the Registered Nurse. Often times, nursing students find themselves leaning towards specializing in a specific specialty of nursing. Whether it be psychiatry, intensive care, emergency care, neurology, oncology, pediatric, geriatric, operating room, home health, case management, post-anesthesia care, cardiac telemetry, dialysis, labor and delivery, radiology or school nursing, at the heart of each of these specialties lies the well-rounded medical-surgical nurse. You see, medical-surgical nursing offers the new graduate Registered Nurse the opportunity to learn all of the necessary skills needed in these other specialty areas.
I remember my early days of nursing school. I had my heart set on being an intensive care or emergency care RN. The thought of being a “high-level” caregiver was attractive, fed my need for adrenaline and supported my false perception that ICU/ER nurses knew more than their medical-surgical colleagues. Little did I know, my medical-surgical training would be invaluable when it came time to transfer to these other areas of acute care. My medical-surgical experience was irreplaceable and supportive to my success and competency as a registered nurse in the ICU and ER setting. As I grew into the intensive care and emergency care RN role, I had the opportunity of training many new graduate RN’s. What I found was that almost all of these individuals lacked the basic skill sets to care for the intensive needs of these critically ill patients and required an extended period of time of breaking in and learning. I actually found that those without medical-surgical experience required more precepting time and rarely came into their own within the first year of nursing.
Medical-Surgical nursing covers just about every aspect of patient care. Medical-Surgical nurses can expect to treat patients at various levels of illness states. These nurses are proficient in most all nursing procedures that take place at the bedside such as: the insertion, care and removal of Foley catheters, intravenous needles and nasogastric tubes; Percutaneous Endoscopic tube care and feeding, and rectal tube care. Furthermore, medical-surgical registered nurses care for Post-Operative joint and most other patients recovering from minor surgical procedures. Another important skill that med-surg nurses possess is the ability to perform wound care including but not limited to stitch removal, pressure ulcer management, and most dermatological wound diseases. Finally, medical-surgical registered nurses are proficient in caring for patients with cardiac telemetry monitoring. This patient population is the majority served as many acute care patients have a cardiac comorbidity. They will most likely require telemetry monitoring by an Advanced Cardiac Life Support (ACLS) trained registered nurse. I equate the medical-surgical nurse to that of the military infantry person being first in battle, first to respond and the one of the most valued members of the force. This is not to say that the other members of the team are not valuable but rather that the medical-surgical nurse is trusted and someone you want by your side when something goes wrong. They are trained to adapt, respond, modify and adjust at any given notice. They are able to think outside of the box and problem solve in a timely manner so that the best care can be provided to the patient when they need it the most and care is not delayed. I value my own personal medical-surgical experience over all of the areas (ICU, ER, OR, Psychiatry) that I have gained experience in. Medical-Surgical nursing experience follows the registered nurse everywhere they go. It is the quintessential Phillips head screwdriver that is always needed. These are just a few examples of what a medical-surgical nurse is able to do.
The Career Path of The Medical-Surgical (Med-Surg) Registered Nurse
The career path of the medical-surgical registered nurse is broad in nature in that a med-surg nurse has many opportunities for employment in the field of healthcare. Medical-surgical nurses are in high demand as most of nursing and the care patients receive revolves around this particular setting. Medical-surgical nurses can expect to have opportunities in the acute care hospital setting, operating room, outpatient clinics, skilled nursing facilities (SNIF), home health and various other areas where the skills of med-surg nurses are needed. Most employers looking for registered nurses want to know that a nurse has the basic skills necessary to care for a variety of illnesses and medical-surgical nurses have these skills. Most of these professionals will work in the acute care hospital setting.
Another caveat is that Medical-surgical nurses make great candidates for promotional advancement opportunities and are often sought out for clinical nurse management positions. These professionals are able to lead, train and educate their staff in the essential areas of nursing necessary to care for the majority of patients being treated in the acute care setting. This is another reason for registered nurses to consider first spending time on a medical-surgical floor before venturing off into a more specialized care setting.
Typical Salary Ranges of The Medical-Surgical (Med-Surg) Registered Nurse
Salary ranges for medical-surgical nurses vary from region to region and state to state. The BSN (Bachelor of Science) trained med-surg nurse is expected to be more marketable than the ADN (Associate Degree) registered nurse as acute care hospitals expand their services and become more Magnet driven. However, once employed, the ADN and BSN trained nurse fall within the same pay scale. The key here is getting employed.
According to the Bureau of Labor Statistics, the hourly wage range for the Registered Nurse is $23.41 – $50.05. with the mean or majority of Registered Nurses falling at or around $35.36 per hour (bls.gov, 2018). To get a better idea of the different wage opportunities that exist you can visit the Bureau of Labor Statistics website. Here you will find a lot more information about the different settings and opportunities that exist for Registered Nurses. One thing to note with regards to Registered Nursing salaries is that the pay ranges differ greatly depending upon population, region, and demand. For example, in the Southern California region, and the area I live, non-union Registered Nurses can make anywhere between $37.00 – 61.00 an hour depending upon how much experience they have. I personally have not ever relied upon statistics to understand exactly what my potential is given the volatility of the rates and the vast differences in the areas served. It is always best to investigate a particular organization you wish to work for and inquire as to what their pay scale is. Furthermore, it is important to understand how nurses are paid. If you work for an organization in Southern California then you can expect to get a base hourly rate + time and a half for any hour over 8 hours in a given shift. Most Registered Nurses work 12-hour shifts so their base rate is paid for the first 8 hours and then time and a half paid for the last 4 hours of that shift. For example, a Registered Nurse who makes $40.00 an hour and works 12-hour shifts will get $320.00 for the first 8 hours (8 x $40.00) and $240.00 for the last 4 hours (4 x $60.00) giving the nurse a total of $560.00 for that respective 12-hour shift. Any time worked over 12 hours is paid at a double-time rate or in this case, $80.00 an hour.
Medical-surgical training is valuable and makes a nurse marketable. The job outlook is plentiful and regardless of the region or state you live in, the need is always present. When deciding on where to set your roots down and work as a Registered Nurse, be sure to get the most bang for your buck. Do the research, scope out the different markets and make a decision that is based upon what you want for yourself, overall quality of life, and ultimately where you see yourself in the future.
By Jeremy R. Verhines MSN, RN, PMHNP-BC
Psychiatric Mental Health Nurse Practitioner
Bureau of Labor Statistics. (2018). Occupational employment and wages, May 2017: 29-1141
Registered Nurse. https://www.bls.gov/oes/current/oes291141.htm