critical thinking med surg nursing

Critical thinking skills in intensive care and medical-surgical nurses and their explaining factors

Affiliations.

• 1 Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran. Electronic address: [email protected].
• 2 Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran; Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran. Electronic address: [email protected].
• 3 Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran; Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran; Social Determinant of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran. Electronic address: [email protected].
• PMID: 32283476
• DOI: 10.1016/j.nepr.2020.102783

Critical thinking affects patient safety in critical situations. Nurses, in particular, intensive care unit (ICU) nurses, need to develop their critical thinking skills. The present article seeks to compare the level of critical thinking in medical-surgical and ICU nurses and investigate the factors explaining it. A cross-sectional study was conducted on 120 medical-surgical and ICU nurses (60 per group). Data were collected using the California Critical Thinking Skills Test and analyzed in SPSS-16 using independent samples t-test, ANOVA, and the regression analysis. The mean critical thinking score was 8.68 ± 2.84 in the ICU nurses and 9.12 ± 2.99 in the medical-surgical nurses. No significant differences were found between the two groups in terms of the critical thinking score and the scores of its domains. The results of the regression analysis showed that demographic variables explain only 8% of the variations in critical thinking score, as only gender explains nurses' critical thinking score. The results revealed poor critical thinking scores in the nurses working in medical-surgical wards. Investigating the reasons for the poor scores obtained and using educational strategies such as PBL, conceptual map, participation in interdisciplinary rounds, the development of clinical guidelines and participation in continuing education conferences are recommended for developing critical thinking skills in nurses.

Keywords: Critical thinking; Intensive care unit; Iran; Medical-surgical ward; Nurse.

Copyright © 2020 Elsevier Ltd. All rights reserved.

• Critical Care Nursing / statistics & numerical data*
• Critical Care*
• Cross-Sectional Studies
• Medical-Surgical Nursing / statistics & numerical data*
• Patient Safety*
• Surveys and Questionnaires
• Young Adult

The Value of Critical Thinking in Nursing

• How Nurses Use Critical Thinking
• How to Improve Critical Thinking
• Common Mistakes

Some experts describe a person’s ability to question belief systems, test previously held assumptions, and recognize ambiguity as evidence of critical thinking. Others identify specific skills that demonstrate critical thinking, such as the ability to identify problems and biases, infer and draw conclusions, and determine the relevance of information to a situation.

Nicholas McGowan, BSN, RN, CCRN, has been a critical care nurse for 10 years in neurological trauma nursing and cardiovascular and surgical intensive care. He defines critical thinking as “necessary for problem-solving and decision-making by healthcare providers. It is a process where people use a logical process to gather information and take purposeful action based on their evaluation.”

“This cognitive process is vital for excellent patient outcomes because it requires that nurses make clinical decisions utilizing a variety of different lenses, such as fairness, ethics, and evidence-based practice,” he says.

How Do Nurses Use Critical Thinking?

Successful nurses think beyond their assigned tasks to deliver excellent care for their patients. For example, a nurse might be tasked with changing a wound dressing, delivering medications, and monitoring vital signs during a shift. However, it requires critical thinking skills to understand how a difference in the wound may affect blood pressure and temperature and when those changes may require immediate medical intervention.

Nurses care for many patients during their shifts. Strong critical thinking skills are crucial when juggling various tasks so patient safety and care are not compromised.

Jenna Liphart Rhoads, Ph.D., RN, is a nurse educator with a clinical background in surgical-trauma adult critical care, where critical thinking and action were essential to the safety of her patients. She talks about examples of critical thinking in a healthcare environment, saying:

“Nurses must also critically think to determine which patient to see first, which medications to pass first, and the order in which to organize their day caring for patients. Patient conditions and environments are continually in flux, therefore nurses must constantly be evaluating and re-evaluating information they gather (assess) to keep their patients safe.”

The COVID-19 pandemic created hospital care situations where critical thinking was essential. It was expected of the nurses on the general floor and in intensive care units. Crystal Slaughter is an advanced practice nurse in the intensive care unit (ICU) and a nurse educator. She observed critical thinking throughout the pandemic as she watched intensive care nurses test the boundaries of previously held beliefs and master providing excellent care while preserving resources.

“Nurses are at the patient’s bedside and are often the first ones to detect issues. Then, the nurse needs to gather the appropriate subjective and objective data from the patient in order to frame a concise problem statement or question for the physician or advanced practice provider,” she explains.

Top 5 Ways Nurses Can Improve Critical Thinking Skills

We asked our experts for the top five strategies nurses can use to purposefully improve their critical thinking skills.

Case-Based Approach

Slaughter is a fan of the case-based approach to learning critical thinking skills.

In much the same way a detective would approach a mystery, she mentors her students to ask questions about the situation that help determine the information they have and the information they need. “What is going on? What information am I missing? Can I get that information? What does that information mean for the patient? How quickly do I need to act?”

Consider forming a group and working with a mentor who can guide you through case studies. This provides you with a learner-centered environment in which you can analyze data to reach conclusions and develop communication, analytical, and collaborative skills with your colleagues.

Practice Self-Reflection

Rhoads is an advocate for self-reflection. “Nurses should reflect upon what went well or did not go well in their workday and identify areas of improvement or situations in which they should have reached out for help.” Self-reflection is a form of personal analysis to observe and evaluate situations and how you responded.

This gives you the opportunity to discover mistakes you may have made and to establish new behavior patterns that may help you make better decisions. You likely already do this. For example, after a disagreement or contentious meeting, you may go over the conversation in your head and think about ways you could have responded.

It’s important to go through the decisions you made during your day and determine if you should have gotten more information before acting or if you could have asked better questions.

During self-reflection, you may try thinking about the problem in reverse. This may not give you an immediate answer, but can help you see the situation with fresh eyes and a new perspective. How would the outcome of the day be different if you planned the dressing change in reverse with the assumption you would find a wound infection? How does this information change your plan for the next dressing change?

Develop a Questioning Mind

McGowan has learned that “critical thinking is a self-driven process. It isn’t something that can simply be taught. Rather, it is something that you practice and cultivate with experience. To develop critical thinking skills, you have to be curious and inquisitive.”

To gain critical thinking skills, you must undergo a purposeful process of learning strategies and using them consistently so they become a habit. One of those strategies is developing a questioning mind. Meaningful questions lead to useful answers and are at the core of critical thinking .

However, learning to ask insightful questions is a skill you must develop. Faced with staff and nursing shortages , declining patient conditions, and a rising number of tasks to be completed, it may be difficult to do more than finish the task in front of you. Yet, questions drive active learning and train your brain to see the world differently and take nothing for granted.

It is easier to practice questioning in a non-stressful, quiet environment until it becomes a habit. Then, in the moment when your patient’s care depends on your ability to ask the right questions, you can be ready to rise to the occasion.

Practice Self-Awareness in the Moment

Critical thinking in nursing requires self-awareness and being present in the moment. During a hectic shift, it is easy to lose focus as you struggle to finish every task needed for your patients. Passing medication, changing dressings, and hanging intravenous lines all while trying to assess your patient’s mental and emotional status can affect your focus and how you manage stress as a nurse .

Staying present helps you to be proactive in your thinking and anticipate what might happen, such as bringing extra lubricant for a catheterization or extra gloves for a dressing change.

By staying present, you are also better able to practice active listening. This raises your assessment skills and gives you more information as a basis for your interventions and decisions.

Use a Process

As you are developing critical thinking skills, it can be helpful to use a process. For example:

• Ask questions.
• Gather information.
• Implement a strategy.
• Evaluate the results.
• Consider another point of view.

These are the fundamental steps of the nursing process (assess, diagnose, plan, implement, evaluate). The last step will help you overcome one of the common problems of critical thinking in nursing — personal bias.

Common Critical Thinking Pitfalls in Nursing

Your brain uses a set of processes to make inferences about what’s happening around you. In some cases, your unreliable biases can lead you down the wrong path. McGowan places personal biases at the top of his list of common pitfalls to critical thinking in nursing.

“We all form biases based on our own experiences. However, nurses have to learn to separate their own biases from each patient encounter to avoid making false assumptions that may interfere with their care,” he says. Successful critical thinkers accept they have personal biases and learn to look out for them. Awareness of your biases is the first step to understanding if your personal bias is contributing to the wrong decision.

New nurses may be overwhelmed by the transition from academics to clinical practice, leading to a task-oriented mindset and a common new nurse mistake ; this conflicts with critical thinking skills.

“Consider a patient whose blood pressure is low but who also needs to take a blood pressure medication at a scheduled time. A task-oriented nurse may provide the medication without regard for the patient’s blood pressure because medication administration is a task that must be completed,” Slaughter says. “A nurse employing critical thinking skills would address the low blood pressure, review the patient’s blood pressure history and trends, and potentially call the physician to discuss whether medication should be withheld.”

Fear and pride may also stand in the way of developing critical thinking skills. Your belief system and worldview provide comfort and guidance, but this can impede your judgment when you are faced with an individual whose belief system or cultural practices are not the same as yours. Fear or pride may prevent you from pursuing a line of questioning that would benefit the patient. Nurses with strong critical thinking skills exhibit:

• Learn from their mistakes and the mistakes of other nurses
• Look forward to integrating changes that improve patient care
• Treat each patient interaction as a part of a whole
• Evaluate new events based on past knowledge and adjust decision-making as needed
• Solve problems with their colleagues
• Are self-confident
• Acknowledge biases and seek to ensure these do not impact patient care

An Essential Skill for All Nurses

Critical thinking in nursing protects patient health and contributes to professional development and career advancement. Administrative and clinical nursing leaders are required to have strong critical thinking skills to be successful in their positions.

By using the strategies in this guide during your daily life and in your nursing role, you can intentionally improve your critical thinking abilities and be rewarded with better patient outcomes and potential career advancement.

Frequently Asked Questions About Critical Thinking in Nursing

How are critical thinking skills utilized in nursing practice.

Nursing practice utilizes critical thinking skills to provide the best care for patients. Often, the patient’s cause of pain or health issue is not immediately clear. Nursing professionals need to use their knowledge to determine what might be causing distress, collect vital information, and make quick decisions on how best to handle the situation.

How does nursing school develop critical thinking skills?

Nursing school gives students the knowledge professional nurses use to make important healthcare decisions for their patients. Students learn about diseases, anatomy, and physiology, and how to improve the patient’s overall well-being. Learners also participate in supervised clinical experiences, where they practice using their critical thinking skills to make decisions in professional settings.

Do only nurse managers use critical thinking?

Nurse managers certainly use critical thinking skills in their daily duties. But when working in a health setting, anyone giving care to patients uses their critical thinking skills. Everyone — including licensed practical nurses, registered nurses, and advanced nurse practitioners —needs to flex their critical thinking skills to make potentially life-saving decisions.

Meet Our Contributors

Crystal Slaughter, DNP, APRN, ACNS-BC, CNE

Crystal Slaughter is a core faculty member in Walden University’s RN-to-BSN program. She has worked as an advanced practice registered nurse with an intensivist/pulmonary service to provide care to hospitalized ICU patients and in inpatient palliative care. Slaughter’s clinical interests lie in nursing education and evidence-based practice initiatives to promote improving patient care.

Jenna Liphart Rhoads, Ph.D., RN

Jenna Liphart Rhoads is a nurse educator and freelance author and editor. She earned a BSN from Saint Francis Medical Center College of Nursing and an MS in nursing education from Northern Illinois University. Rhoads earned a Ph.D. in education with a concentration in nursing education from Capella University where she researched the moderation effects of emotional intelligence on the relationship of stress and GPA in military veteran nursing students. Her clinical background includes surgical-trauma adult critical care, interventional radiology procedures, and conscious sedation in adult and pediatric populations.

How to Get Into Med-Surg Nursing

What is med surg nursing.

• How to Become
• Essential Skills
• A Day in the Life

Med surg nursing stands for medical surgical nursing, and it's the largest nursing specialty in the US. A med surg nurse is a specific type of surgical nurse who cares for patients preparing for or recovering from surgery. But med surg nurses' duties expand beyond surgical patients, as they provide care for a wide range of non-surgery patients in the hospital as well.

Medical surgical nurses provide 24-hour care to patients during their hospital stay. Admitted patients will spend more one-on-one time with their med-surg nurse than any other medical professional while admitted to the hospital.

Med-surg nursing provides a range of specialties for nurses to enter, such as:

• General surgery
• Plastic surgery
• Neurosurgery
• Vascular surgery
• Cardiac care
• Gastrointestinal

Med-surg nurses often work at a hospital or medical center in an acute care or med surg unit at the bedside. However, this nursing specialty may also be found in other areas, such as outpatient clinics or home healthcare facilities. 

What Does a Med Surg Nurse Do?

Med-surg nurses provide direct bedside nursing care in a med-surg unit, which is a hospital ward for patients who are preparing for or recovering from surgical procedures. On shift, a medical surgical nurse usually manages the care of 4 to seven patients at a time. They also discharge patients and admit new patients into their care throughout their shifts. 

Some critical med surg nursing duties and responsibilities include the following:

• Admitting patients to the med surg unit
• Administering medication and providing pain control
• Ambulating patients
• Providing wound care
• Monitoring and recording vital signs and events in electronic medical records (EMRs)
• Working with ancillary specialties - such as physical therapy, diabetes specialists, or speech therapy - to coordinate care
• Performing or ensuring diagnostic testing is completed
• Providing patient education and discharge instructions
• Discharging patients to outpatient facilities or home

Find Nursing Programs

Med surg nurse salary.

The median pay for nurses is $81,220 annually or $39.05 per hour, according to 2022 reports from the US Bureau of Labor Statistics (BLS). But that’s an average across nurses with different degrees, working in many specialties and living in various locations. RN salary varies depending on several factors and can range widely throughout the country. 

One such factor is your nursing specialty, with med surg nurses achieving higher salaries than general RNs. For example, ZipRecruiter reports med surg nursing salaries at $120,699 a year, while general RN salaries average $90,901 annually.

Other factors that may impact your med surg nursing salary include:

• The city and state where you live
• The type of healthcare facility you work in 
• Whether you work 8, 10, or 12 hours shifts
• Whether you work full-time or part-time
• How many shifts you work in a week

Med-surg nurses living in some areas of the country may earn a much higher income than others. However, the salary usually aligns with the cost of living in the area. For example, South Dakota nurses typically earn less than San Francisco nurses. However, it's also much more expensive to live in San Fransisco than in many other states, such as South Dakota.

How to Become a Med Surg Nurse

To become a med-surg nurse, you must meet the following requirements: 

1. Attend an Accredited Nursing Program

There are two pathways to becoming an RN :

Associate's degree in nursing (ADN), or 

Bachelor's degree in nursing (BSN) 

2. Pass the National Licensure Examination

Becoming an RN requires you to pass the National Council Licensure Examination for Registered Nurses ( NCLEX-RN ). Per diem nurses must also maintain a current and active license. Once licensed, you must renew your RN credential every two years by completing and submitting  continuing education units (CEUs) per your state's nursing board requirements.

3. Apply for Med-Surg Nursing Jobs

You can begin working in med-surg nursing right away through new nurse graduate programs in your area. Most new graduate med surg nursing programs last 2-6 months and offer the in-depth training you need to be a successful med surg nurse. Often, facilities pair recent nursing grads with a tenured nurse to help teach them core med surg nursing skills and competencies.

>> See Med-Surg Nursing Jobs Hiring Now

4. Become a Certified Med-Surg RN

After earning a minimum of one year of experience, you can sit for the Medical-Surgical Nursing Certification (MEDSURG-BC™) exam. Certification will let your employer, coworkers, and patients know that you are an expert in your field and can provide the highest level of patient care.

Med Surg Nursing Skills & Competencies

The ability to stay calm.

Caring for surgical patients is not easy because their conditions can rapidly become serious or critical. You also have many responsibilities that you must juggle, making the med-surg nursing environment hectic and stressful. Therefore, Med surg nurses must be able to maintain a calm demeanor and work well under pressure.

Organization & Multitasking

Med-surg nurses often care for 4-7 patients at once, all of whom need specific care. On top of that, they must admit and discharge patients throughout the day and tend to any emergencies. To balance all those duties, med surg nursing requires tons of multitasking and organizational skills. 

Critical Thinking

There are many moments throughout the shift when a med surg nurse must prioritize their duties. Sometimes, they do so under urgent conditions, making critical thinking skills a must. Being able to prioritize tasks and think on your feet can make a huge difference in a med surg unit.

Competencies

To work in med-surg nursing, you must be proficient in hundreds of nursing competencies, a few of which include:

• Assessing neurological status
• Managing different types of catheters, such as urinary or epidural
• Providing care for drains, such as a chest tube or hemovac wound drain
• Providing CPR when needed
• Understanding and educating on medication administration, contraindications, side effects, and dosing calculations
• Providing pulmonary care such as tracheal suctioning, chest drainage symptoms, and assessing breath sounds
• Starting and maintaining IVs and providing IV medication
• Performing complex dressing changes
• Providing care for braces, casts, and traction devices

Zip Recruiter reports that employers are looking for several specific keyword skills when reviewing potential med-surg travel nursing candidate’s resumes, some of which include:

• Inpatient care
• Treatment planning
• Behavioral  analysis
• Medical records

>> Related: How to Become a Circulating Nurse

What Is It Like to Work in Med Surg Nursing?

Med-surg nurses provide essential and often life-saving care for their patients and families during some of the most challenging times of their lives. Although working in med-surg nursing can be very stressful and exhausting, many say the career gives them a sense of pride in their work. 

A career as a med-surg nurse may not be suitable for everyone. This nursing specialty requires a sense of determination, the ability to manage the complex patient care of multiple patients simultaneously, and a strong stomach. 

But if learning about various surgical procedures while utilizing a wide range of complex nursing skills appeals to you, med surg nursing might be the perfect career for you!

Sarah Jividen , RN, BSN, is a trained neuro/trauma and emergency room nurse turned freelance healthcare writer/editor. As a journalism major, she combined her love for writing with her passion for high-level patient care. Sarah is the creator of Health Writing Solutions , LLC, specializing in writing about healthcare topics, including health journalism, education, and evidence-based health and wellness trends. She lives in Northern California with her husband and two children. 

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Medical-Surgical Nursing: Critical Thinking in Patient Care (5th Edition) Hardcover – Dec 8 2010

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• ISBN-10 0135075947
• ISBN-13 978-0135075944
• Edition 5th
• Publisher Pearson
• Publication date Dec 8 2010
• Language English
• Dimensions 22.1 x 5.84 x 27.69 cm
• Print length 1944 pages
• See all details

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Product description

About the author.

Priscilla LeMone, RN, DSN, FAAN

Associate Professor Emeritus. Sinclair School of Nursing, University of Missouri

Adjunct Associate Professor of Nursing, College of Nursing, The University of Ohio

Priscilla LeMone spent most of her career as a nurse educator, teaching medical-surgical nursing and pathophysiology at all levels from diploma to doctoral students. She has a diploma in nursing from Deaconess College of Nursing (St. Louis, Missouri), baccalaureate and master’s degrees from Southeast Missouri State University, and a doctorate in nursing from the University of Alabama—Birmingham. She is retired as an Associate Professor Emeritus, Sinclair School of Nursing, University of Missouri—Columbia, but continues to keep up to date in nursing both as an Adjunct Associate Professor at the Ohio State University, College of Nursing and as an author of nursing textbooks.

Dr. LeMone had numerous awards for scholarship and teaching during her more than 30 years as a nurse educator. She is most honored for receiving the Kemper Fellowship for Teaching Excellence from the University of Missouri—Columbia, the Unique Contribution Award from the North American Nursing Diagnosis Association, and for being selected as a Fellow in the American Academy of Nursing

Dr. LeMone currently lives in Ohio. She enjoys traveling, gardening, knitting and reading fiction.

She believes that her education gave her solid and everlasting roots in nursing. Her work with students has given her the wings that have allowed her love of nursing and teaching to continue through the years

Karen M. Burke, RN, MS

Karen Burke has been a nurse educator for much of her career, teaching basic and advanced medical-surgical nursing and pathophysiology. She retired as director of the nursing and health occupations programs at Clatsop Community College in Astoria, Oregon, subsequently serving as nursing education consultant and program manager for the Oregon State Board of Nursing. She currently provides consulting services for nursing and higher education.

Ms. Burke earner her diploma in nursing from Emanuel Hospital School of Nursing in Portland, Oregon, later completing baccalaureate studies at Oregon Health & Science University, and a master’s degree in nursing at the University of Portland. She has been actively involved in nursing education and clinical nursing education reform, as well as in initiatives to address the nursing faculty shortage. Ms. Burke is coauthor of another text, Medical-Surgical Nursing Care (3rd edition) with Elaine Mohn-Brown and Linda Eby.

Ms Burke strongly values the nursing profession and the importance of providing a strong education in the art and science of nursing for students preparing to enter the profession, no matter which educational path is being pursued.

Gerene Bauldoff, RN, PhD, FAAN

Gerene Bauldoff is an Associate Professor of Clinical Nursing at the Ohio State University College of Nursing in Columbus, Ohio. She has been a nurse educator for ten years, teaching medical-surgical nursing, clinical specialist role and translational science courses at the baccalaureate, master’s and doctoral levels. Prior to her nursing educator role, her clinical background includes home health nurse, lung transplant coordinator and pulmonary rehabilitation coordinator. Dr. Bauldoff has a diploma from the Western Pennsylvania Hospital School of Nursing, Pittsburgh, PA, and a BSN from LaRoche College, in Pittsburgh. Her graduate education is from the University of Pittsburgh, with a MSN in Medical-surgical nursing (Cardiopulmonary clinical nurse specialist) and PhD in Nursing in 2001, training under Leslie Hoffman, PhD, RN, FAAN.

Dr. Bauldoff is an active member in multiple professional organizations including Sigma Theta Tau International Honor Society of Nursing, the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), the American Thoracic Society Nursing Assembly and the American College of Chest Physicians (ACCP). She is a recognized expert in medical-surgical nursing, focusing on the care of the patient with chronic pulmonary disease and served as the nursing representative on the ACCP/AACVPR Evidence-based Guidelines for Pulmonary Rehabilitation published in 2007. She has been honored with fellowship in AACVPR and ACCP. She currently serves on the Board of Directors of the American Association of Cardiovascular and Pulmonary Rehabilitation and has been appointed to the Community-Based Care board of the Ohio Council of Home Care and Hospice.

Dr. Bauldoff feels nursing is the best profession, using of scientific evidence to provide the highest quality of care while maintaining the personal relationship with the patient and their family. Her experiences provide her with insights and lessons learned that she shares with her students.

Dr. Bauldoff resides in central Ohio. She enjoys reading, walking, bicycling, golf and spending time with her family and friends. She is learning the intricacies of social networking and keeps up to date with technology to be able to interface with her students, family and friends.

Product details

• Publisher ‏ : ‎ Pearson; 5th edition (Dec 8 2010)
• Language ‏ : ‎ English
• Hardcover ‏ : ‎ 1944 pages
• ISBN-10 ‏ : ‎ 0135075947
• ISBN-13 ‏ : ‎ 978-0135075944
• Item weight ‏ : ‎ 3.67 kg
• Dimensions ‏ : ‎ 22.1 x 5.84 x 27.69 cm

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How To Critically Think (Nursing)

Clinical , Study Tips and Getting Organized

Are you SUPER confused on what critical thinking means in nursing school?

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In this video, I’ll walk you through what critical thinking is and how you can do it in nursing school.

Here’s what we’ll talk about:

There are 2 parts to critical thinking: 1. Connecting the dots with everything you’re learning 2. Planning ahead

I’ll also walk you through 9 critical thinking questions to ask to help you critically think while you study or take care of patients at clinical during nursing school.

Click here to get your FREE critical thinking cheat sheet.

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Med Surg Nursing Guide [with Download]

Nursing students have to take Med Surg nursing classes in nursing school to provide a comprehensive understanding of the nursing profession and prepare for a successful career in healthcare.

Med sug nursing is considered a core specialty within the nursing profession. It provides the foundation for all other nursing specialties and is essential for providing safe and effective patient care.

Nursing students who are interested in specializing in areas such as oncology, orthopedics, critical care, and more can build a strong foundation in Med Surg nursing that will serve as a basis for further study and specialization.

What is Med Surg nursing?

Medical-surgical (med surg) nursing is a specialty within nursing that focuses on providing care to adult patients with acute or chronic medical conditions that require interventions such as medication, surgery, or other medical treatments. 

Nurses in med sug units may provide a wide range of services, including administering medications, monitoring vital signs, performing procedures, educating patients and families, and collaborating with other healthcare professionals to develop and implement care plans.

Med surg nursing requires a strong foundation in anatomy, physiology, pharmacology, and other related subjects, as well as excellent critical thinking and communication skills. It is a demanding and rewarding specialty that offers opportunities for growth and advancement within the nursing profession.

How to Study for Med Surg

Here are some important things nursing students need to know about Med Surg nursing classes:

• Be ready to learn a wide range of medical conditions and procedures , including but not limited to: cardiovascular, respiratory, gastrointestinal, neurologic, endocrine, and musculoskeletal systems.
• Understand that med surg is a strong foundation in anatomy, physiology, and pharmacology. It’s important to understand the basic mechanisms underlying various medical conditions and treatments.
• Build your critical thinking and clinical reasoning skills . Med Surg nursing requires strong critical thinking and clinical reasoning skills to quickly assess patients, identify problems, and make sound clinical judgments.
• Understand patient education and advocacy as key roles for Med Surg nurses. You need to be able to explain medical conditions and treatments to patients and their families so that they can understand and participate in their care.
• Collaborate with other health care professionals , including physicians, pharmacists, physical therapists, and social workers. Effective communication and teamwork are crucial to providing high-quality patient care.
• Take opportunities for specialization. Med Surg nursing is a diverse field that offers opportunities for specialization in areas such as oncology, orthopedics, critical care, and more.

Med Surg Study Guide Download

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Critical Thinking For Med-surg nursing

Specialties Med-Surg

Published Aug 12, 2006

Just failed PBDS and lost my travel job. Had never heard of this test before nor did any of my former coworkers.So I tried doing some research and very hard to find info but I did find one book that might help. Apparantly critical thinking is the rage or becoming the rage for testing nurses.

The book will be released September 2006 and is by the F.A Davis co. priced at $31.95. The title is

Med-surg Success;A Course Review Applying Critical Thinking To Test Taking

I did a google search on the title and it will bring up the website for the book. Please keep us informed if anyone buys this book and how you rate it....thanks

• + Add a Comment

What is the PBD test? If you are doing your job well, then why were you terminiated? What was your specialty? Why didn't they allow you to take more classes for self improvement, before, this happened? I have never heard of this before.

I personally could use alot of improvement in my critical thinking skills at work. I will try to find this book on the internet, probably amazon.com.

Thank you for your transparency in making this post.

Mojofla, What is the PBD test? If you are doing your job well, then why were you terminiated? What was your specialty? Why didn't they allow you to take more classes for self improvement, before, this happened? I have never heard of this before. I personally could use alot of improvement in my critical thinking skills at work. I will try to find this book on the internet, probably amazon.com. Thank you for your transparency in making this post.

gentle... There are plenty of threads here on PBDS. Just go under search and type in PBDS. It will explain the test and really has nothing to do with doing your job well.All the questions you asked are answered on threads for PBDS ..then you will get an idea of the test and possible consequences. As you can see under ny name my areas of nursing. It was med/surg floor and the test was designed as an assessment/learning tool but some hospitals use it to terminate you. The hospital where I was doesnt consider it as a termination..just that you are not hirable as a travel nurse. They did state I was qualified to work a a staff nurse or a 6 month seasonal contract working 3- 12hr shifts one week and 4-12hr shifts the next. However I am moving back to my old hospital and will have my pay/benefits reinstated.(I actully made more as a staff RN where I was with benefits and vacation) I moved here for a year due to my fiance job relocation but we have decided to now go back home. I think it was just wrong to treat people like this. I am a good nurse and very qualified. My former co-workers rolled over laughing when I told them of this test and that it basically said I had no critical thinking skills.

I basically want to make people aware of the test and possible consequences. Thank goodness I was not financially affected by loss of this contract but a lot of us do live paycheck to paycheck, have bills,kids and I hate to see anyone else pack up move and have to repack and leave. As I understand you will not get travel reimbursed by most companies. The hospital did pay for orientation but I know of 1 persn who lost her paycheck to the travel company because she had to spend a few extra days in their housing after she was sent packing. It was her first travel experience and a very unpleasant experience for her.

At the hospital where I did the PBDS I did work one 12 hr shift because no one notified me that my contract was null & void . The nurse manager never even said anything to me. This incompetent old nurse however was the only one who could put an NG in a pt for them. The nurse orientating me also had a trach pt...she didn't know trach care. I had to tell her what the trach "inserts "were and to order up a box of the inserts( shileys). PICC/CVC dressings didnt look like they were changed ..nothing was dated as to when things were done last. Neither she nor the clinical coordinator took the test and stated they would never pass it.

Please do look up the threads as you will see/hear different experiences/stories from both travel nurses and staff nurses.

I went to a bookstore and saw a small pocked sized book for medsurg by Davis co. and after reading the threads and links found the 10 or 11 medical diagnosis you must make on the test and it gave you the steps you should take,things to do for that diagnosis. I will pick that book up .

GOOD LUCK and hope this helps.

DevelopmentRN

You can run and you can hide..............but you can't run and hide from PBDS.

gentle... There are plenty of threads here on PBDS. Just go under search and type in PBDS. It will explain the test and really has nothing to do with doing your job well.All the questions you asked are answered on threads for PBDS ..then you will get an idea of the test and possible consequences. As you can see under ny name my areas of nursing. It was med/surg floor and the test was designed as an assessment/learning tool but some hospitals use it to terminate you. The hospital where I was doesnt consider it as a termination..just that you are not hirable as a travel nurse. They did state I was qualified to work a a staff nurse or a 6 month seasonal contract working 3- 12hr shifts one week and 4-12hr shifts the next. However I am moving back to my old hospital and will have my pay/benefits reinstated.(I actully made more as a staff RN where I was with benefits and vacation) I moved here for a year due to my fiance job relocation but we have decided to now go back home. I think it was just wrong to treat people like this. I am a good nurse and very qualified. My former co-workers rolled over laughing when I told them of this test and that it basically said I had no critical thinking skills. I basically want to make people aware of the test and possible consequences. Thank goodness I was not financially affected by loss of this contract but a lot of us do live paycheck to paycheck, have bills,kids and I hate to see anyone else pack up move and have to repack and leave. As I understand you will not get travel reimbursed by most companies. The hospital did pay for orientation but I know of 1 persn who lost her paycheck to the travel company because she had to spend a few extra days in their housing after she was sent packing. It was her first travel experience and a very unpleasant experience for her. At the hospital where I did the PBDS I did work one 12 hr shift because no one notified me that my contract was null & void . The nurse manager never even said anything to me. This incompetent old nurse however was the only one who could put an NG in a pt for them. The nurse orientating me also had a trach pt...she didn't know trach care. I had to tell her what the trach "inserts "were and to order up a box of the inserts( shileys). PICC/CVC dressings didnt look like they were changed ..nothing was dated as to when things were done last. Neither she nor the clinical coordinator took the test and stated they would never pass it. Please do look up the threads as you will see/hear different experiences/stories from both travel nurses and staff nurses. I went to a bookstore and saw a small pocked sized book for medsurg by Davis co. and after reading the threads and links found the 10 or 11 medical diagnosis you must make on the test and it gave you the steps you should take,things to do for that diagnosis. I will pick that book up . GOOD LUCK and hope this helps.

Thanks for the post. I did read several other posts regarding pbds and will keep a look out. Haven't purchased a book yet. Will be purchasing as soon as I can. Until then, I will read for understanding wisdom --vs passing a test.

DevelopmentRN...I have no idea why you would post that comment.The nurses here are looking for advice on how to better deal with and pass the PBDS. I see you have posted prior that you have background in developing programs for new grads...so maybe instead you can post some worthwhile advice instead of posting this same comment on a couple of threads. Nobody is running or hiding here...

nrsang97, BSN, RN

2,602 Posts

I have been a RN for 5 years. My hospital system implemented the test last year. Just because you didn't pass dosen't mean you aren't a good nurse. The test shows you a scenario of a pt having complications, or hearing a snipet of conversation. You have to answer based on what you see and hear. I watched all the scenarios last year during my preceptor class and then had to take the test myself recently. So I can see why people fail. But you should be given your results and with some constructive advice. I think I did well because I had a heads up on what was on the test. Don't let this get you down. You don't get all the info you need to make a decision about the pt. Example (Pt has bun 35 creat 2.1 pt nauseated and vomiting after bowel surgery output was 2000, then 900, pt had been treated with massive fluid replacement for hypovolemic shock. my dx renal faliure. so you can see you need more info than the test gives you)

:smilecoffeecup: Hi mojofla

I just loved what you posted

P.S I have to take the PBDS for a position in Broward Florida wish me luck I have failed it in Naples,too

I am also a travel nurse and failed my PBDS. What a horrible test!!! I got home and had a message on my machine telling me my contract was cancelled and I had 48 hrs to get out of the apartment they provided! I have been a nurse for 22 yrs so I know what I am doing. I am trying to get a position in another hospital as an internal seasonal contract and found out I have to take the test again. I am terrified. I am paying the travel agency to live in the apartment for the next week and half and after that I don't know what I am going to do. I am going to buy that book as soon as I am off line and hope and pray I can pass it the next time.

As a staff nurse I have taken PBDS at two different hospitals in two different states. Now as an educator, our hospital stopped using the PBDS, last year, because it was not measuring "competency" but rather teaching people to remember senarios. From an educator standpoint, the PBDS is a time comsuming test answers plus the PBDS senarios could be subjective in certain cases. It was frustrating to me to take the tests as a staff nurse and grade the tests as an educator -- a lose/lose situation. I am glad we change to something different. That is my thoughts.

sjt9721, BSN, RN

... But you should be given your results and with some constructive advice...

Many travel and agency companies require the nurse to be successful on the initial assessment.

No, it's not the original intent of PBDS, but it's the way that some companies/facilities choose to implement it.

On another site many travel nurses are refusing to accept assignments at facilities that require this test. But more and more facilities are using this test. Guess this is another way to contribute to the nursing shortage.

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Med-Surg Success: A Q&A Review Applying Critical Thinking to Test Taking (Davis's Success) 2nd Edition

There is a newer edition of this item:.

The road to nursing success begins here!

• A complete review of core concepts.
• More than 2,265 classroom-tested, NCLEX®-style questions. (Alternate-item format, too!)
• Test-taking hints and rationales for correct and incorrect answers.

TWO BOOKS IN ONE! Course review now. NCLEX®-prep later.

Assure your mastery of medical surgical nursing knowledge while honing your critical thinking and test-taking skills. The 2nd Edition of this popular resource features 2,000 questions that reflect the latest advances in medical-surgical nursing and the new, 2010 NCLEX-RN® test plan. The seemingly huge volume of information you must master has been organized into manageable sections divided by body systems and specific diseases.

Each chapter is a self-contained unit. For each practice question, you’ll find the answer, rationales for correct and incorrect responses, and a test-taking tip. The comprehensive exam at the end of each chapter assesses your strengths and weaknesses, identifying areas for further study.

The bonus CD-ROM, featuring 265 questions, offers an interactive approach to course review and exam preparation.

What instructors and students are saying about the Success Series:

”We have used your products for students to help increase critical thinking skills, prepare for NCLEX and course exams, and for review of nursing content. We recommend students purchase the Success Series and review the content and questions for remediation and to enhance nursing knowledge. The terminology at the beginning of each chapter provide key terms for the students to review before answering questions. The books are all encompassing in regards to what students need to review across the curriculum. We love them!!” – Louise Outlaw, Instructor at Brown Mackie College, St.Louis

“The success books have helped me so much in many of my nursing courses, specifically in my med-surg nursing class. I found that the success books helped me to know where to focus my studying and also gave me a lot of great review questions that really prepared me for my exams! By using the med-surg success book, my grades shot up from an 89 to a 96. Also through the med-surg success book, my grades were consistently in the mid to high 90's range. I encourage all my friends to use the success books and they can agree that it has really helped them as well.” - Esther Hung, Student Nurse at Molloy College, Rockville Centre, NY

• ISBN-10 0803625049
• ISBN-13 978-0803625044
• Edition 2nd
• Publisher F.A. Davis Company
• Publication date November 19, 2010
• Language English
• Dimensions 8.5 x 1.25 x 11 inches
• Print length 688 pages
• See all details

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Product details

• Publisher ‏ : ‎ F.A. Davis Company; 2nd edition (November 19, 2010)
• Language ‏ : ‎ English
• Paperback ‏ : ‎ 688 pages
• ISBN-10 ‏ : ‎ 0803625049
• ISBN-13 ‏ : ‎ 978-0803625044
• Item Weight ‏ : ‎ 3.32 pounds
• Dimensions ‏ : ‎ 8.5 x 1.25 x 11 inches
• #21 in Medical & Surgical Nursing (Books)
• #332 in Nursing Reviews & Study Guides (Books)

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