Arthur Jarvis University, Department of nursing science.

Course: Medical Surgical Nursing 1

Level: 300 Semester: First

Introduction:
Medical surgical nursing is a specialized field of nursing that focuses on
providing care to adult patients (18 years and above) who are undergoing
surgical procedures or have medical conditions requiring intervention. It
encompasses a wide range of healthcare settings, including hospitals, clinics,
and ambulatory care centers.
It is sometimes referred to as adult care nursing.
The role of a medical surgical nurse is crucial in promoting and maintaining the
health and well-being of patients throughout their surgical or medical treatment
journey. These nurses work collaboratively with other healthcare professionals
to ensure optimal patient outcomes.
In medical surgical nursing, nurses play a key role in providing comprehensive
care to patients before, during, and after surgery. They assess patients' health
status, administer medications, monitor vital signs, manage wounds, provide
education, and support patients and their families throughout the healing
process.
Medical surgical nurses also play an essential role in the management of
medical conditions such as cardiovascular disorders, respiratory diseases,
gastrointestinal problems, and musculoskeletal conditions. They are trained to
identify potential complications, initiate appropriate interventions, and ensure
patients receive timely and effective care.
The field of medical surgical nursing is dynamic and continually evolving.
Advancements in technology, surgical techniques, and medical treatments
require nurses to stay updated with the latest evidence-based practices. They
must possess excellent critical thinking skills, effective communication abilities,
and a compassionate approach to provide holistic care to their patients.
In conclusion, medical surgical nursing is a specialized area of nursing that
focuses on providing comprehensive care to patients with surgical and medical
conditions. The role of a medical surgical nurse is vital in ensuring positive
patient outcomes and promoting the well-being of individuals undergoing surgery
or medical interventions.

Definition and Scope of Medical Surgical Nursing:

Medical surgical nursing is a nursing specialty that encompasses the care of
adult patients with a wide range of surgical and medical conditions. It involves
the application of nursing principles and interventions to promote health, prevent
complications, and facilitate the recovery of patients undergoing surgical
procedures or managing medical illnesses.
The scope of medical surgical nursing is diverse and encompasses various
aspects of patient care across different healthcare settings. Medical surgical
nurses provide care to patients before, during, and after surgical procedures,
ensuring their physical, emotional, and psychological well-being.
In the preoperative phase, medical surgical nurses assess patients, collect
health history, perform physical examinations, and collaborate with the
healthcare team to develop a comprehensive care plan. They educate patients
about the upcoming surgery, provide information about the procedure, and
address any concerns or questions the patients may have.
During the intraoperative phase, medical surgical nurses work closely with the
surgical team to ensure patient safety and provide support. They assist with
patient positioning, maintain a sterile environment, monitor vital signs, administer
medications as prescribed, and communicate relevant information to the surgical
team.
In the postoperative phase, medical surgical nurses closely monitor patients in
the recovery period, assess their condition, manage pain, provide wound care,
and facilitate their transition from the surgical unit to other care settings. They
educate patients and their families about postoperative care, medications, and
potential complications to promote a smooth recovery process.
Medical surgical nursing also involves the management of medical conditions
that do not require surgical interventions. Nurses in this specialty care for
patients with complex medical illnesses, such as cardiovascular diseases,
respiratory disorders, gastrointestinal problems, and musculoskeletal
conditions etc. They monitor patients' conditions, administer medications,
 manage symptoms, provide education, and collaborate with the healthcare team
to develop comprehensive care plans.
Medical surgical nurses play a critical role in health promotion and disease
prevention. They educate patients about lifestyle modifications, facilitate early
detection of diseases through screenings, and promote adherence to treatment
regimens.
In summary, the medical surgical nurse role is that of
 Provider of care
 Manager of care
 Member of the profession
Principle of medical surgical nursing
The basic principle of this course is to provide nursing students with the
knowledge and skills required to understand and be able to render evidence
based care to patients. Evidence based practice (EBP) will be centered on the
steps of the nursing process: Assessment, Diagnosis, Objective setting,
Planning, Implementation of plan, and Evaluation.

Competencies in medical surgical nursing

1.Excellent assessment, technical, organizational and prioritization skills

2. Administration of medication/ treatment to patients

3. Operation and monitoring of medical equipment and appliances such as bedside

monitors, intravenous infusion, oxygen administration etc.

4. Patient/family teaching on how to manage minor illnesses and injuries

5. Adaptability to working across multiple health settings

6. Knowledge of documentation

7. Good communication skill

8. Ability to collaborate with other medical professionals

9. Versatility

Roles of The Nurse in medical surgical nursing.

As stated ear lier, nursing is the diagnosis and treatment of human responses to

health and illness and therefore focuses on a broad array of phenomena. There are

three major roles assumed by the nurse when caring for patients. These roles are

often used in concert with one another to provide comprehensive care. The

professional nurse in institutional, community-based or public health, and home care

settings has three major roles: the practitioner role, which includes teaching and

collaborating; the leadership role; and the research role. Although each role carries

specific responsibilities, these roles relate to one another and are found in all nursing

positions. These roles are designed to meet the immediate and future health care

and nursing needs of consumers whom are the recipients of nursing care.

Practitioner Role

The practitioner role of the nurse involves those actions that the nurse takes when

assuming responsibility for meeting the health care and nursing needs of individual

patients, their families, and significant others. This role is the dominant role of nurses

in primary, secondary, and tertiary health care settings and in home care and

community nursing. It is a role that can be achieved only through use of the nursing

process, the basis for all nursing practice. The nurse helps patients meet their needs

through direct intervention, by teaching patients and family members to perform

care, and by coordinating and collaborating with other disciplines to provide needed

services.

Leadership Role

The leadership role of the nurse has traditionally been perceived as a specialized

role assumed only by those nurses who have titles that suggest leadership and who

are the leaders of large groups of nurses or related health care professionals.

However, the constant fluctuation of health care delivery demands and consumers
requires a broader definition of nursing leadership, one that identifies the leadership

role as inherent within all nursing positions. The leadership role of the nurse involves

those actions the nurse executes when assuming responsibility for the actions of

others that are directed toward determining and achieving patient care goals.

Nursing leadership is a process involving four components: decision making,

relating, influencing, and facilitating. Each of these components promotes change

and the ultimate outcome of goal achievement. Basic to the entire process is

effective communication, which determines the accomplishment of the process.

Leadership in nursing is a process in which the nurse uses interpersonal skills to

effect change in the behavior of others. The components of the leadership process

are appropriate during all phases of the nursing process and in all settings.

Research Role

The research role of the nurse was traditionally viewed as one carried out only by

academicians, nurse scientists, and graduate nursing students. Today, participation

in the research process is also considered to be a responsibility of nurses in clinical

practice. The primary task of nursing research is to contribute to the scientific base of

nursing practice. Studies are needed to determine the effectiveness of nursing

interventions and nursing care. Through such research efforts, the science of nursing

will grow and a scientifically based rationale for making changes in nursing practice

and patient care will be generated. Evidence-based practice will be facilitated, with a

resultant increase in the quality of patient care. Nurses who have preparation in

research methods can use their research knowledge and skills to initiate and

implement

timely, relevant studies. This is not to say that nurses who do not initiate and

implement nursing research studies do not play a significant role in nursing research.
Every nurse has valuable contributions to make to nursing research and a

responsibility to make these contributions. All nurses must constantly be alert for

nursing problems and important issues related to patient care that can serve as a

basis for the identification of researchable questions.

Those nurses directly involved in patient care are often in the best position to identify

potential research problems and questions. Their clinical insights are invaluable.

Nurses also have a responsibility to become actively involved in ongoing research

studies. This participation may involve facilitating the data collection process, or it

may include actual collection of data. Explaining the study to other health care

professionals or to patients and their families is often of invaluable assistance to the

nurse who is conducting the study. Above all, nurses must use research findings in

their nursing practice. Research for the sake of research alone is meaningless.

Evidence-based practice requires the inclusion of valid research. Only with the use

and evaluation of research findings in nursing practice will the science of nursing be

furthered. Research findings can be substantiated only through use, validation,

replication, and dissemination. Nurses must continually be aware of studies that are

directly related to their own area of clinical practice and critically analyze those

studies to determine the applicability of their conclusions and the implications for

specific patient populations. Relevant conclusions and implications can be used to

improve patient care.

Approaches to care in medical surgical nursing

Nursing care can be carried out through a variety of organizational methods. The

model of nursing care used varies greatly from one facility to another and from one

set of patient circumstances to another. The following are some models/ approaches

in use:
  Task based/functional nursing

 Primary nursing

 Team nursing

 Case based management

 Community-based/ community health approach

Team Nursing

Team nursing, which had its origins in the 1950s and 1960s, involved use of a team

leader and team members to provide various aspects of nursing care to a group of

patients. In team nursing, medications might be given by one nurse while baths and

physical care are given by a nursing assistant under the supervision of a nurse team

leader. Team members will include nurses of varying ranks and skills, and in some

cases, nursing assistants. With the current emphasis on cost containment in health

care agencies, variations of team nursing are being used, and unlicensed assistive

personnel (UAP) are increasingly being included as team members, especially in the

western world.

There has been little substantiation, however, that team nursing is cost-effective. The

quality of patient care with this system is questionable, and fragmentation of care is

of concern.

Primary Nursing

Primary nursing refers to comprehensive, individualized care provided by the same

nurse throughout the period of care. This type of nursing care allows the nurse to

give direct patient care rather than manage and supervise the functions of others

who provide direct care for the patient. This care method is rejected by many

institutions as too costly; the patient–nurse ratio is small, and a larger professional
staff is needed, because the primary nurse is usually an RN. However, primary

nursing may provide a foundation for transition to case management in some

institutions.

The primary nurse accepts total 24-hour responsibility for a patient’s nursing care.

Nursing care is directed toward meeting all of the individualized patient needs. The

primary nurse is responsible and accountable for involving the patient and family

directly in all facets of care and has autonomy in making decisions in this regard.

The primary nurse communicates with other members of the health care team

regarding the patient’s health care. This process promotes continuity of care and

collaborative efforts

directed toward quality patient care.

During times when the primary nurse is not scheduled to work, an associate nurse or

co-nurse assists in overseeing the delivery of care. The associate nurse implements

the nursing plan of care and provides feedback to the primary nurse for evaluating

the plan of care. The primary nurse assumes responsibility for making appropriate

referrals and for ensuring that all relevant information is provided to those who will be

involved in the patient’s continuing care, including the family. The long-term survival

of primary nursing as it is currently designed is uncertain. As cost-containment

measures continue and patient acuity increases, staffing ratios of patients to nurses

are increasing.

Many nursing service departments and agencies are meeting the increased

workload demands by making modifications in their approach to primary nursing or

by reverting to team or functional systems for delivering care.

Assignment: Read up and write on the other three approaches not discussed here.

Submit on my personal WhatsApp page within ONE WEEK!

Definition of some terms commonly used in medical surgical nursing

Medicine: The branch of medical science that deals with nonsurgical techniques of
treating illnesses.

Surgery: The branch of medical science that treats diseased or injury by operative
procedures.

Health: State of complete physical, mental and social well-being, not merely the
absence of disease.

Sepsis: Presence of pathogens or their toxins in the body, leading to a response by

the immune system.

Surgical asepsis: Condition of being aseptic (sterile).

Sterile: Complete absence of microbes, achieved through cleaning process.

Aseptic technique: All steps taken to prevent contamination of surgical site by

infectious agents.

Curettage: Surgery to remove tissue growths from a body cavity by scraping with a
curette.

Debridement: Surgical removal of foreign material and dead tissue from a wound in
order to prevent infection and promote healing.

Dehiscence: Bursting open of a wound, especially a surgical abdominal wound.

Acute:

Chronic:

Diagnosis:

Pathology:

Pathophysiology:

Health-illness continuum:

Patient/client:
Find out the meaning of the highlighted words above and include in the assignment
to be submitted in ONE WEEK time!