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Medical/Surgical Nursing Celebration of the Specialty

Wednesday September 15, 2004
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Medical/surgical nursing has long been
considered the foundation of nursing, the clinical area where new graduates began their practice to get basic experience. Medical/surgical adult health nursing practice has served as the springboard to specialization in other areas of
nursing, such as oncology, cardiology, neurology,
and more. As a result of this traditional approach, medical/surgical nursing has not been perceived as
a specialty. Med/surg nurses could often be heard saying, "I'm just a nurse."
A quiet revolution to change this mindset began in 1991 with the founding of the Academy of Medical-Surgical Nurses (AMSN), the first professional nursing organization to recognize medical/surgical nursing as a specialty. Now that quiet revolution is exploding into a celebration of the value of med/surg nurses and the many contributions they make to patient care and health care in the U.S.
However, declaring that medical/surgical nursing is a specialty practice does not necessarily make it so. The American Nurses Association developed criteria that, if met, substantiated a practice area as a specialty. In a recent update on specialty criteria, Recognition
of a Specialty, Approval of Scope Statements and Acknowledgment of Nursing Practice Standards, ANA outlined the measures of a specialty. A specialty -
Is clearly defined and subscribes to the overall
purposes and functions of nursing
Defines itself as nursing
Adheres to the overall licensure requirements
of the profession
Is national or international in scope
Can identify a need and demand for itself
Has a well-derived knowledge base particular
to the practice of the specialty
Is organized and represented by a national
specialty association
Is concerned with phenomena within the
discipline of nursing
Has defined competencies for the area of
specialty practice
Has existing mechanisms for supporting,
reviewing, and disseminating research to
support its knowledge base
Has continuing education programs that prepare nurses in the specialty
Includes a substantial number of nurses who devote most of their practice to the specialty
After reading these criteria, there is no doubt that medical/surgical nursing is a specialty.
To highlight the expanding boundaries of the
specialty of medical/surgical nursing, a closer look at two criteria points the way. Criterion #1: "A specialty has defined competencies for the area of specialty practice." Adult clients receive the majority of health care provided in this country. The specialty knowledge needed by med/surg nurses to provide quality care
to these adults went unrecognized for many years. Until AMSN developed the Scope and Standards for Medical-Surgical Nursing Practice,1 med/surg nurses practiced under ANA's general Standards of Clinical Nursing Practice.2,3,4 No scope or standards of practice existed specifically for med/surg nursing practice. Today the Scope and Standards for Medical-Surgical Nursing Practice exists to help guide med/surg nurses' practice and so the public understands what to expect from med/surg nurses. The long overdue acknowledgement of the uniqueness of the specialty of medical/surgical nursing is indeed a reason
to celebrate.
Med/surg nurses would strongly agree that medical/
surgical nursing has a well-derived knowledge base particular to the practice of the specialty. More than ever, the expertise of med/surg nurses is needed to manage the complex needs of adults with acute illness complicated by comorbidities like diabetes, hypertension, and cardiovascular disease. The focus of medical/surgical nursing is not limited to a disease or a body system; the focus is holistic in nature and demands a broad knowledge base that spans adult health. The knowledge base in adult health practice continues to grow, and access to new information
is made possible through journals like Med-Surg Nursing. And, today, more than ever, med/surg
nurses are broadening that knowledge base through research and evidence-based practice projects. These nurses are disseminating their results in journals
and at conferences to ensure that medical/surgical nursing practice can build on research evidence.
A cause for great celebration!
Criterion #2: A specialty "is concerned with the phenomena within the discipline of nursing." Phenomena within the discipline of nursing would include issues that affect the quality of patient care, the safety of patient care, conditions in the workplace that affect the delivery of care, legislation that impacts the delivery of health care services, and more. Clearly these issues have been in the forefront over the last decade as med/surg nurses have struggled with staffing shortages, increases in the nurse-to-patient ratios, and changes in the care delivery systems in employing agencies. As the representative of med/surg nurses, AMSN has addressed these issues and collaborated with other nursing specialty organizations to speak out on these critical topics. In addition, med/surg nurses have been active in expressing their concerns to legislators and policy makers. Progress has been made as legislators and the general public recognize that quality medical/surgical nursing care is a predictor of good patient outcomes. This progress
is cause for celebration, but more needs to be done
to affirm the value of med/surg nurses.
Although medical/surgical nursing meets all the
criteria for a specialty, one barrier may prevent some med/surg nurses from believing this reality: That barrier is the feeling of not being valued. Unfortunately, many med/surg nurses still describe themselves as "just a nurse." In doing so, they belittle the contributions that they make to patient care. If med/surg nurses
do not believe that they are valuable contributors
to health care, they cannot exude the pride in their specialty that is so warranted. So our challenge as med/surg nurses is to instill that sense of belonging to all of our colleagues.
Med/surg nurses are essential players in providing care to adults. Their clinical knowledge and skills, their ability to synthesize patient information and implement individualized patient care interventions, and their capability to efficiently organize care for multiple acutely ill adults make them an invaluable part of the health care team. Med/surg nurses are extraordinary professionals. Med/surg nurses should feel proud, be proud, and celebrate the unique
contributions they make to the health care of adults in our country.
Cecelia Gatson Grindel, RN, PhD, CMSRN, is president of the Academy of Medical-Surgical Nurses.
References
1. Academy of Medical-Surgical Nursing. Scope and Standards of Medical-Surgical Nursing Practice. Pitman, NJ: Academy of Medical-Surgical Nurses; 1995.
2. American Nurses Association. Standards of Nursing Practice. Washington, DC: American Nurses Association; 1973.
3. American Nurses Association. Standards Clinical of Nursing Practice. Washington, DC: American Nurses Association; 1991.
4. American Nurses Association. Standards Clinical of Nursing Practice. 2nd ed. Washington, DC: American Nurses Association; 1998.