INTRODUCTION * Medical-surgical nursing is a nursing specialty area concerned with the care of adult patients in a broad range of settings. Medical-surgical nursing has the largest group of professionals in the field of nursing, Advances in medicine and nursing have resulted in medical- surgical nursing evolving into its own specialty. Many years ago a majority of hospital nurses worked onwards, and everyone was a medical-surgical nurse. Today licensed medical-surgical nurses work ina variety of positions, inpatient clinics, emergency departments, administration, out patient surgical centers, home health care, ambulatory surgical care, and skilled nursing homes. Some military medical-surgical nurses serve on battlefields. HISTORY During the late nineteenth and early twentieth centuries in the United States, adult patients in many of the larger hospitals were typically assigned to separate medical, surgical, and obstetrical wards. Nursing education in hospital training schools reflected these divisions to prepare nurses for work on these units . Early National League of Nursing Education (NLNE) curriculum guides treated medical nursing, surgical nursing, and disease prevention (incorporating personal hygieneand publicsanitation) as separate topics© By the 1930s, however, advocates recommended that medical and surgical nursing be taught in a single, interdisciplinary course, because the division of the two was considered an artificial distinction. © Surgical nursing came to be seen as the care of medical patients who were being treated surgically . © The NLNE's 1937 guide called for a “Combined Course” of medical and surgical nursing © Students were expected to learn not only the theory and treatment of abnormal physiological conditions, but also to providetotal care of the patient by understanding the role of health promotion and the psychological, social, and physical aspects thataffected a patient's health. © While the integration of this approach into nursing school curriculawas slow, by the 1960s, nursing schools emphasized the interdisciplinary study and practiceof medical and surgical nursing. © Inthe 1960s and 1970s, standards were developed for many nursing specialties, including medical-surgical nursing, Standards, Medical-Surgical Nursing Practice, written by a committee of the Division on Medical-Surgical Nursing of the American Nurses’ Association (ANA), was published in 1974 . © It focused on the collection of data, development of nursing diagnoses and goals for nursing, and development, implementation, and evaluation of plans of care. A Statement on the Scope of Medical- Surgical Nursing Practice followed in 1980. © In1991, the Academy of Medical-Surgical Nurses (AMSN) was formed to providean independent specialty professional organization for medical-surgical and adult health nurses. * In1996, the AMSN published its own Scope and Standards of Medical-Surgical Nursing Practice, building on similar ANA documents. © The second edition appearedin 2000 . * Both the ANA and AMSN documents stated that while only clinical nurse specialists were expected to participate in research, all medical-surgical nurses must incorporate research findings in their practice.volution of Medical Surgice nursing © Inancient times, when medical care was associated with good or evil spirits, the sick were usually cared for in temples and houses of worship. » These women had no real training by today's standards, but experience taught them valuable skills, especially in the use of herbs and drugs, and some gained fame as the physicians of their era © Inthe 17th cent., St. Vincent de Paul began to encourage women to undertake some form of training for their work, but there was no real hospital training school for nurses until one was established in Kaiserwerth, Germany, in 1846. © There, Florence Nightingale received the training that laterenabled her to establish, at St. Thomas's Hospital in London, the first school designed primarily to train nurses rather than to provide nursing service for the hospital ° Inthe United States, nursing modernized rapidly during the late 19th and early 20th centuries. © The number of hospitals nationwide grew from only 149 in 1873 to 4,400 in 1910. © With this growth, new positions for nurses developed, and nursing gained respectable social status. © Nursing subsequently became one of the most important professions open to women until the social changes brought by the revival of the feminist movement that began in the 1960s.© During the late nineteenth and early twentieth centuries in the United States, adult patients in many of the larger hospitals were typically assigned to separate medical, surgical, and obstetrical wards. » Nursing education in hospital training schools reflected these divisions to prepare nurses for work on these units « Early National League of Nursing Education (NLNE) curriculum guides treated medical nursing, surgical nursing, and disease prevention (incorporating personal hygiene and public sanitation) as separate topics. © By the 1930s, however, advocates recommended that medical and surgical nursing be taught ina single, interdisciplinary course, because the division of the two was considered an artificial distinction. Surgical nursing came to be seenas the care of medical patients who were being treated surgically. © The NLNE's 1937 guide called for a “Combined Course” of medical and surgical nursing © Students were expected to learn not only the theory and treatment of abnormal physiological conditions, but also to provide total care of the patient by understanding the role of health promotion and the psychological, social, and physical aspects that affected a patient's health. © 19608, nursing schools emphasized the interdisciplinary study and practice of medical and surgical nursing, © 19608 and 1970s, standards were developed for many nursing specialties, including medical-surgical nursing.© Standards, Medical-Surgical Nursing Practice, written bya committee of the Division on Medical-Surgical Nursing of the American Nurses’ Association (ANA), was published in 1974. © It focused on the collection of data, development of nursing diagnoses and goals for nursing, and development, implementation, and evaluation of plans of care. © A Statement on the Scope of Medical-Surgical Nursing Practice followed in 1980, © In1g91, the Academy of Medical-Surgical Nurses (AMSN) was formed to provide an independent specialty professional organization for medical- surgical and adult health nurses. = In1996, the AMSN published its own Scope and Standards of Medical-Surgical Nursing Practice © The second edition appeared in 2000 . * Both the ANA and AMSN documents stated that while only clinical nurse specialists were expected to participate in research, all medical-surgical nurses must incorporate research findings in their practice LEE HISTORICAL DEVELOPMENT OF MEDICAL SURGICAL NURSING IN INDIA © The history of Indian medicine begins from 3000 BC. © Inthe Indus valley civilizations they have given importance to health and hygiene. * In2000 BC the RIGVEDA marks the beginning of Indian system of medicine. © The conditions like fever, cough, constipation, diarrhea, dropsy abscesses, seizures, skin diseases including leprosy were treated from that time. ° The herbs were used for the treatment.© In272 BC king Ashoka built number of hospitals. He had givenhis emphasis on the prevention of the diseases. j, » Doctors, Nurses and the Midwifes were also available in that time. © Nalandaand Thaxaxila were the two famous medical schools. » In100 BC, the surgical field was the well known by surgeons Sus © Especiallytwo types of operation at those times were outstanding, Removal of the gall bladder stone and the plasticsurgery of the nose. © Nursing in India: In the beginning nursing was hindered by many difficulties like the cast system among the Hindus, the Pardha system among the Muslims and the low status of the women. Inthe beginning period the nurse has a servant image 50 no one was ready for nursing. © The military nursing was the earliest type of the & nursing in 1664 the British east India company helped tostart a hospital for soldiers in madras (St. George HOSPITAL). © The company appointed staff was served in the hospital. In 1854 the government sanctioned training school for the midwives. © 1864 Miss Florence Nightingale starts the effortsto = reform the hospitals. St. Stephens Hospital Delhi - 1864 - First to train Indian girls as nurses. © In1871 the government, general hospital of madras tooka plan to train the nurses. © The nurses from England were the in charge of the training and the students were those who previously received there diploma in midwifery.© 1905 - T.N.A.] established. © 1926 — Madras state formed the first registration council 1946 — First four year Basic Bachelor degree program established in R.A.K (Raikumari Amrit Kaur College of Nursing) Delhi and C.M.C Vellore. * Afteri947 the many changes begin to take place © Theattitude towards the nursing begins to change and nursing started to be seen asa profession. © The Indian Nursing Council was passed by ordinanceon December31, 1947. © The council was constituted in 1949. © The development of Nursing in India was greatly influenced by the Christian missionaries, World War, British rule and by the International agencies suchas the World Health Organization UNICEF, the Red Cross, UNSAID etc. © 1960 - First Masters Degree program was started in RA.K College of Nursing Delhi. * In1g70 the WHO recognized nursing asa profession. © Nursing today provides an ever widening scope of opportunity for service. © Today nurses enjoy many rights and privileges, but the desired standards by the complete dedication for the profession. EDICAL-SURGICAL NURSING TODAY © Recent trends affecting nursing as a whole have also affected medical-surgical nurses, including the increasing use of nursing case management, expansion of advanced practice nursing, total quality improvement, development of clinical pathways, changes in the professional practice model to include greater numbers of nonprofessional staff, health care reform, and the rise of managed care . © The trend toward increased acuity of patients, begun in the 1980s, has become a fact of life.© Medical-surgical nurses must master a wide range of topics and are expected to apply new research findings in theit practice. © Manyuseful development resources areavailable for nursing, but bibliometric studies of the journal literature specifically used to support medical-surgical nursing are rare. * Moorbath included a citation analysis of the 1990 issues of the Journal of Advanced Nursing torepresent adult nursing in his study of journals needed to support the Project 2000 nursing coursein the United Kingdom © Today, medical-surgical nursing is its own specialty, and many nurses work in this field at some point in their career. * While it’s often been regarded as a stepping stone toward other types of nursing, many nurses continue in this field throughout their career. © Once considered an entry-level job position, medical- surgical nursing has now gained the respect it deserves, as an important profession. © Medical-surgical nurses work with patients in a variety of settings, including hospitals, assisted living facilities, hospice centers, independent medical practices, and urgent care centers. * Medical-surgical nurses have an impressively large skill set, a result of working across a variety of medical specialties and subspecialties. © They're knowledgeable about all aspects of human health, including psychology and mental health, and work with patients of all ages. © It'snot uncommon for medical-surgical nurses to also actas advocates for patients, and nearly all adult patients are seen at some point in their care by a medical-surgical nurse.CONCLUSION © It'sa rigorous, challenging job, testing your skills every day. It’s not for everyone, but many nurses thrive in this specialty, © It'sactually the most common nursing specialty. * Medical-surgical nursing is ajob where you experience new things and acquire new skills on a daily basis. It's a challenging role, but for many nurses, it's also a passion.