Adult medical/surgical nursing has been regarded as the basic roots of nursing from which various sub-specialty and super-specialty arenas like oncology, cardiology and neurology have branched out. Due to this traditional approach, this field in itself could not achieve the status of being a separate specialty; although on recent years Academy of Medical-Surgical Nurses (AMSN) has provided the field it's long overdue status (Gatson, 2004). "Medical-surgical or adult health nursing is a complex specialty that requires a wide-ranging literature to inform its research and practice" (Taylor, 2005). Medical-surgical nurses, also known as adult health nurses, specialize in the care of adults with a "known or predicted physiological alteration" (ANA, 1974).The vast scope of adult medical/surgical nursing extends to healthcare settings, including acute and sub acute medical-surgical units, collaborative practices with physicians, home health care agencies, clinical education, and care management that aim to deliver quality, evidence-based care in order to maximize patient care outcomes. Most adult patients present with the most complex health needs there it is required for a learner to develop critical thinking skills while assessing, planning, implementing and evaluating care of the adult client at an accomplished level (PCT, Catalog). Furthermore, the majority of health care consumers in the country comprise of adult clients. The specialized and advanced knowledge and skills of adult medical /surgical nurses are needed to deal with acute illness complicated by co morbidities like diabetes, hypertension, and cardiovascular disease all of which are specific to the adult population. Comprehensive, total patient care, rather than a focus on a particular organ system or problem, is an important aspect of this specialty (Harkness, 1999). The scope of adult nursing is not restricted to a particular disease or a body system and holistic wellbeing which demand an extensive knowledge base about all aspects of adult health. "The care provided is holistic and is rooted in health promotion, disease prevention, and health maintenance and may be carried out in community and institutional settings" (Grindel, 2005).
The field of nursing involves simultaneous application of art and a scientific knowledge to understand oneself and one's relationship with individuals, groups, and communities. "Nursing is a therapeutic helping relationship devoted to promoting, restoring, and maintaining the health of individuals, families, groups and communities" (Aurora, Catalog). Learners ought to undergo a rigorously planned professional curriculum for human services that is applicable to the society and reflects the diverse needs of the community with the primary areas of focus being caring, health, learning and commitment to human dignity.
Certification for Adult Medical-Surgical Nursing should be delivered solely on basis of individual performance regarding professional practice of medical-surgical nursing (Aurora, Catalog). The certificate program may contain printed hand-outs, videotapes, computerized simulations and lessons, case studies and practical assignments based on advanced reading and research. Knowledge and skill development can be further enhanced by active interactions like educational forums, conferencing, learning labs and faculty consultation. Hands-on clinical training can be conducted under the guidance of preceptors and faculty in medical-surgical areas at authorized medical institutes. Clarity of theoretical concepts is assessed by examinations and written or oral assignments. Practical and clinical skills are assessed in simulated lab situations prior to the actual internship. Learners with prior knowledge, skills, and/or experience fundamental to medical-surgical nursing practice may qualify prior to internship. Learners have to develop a constant need to broaden their knowledge base by through research and evidence-based practice projects. Medical-surgical or adult health nurses may pursue advanced