[ncriverrat]

Hi!!
Well I'm a new grad- just got my first job as an R.N. I had a choice between I.C.U. and med-surg, and went with med-surg because I thought it would be best for me as a new grad.

I start work Monday, bright and early. I'm working a couple weeks on days then moving to nights.

My question is:
What are the most common nursing skills you do personally on this floor? I have some experience with med-surg, but looking for more input. I'm trying to brush up on a few nursing skills before going to work. So, what skills do you find yourself doing for the most part?

Thanks, I really appreciate the input, and wish me luck!!

[Fairlythere]

Boy, I have been on the medical floor (some surg,mostly med) for three months now. I cant say there is a certain skill I do every day because our cases are all so different. Lets see, things I do every shift practically:
1. Wait in line to get to the pyxis
2. Run the halls looking for another nurse to witness narcotic wastes and insulin
3. dress and undress in isolation gowns and gloves in record time
4. Pop caps off 10 cc flush syringes every five minutes or so...
5. stop occluded iv pumps and get air out of lines
6. Fly down the halls at least four times a night rushing to the bed alarm, only to find an aid is in there and just couldn't get to it to turn it off...
7. Wolf down whatever food I brought in five minutes before my phone goes off so I can last the rest of the night without falling over and never admit I dont take real lunch breaks
Oh, and you need skills on calling docs and getting orders for anti nausea meds and sleeping pills you inevitably find out were not put on the admission sets when your pt. looses their stomach contents at 2 am. Wake the doc up,be polite, know what to ask for and dont make him/her say it twice.

LOL, I know you wanted a serious skills answer, I just couldnt resist. You do need a lot of IV re-starts, blood products admin, assessment skills like neuro checks, respiratory, skin, etc to catch problems, get to know lab values, know which pain meds are effective for how long and be prepared to give a lot of em, and most important of all, HANDWASHING. I tell ya, I have never known there was so much CDIFF, MRSA, and VRE hanging around.

By the way, when I started three months ago, I had never done blood admin, not much pain pills, little lab skills, no chest tubes, etc. I am still learning and will be for a long long time. Hang in there.

[veegeern]

FairlyThere has it right. I'd only add that you need good communication skills and LOTS of patience! Oh, and everything that you see the nursing assistant do...become as quick and proficient at it as they are. It will save you lots of time, effort, and linens when you're the one going to assist the patient.

[SusanNC]

Hi River,

I think Fairly gave you a good overview of what sort of skills you need on Med/Surg (basically - everything you learned in school and more). I'm also a New Grad and started 3 months ago. When my Mgr. hired me, she said she wasn't worried about any lack of Nursing Skills because those could be taught. Said her biggest concern was people having good organizational/time management skills and ability to be flexible.

With each new pt, I get more and more experience with procedures, so that hasn't been a big problem. For me and most new Nurses I know, the hardest part has been "time management" and learning how to juggle a diverse group of patients. In School, I usually aced prioritization questions on exams - it's totally different when you're dealing with real live people and several are calling out for help at the same time. We have to carry a phone and never fails that I'll be helping one pt. and the phone will ring with another pt. telling me they need something "NOW". Unless it's an emergency, I try and finish up with one pt. before moving on to the next, but some are impatient and will ring and ring and ring me on the phone until I drop everything and go see what they want (they won't say what they want on the phone, just say - I need my Nurse now).

It's frustrating because quite a few times when I've dropped everything to see what these pt's were ringing me off the hook about - it's been for silly things like they dropped the tv remote on the floor and want me to pick it up (major emergency) or need another blanket - things the techs. could have easily done. Just an observation I've made in my short time Nursing - the sickest patients are usually the most "patient and understanding" and the ones with minor problems are usually the most "demanding"...

On top of all that - what you will find yourself doing more than your Nursing Skills is "PAPERWORK" - Mountains and Mountains of Paperwork. I feel personally responsible for taking the life of at least 1 Tree a day!!!!
I was a Secretary for years and never, ever did this much paperwork - it's insane. One minor procedure requires 12 different forms to be filled out - and your initials in 42 places - crazy. Get used to signing your name really, really fast because you'll be doing it many, many times a day.

Sorry for the long ramble - don't worry so much about any skills you're not sure of, you'll be taught those on the floor. Like I said, the paperwork is a huge part of the job and each hospital has their own way of doing it. So if you get really familiar with the paperwork early on, it'll make the job so much easier. All the Best in your new Career. Sue...

[grace90]

-stepping over family members, IV lines, tables, walkers... and doing Olympic-level acrobatics to turn off a call light on the wall or hit the start button on a pump when the line occludes for the 100th time, troubleshooting occluded IVs

-blindly inserting foley catheters in LOLs who may or may not be with the program or agitated

-holding your breath or breathing through your mouth to deal with a code brown or code mahogany (GI bleed)

-emptying ostomies, foleys, JP's, hemovacs, caring for penroses, emptying puke buckets, dodging puke

-managing NG tubes, trouble shooting them when they aren't functioning

I think I could go on and on...

[KLeigh]

Originally Posted by grace90

-stepping over family members, IV lines, tables, walkers... and doing Olympic-level acrobatics to turn off a call light on the wall or hit the start button on a pump when the line occludes for the 100th time

That's hilarious, grace90!! And all this time, I've been feeling stupid when I try to maneuver through all the equipment in a patient's room, while dodging visitors and trying to keep both feet on the ground....They should realize that they are actually witnessing a talented athelete--not a clumsy nurse who is attempting to untangle her ankles from the vitals sign machine so she doesn't end up tripping over the IV pole and falling into Grandpa's lap! Your post had me laughing out loud!