orthopedics clinicals

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Hey nursing peeps!

I start my first clinicals in the orthopedics floor this week. Any tips on what I should be expecting. Also side note, I'm super excited but also got lots of anxiety going on just thinking about the start of this lol

I did my clinicals during my first semester on an Ortho floor, and I currently work on one as an extern.

I've found that most of the time (and I'm still a student, though), the biggest issues/things you'll run into with ortho pt.'s are mobility, DVT prophylaxis, and pain control. Basically, they need help getting around (and you will need to be careful during re-positioning, especially if they've had hip surgery!), they need some anticoags and SCD's, and pain control, especially before PT/OT comes to work with them or a dressing change is done.

This is just in my experience, though. It depends on your unit. I like Ortho.

Oooh thank you for your reply! I think my biggest thing I'm worried for is doing dressing & wound change. I'm kind of freaking myself out because I haven't dealt with those types of things before. I've seen them, but never physically touched them so that's something that I'm not sure I'm ready to handle.

Specializes in Family Nurse Practitioner.

Most likely of they are post op ortho patients you won't be doing dressing changess because typically they have hydrogel/hydrocolloid dressing that can stay on for several days.

Specializes in Critical Care.

I had clinical on an ortho floor last semester, currently have clinical there, and also float to an ortho floor in my job as an assistant.

As a previous poster said.... your biggest issues are going to be pain control, DVT prevention, and impaired mobility/the consequences thereof. Falls prevention is also a big deal! You will be doing a lot of neurovascular checks, administering/coordinating pain meds, giving anticoagulants, using anti embolism stockings/pumps, and encouraging mobility in your post-op patients. You will get patients who just can't move themselves and need to be turned/positioned frequently so you will learn about how to move pt's with hip replacements/spine surgery. I've never had to do a dressing change. I see a lot of wound-vacs and hydrocolloid dressings which aren't changed that often, so I've just never been around for it. I mainly see patients who've had laminectomies/fusions, joint replacements, suffered fractures, and I have had the occasional amputation as well. I think ortho is an amazing place to start because a lot of these patients are having elective surgery and therefore have a good baseline level of health compared to patients on general med-surg or other critical care floors.

I was definitely a little scared prior to going on ortho because I thought I would accidentally pop out a hip or paralyze someone (and I also was kind of rolling my eyes because I thought it would be so booooooring) but it has turned out to be a great experience and I wouldn't mind working on an ortho unit once I get my RN!

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