New Graduate/First Job Med/Surg

  1. 5
    I just got my first job on a very busy med/surg unit, I start Feb 10th. I'm the first LVN they have hired on this unit in about 10yrs. I want to do a good job and impress them! They went out on a limb to hire me and give me a chance over a few experienced nurses.
    I'll eventually be taking 6 pts on my own, like I said a very busy unit, and they have a lot of traumas! What are some must haves, that I will use everyday for this job, and any advice to impress the RNs I will be working with!?
    Thanks in advance!
    t_tkimbrough, KimberlyRN89, LTCNS, and 2 others like this.

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  2. 14 Comments...

  3. 2
    Be open to learning.

    Go in with your eyes and ears open. Ask questions.

    But find out what your role is exactly. Will you be full scope of practice or will you be an aide.

    I moved hospitals from a regional trauma centre to a rural hospital and the rural had more restrictions on me than you would have believed.

    Go in with your stethoscope, a couple of pens, maybe a penlight.

    Don't go in and try and impress people. It always backfires.
    t_tkimbrough and LTCNS like this.
  4. 1
    Thank you! And when I say impress I don't mean like a know it all, just like you said open to learning and prepared. I will be full scope of practice!
    JustMe54 likes this.
  5. 5
    First of all, congratulations on the position!!! That, in itself, is an accomplishment in this RNs-only/BSN-preferred climate.

    As a former med/surg LPN-turned-RN, I suggest that you keep your eyes and ears open to learning all that you can. If you ask a question, write down the answer. (Buy a notebook and carry it with you at all times. Make sure it has those colorful plastic dividers....they last longer especially when you repeatedly access your information). The notebook not only protects the patients' information, it houses your make-it-or-break-it future in your very first nursing job. Writing down the answers to situations, techniques, door codes, phone numbers, location of supplies, 'check for this lab before giving that antibiotic or medication', etc., keeps you from having to ask your preceptor to repeat him/herself. Of course, when in doubt, don't hesitate ask! That list of phone numbers and extensions that you see taped at the nurse's desk, make a copy of it to go inside your notebook. If there are still physical charts and handwritten orders at your location, copy the orders and take them with you instead of trying to remember what an order said.

    There is a lot to learn and you won't get it all in your orientation period, nor will you get it all in your role as a med/surg nurse. But you have to start building that database somewhere, right? Even if your preceptor and you have blood to hang and your scope of practice doesn't allow you to do it, write down the entire process while you are watching. Policies vary by facility and state. If you're at a facility where the RN only has to spike the bag after the initial verification, you will need to know what to do. (Your role in that should be covered in your classroom orientation).

    As long as I've been in nursing, I still write down everything. There is just too much info embedded in a 12-hour shift for you to try to remember, especially when patients and families and doctors and co-workers all summon you at one time. I could go on and on and on here, but like I said, there is just too much to know and it won't all be covered at once. But I think this is enough to get you started. You will feel overwhelmed but don't let that discourage you because that is a normal feeling with new grads, as well as seasoned nurses starting a new job. When you get your assignment and you have six patients, remember that is a good thing because you could have been that nurse with five patients and an admission right off the bat.

    One last thing, very important!! When you go in to say hello to your patients and they start hurdling all these questions at you, don't panic or fumble. That's what the notebook is for. Don't even attempt to answer those questions unless you do have the answer that they are looking for. Explain to them that since you are just coming on, you are WRITING DOWN their questions and plan to go find the answers as soon as you step in to say hello to 'a couple more patients'. I've found that this approach is readily acceptable IF you indeed make an effort to find the answer by the time you return to their room.

    Good luck and congrats again on the new job!!
    t_tkimbrough, LTCNS, Fire Bird, and 2 others like this.
  6. 0
    I'm not sure what LVN duties involve. As far as I know we don't have any at my hospital. Is that basically the same as PCT (patient care technicians)?
  7. 7
    Welcome to AN! The largest online nursing community!

    This may become a trend to lower labor costs. Good for you in landing the job. There is going to ba a huge learning any other new grad....RN or not. organization will be key. Here are a few brain sheet for you to adapt and use. THe critical thinking flow sheet will help you learn how to look for things on your patient and develop a train of thought/assessment to help you stay organized. GOOD LUCK!!!! Write down questions...if you can't get it answered or need more....lets us help you!

    Look up your nurse practice act in your state and LPN scope of practice BEFORE you start work. What state are you in?

    mtpmedsurg.doc 1 patient float.doc‎
    5 pt. shift.doc‎
    report sheet.doc‎
    day sheet 2 doc.doc

    critical thinking flow sheet for nursing students
    student clinical report sheet for one patient
    Tasj75, KimberlyRN89, mondee619, and 4 others like this.
  8. 2
    Wow, BSNINTHEWORKS...that advice is solid gold for med/surg. I wish I'd read that a year ago.
    BSNbeDONE and tara3hughes like this.
  9. 3
    Quote from Mr. Murse
    I'm not sure what LVN duties involve. As far as I know we don't have any at my hospital. Is that basically the same as PCT (patient care technicians)?
    LVN = Licensed Vocational Nurse

    LVNs and LPNs are one and the same; however, California and Texas use the term LVN to refer to their basic nurses while the rest of the states in the union employ the term LPN. LVNs are licensed nurses with a unique scope of practice, not PCTs.
    t_tkimbrough, Debilpn23, and LTCNS like this.
  10. 1
    [QUOTE=Mr. Murse;7717226]I'm not sure what LVN duties involve. As far as I know we don't have any at my hospital. Is that basically the same as PCT (patient care technicians)?[/

    When I work med/surg, I have my own patient assignment and am responsible for all care, documentation, wound care, medications, etc. Just like the RNs I work alongside. I can't pierce the blood or travisol bag, I can verify, co sign and then resume care of my patient undergoing either blood transfusion or TPN. It's a two nurse start up so there isn't really an issue because I walk next door and do the verification for the RN and their patient.

    That's why I said the OP needs to find out what duties they are responsible for.
    tara3hughes likes this.
  11. 0
    Thank you so much! Lots of great information!!

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