1 month into being a Med/Surg nurse. Help!

  1. 4
    I recently started working on a Med/Surg floor which is dubbed 5East, the Beast lol and for good reason. I knew it was going to be rough, but wow!!! I'm up to 4 patients by myself and have to work up to 5, even though we will have up to 7 at times. I can't even imagine taking on more than what I'm at right now. PCA pumps everywhere, blood infusions, post-ops, admissions and discharges, new Doctor's orders, TPN, feeding tubes of every kind, patients discharged from ICU too soon and all kinds of new meds I've never heard of. I've only been an RN since January and this is my first job. I've already had my moments of crying, pulling myself back together and continue on. There is always something to be done, and I'm constantly running around. I have realized that my time management skills need major work, as I find myself constantly waking patients up because I forgot to to something or check something while I was in their room. This floor is known as the craziest in town and I have been told that if you can work this floor, then you can do anything! I have great preceptors (thank God), and I'm learning something new all the time. I hear the first year of being an RN is the worst, but OMG! I've made the decision to "tough it out" no matter what and its this attitude that keeps me going. If anyone has any advice on how to stay organized or any other helpful info I would appreciate it! Sorry for my venting and please tell me this gets a little easier after I master all the basic stuff and don't have to ask for help all the time. God Bless Med/Surg nurses!!!
  2. 20 Comments so far...

  3. 4
    It just takes time, a ton of patience and a ton of stamina. It will get easier in the sense that you'll start learning how to group tasks, remember to check several different places for meds (fridge, med cabinet, incoming box), better/more efficient ways to chart, etc, etc. But it takes a while. Don't be too hard on yourself.

    I make sure my COW is properly stocked in the morning (alcohol, insulin syringes, tape, saline, etc) so I have the basic things I'll need. I use a brain sheet bc it helps keep me organized. I usually put 2 3X3 post it notes on that sheet that I make short notes of things I'll need, things to chart, things to charge for - you name it. I don't carry a clip board to each pt's room, just my folded up brain sheet in my pocket. I do have a 3 ring binder I keep at my nurses station with extra forms, various notes, or anything with info I'd need to have quickly at hand. I made a card that's the size of my badge that has phone extensions to the places I call the most, laminated it and have it on on my lanyard. Bought myself a pulse ox and tempadots since those 2 things seem to be scarce and I get tired of searching for ours. You have to find a system that works for you and keep revising and perfecting it. Pay attention to what other nurses around you do and don't be afraid to ask them for suggestions on how to be more efficient.

    Seems like the first year of everything is hard work: marriage, new job, kids!!! A year from now you'll look back and have a good laugh at yourself. I know I have with each new "adventure."

    Best of luck to you. Keep hanging in there!! And God bless ALL nurses - each specialty is challenging in its own way.
    `NurseConnie33, Nola009, ZPZGI, and 1 other like this.
  4. 2
    Good for you for taking this one with a great attitude. That's half the battle right there. For any nurse to have 7 patients and be constantly on top of them isn't easy even for the most seasoned nurses.

    I echo the brain sheet and either stocked pockets or COWS or however you can group items needed to reduce running.
    `NurseConnie33 and Hygiene Queen like this.
  5. 1
    Definitely try to anticipate things like assessments, meds, br txs and wound changes so that u can group them together. That helps a lot. It takes time to get a rhythm down.
    zzravizz likes this.
  6. 0
    Get yourself a check list and schedule pt activities around med times and such. You have to check pca hourly so do meds and walking while there. You have 10 ams meds on a person with wounds do it all together. Pre ops and post ops usually give notice so take you break when you know what is going on and try to get your full 30 minutes. It does get better with time
  7. 2
    Thanks so much everyone! Really really appreciate it! That's a great idea...about keeping post it notes. I am having a hard time remembering what I need to chart and forget what I did for which patient (like if I had to bladderscan and in and out cath two different pts) and what the results were. That would help me tremendously! Up to 5 patients now starting tomorrow night and already having some anxiety lol. But I am determined to "get this"
    Nola009 and zzravizz like this.
  8. 2
    Quote from nurse2b121212
    I recently started working on a Med/Surg floor which is dubbed 5East, the Beast lol and for good reason. I knew it was going to be rough, but wow!!! I'm up to 4 patients by myself and have to work up to 5, even though we will have up to 7 at times. I can't even imagine taking on more than what I'm at right now. PCA pumps everywhere, blood infusions, post-ops, admissions and discharges, new Doctor's orders, TPN, feeding tubes of every kind, patients discharged from ICU too soon and all kinds of new meds I've never heard of. I've only been an RN since January and this is my first job. I've already had my moments of crying, pulling myself back together and continue on. There is always something to be done, and I'm constantly running around. I have realized that my time management skills need major work, as I find myself constantly waking patients up because I forgot to to something or check something while I was in their room. This floor is known as the craziest in town and I have been told that if you can work this floor, then you can do anything! I have great preceptors (thank God), and I'm learning something new all the time. I hear the first year of being an RN is the worst, but OMG! I've made the decision to "tough it out" no matter what and its this attitude that keeps me going. If anyone has any advice on how to stay organized or any other helpful info I would appreciate it! Sorry for my venting and please tell me this gets a little easier after I master all the basic stuff and don't have to ask for help all the time. God Bless Med/Surg nurses!!!
    I picked a med/surg unit as my first nursing job as well (technically it's suppose to be medical-telemetry, but I call it the "dump floor" bc we also have suicide watch patients before they go to the psychiatric facility). I haven't even started orientation yet, but I did have the pleasure of doing my senior leadership clinical on that unit and it is intimidating. Your attitude is perfect for med/surg!! You and the other med/surg nurses who can balance all those patient's and tasks are truly amazing!! Good Job! And keep on keeping on!!!!
    `NurseConnie33 and zzravizz like this.
  9. 2
    i am a med surg nurse. and get mostly pts like the ones you describe. the reality is that corners are cut and you will not always be able to do everything and that can come back to hurt you and you will still be held accountable for not meeting unreasonable demands. pts, management and most doctors don't understand all a rn on a busy med surg floor is expected and reaponsible for. The longer I do it, the more fed up with it I get. 7 of these pts are ridiculous. The reality is that it often only gets slightly better because you will have to look less things up and are faster with skills. It sounds a lot like my floor and turnaround is through the roof. barely anyone lasts more than 1.5 years . none but one have ever left for another med surg position and none have returned to it. it is very difficult to do everything you should do on time and document everything and fill out all the constant increasing forma management comea up with. good luck
    ZPZGI and zzravizz like this.
  10. 2
    Thanks for replying, I enjoy reading them as it makes me feel "not so alone in all the chaos" lol I feel like I can't do good patient care...there is just not enough help. They recently cut our CNA's on nights (guess they think we are not as busy, but we are swamped!) But my cool nurse manager of the floor actually showed up in the middle of the night to help...very cool! I find myslef not being able to chart till like 4am (into a 7p-7a shift) and come home absolutely exhausted! And was just recently informed that our hospital is having a hard time getting reimburst for services so that's why they we are so overworked! Hanging in there...whole new respect for nurses working their butts off! You guys rock...we rock!
    zzravizz and anotherone like this.
  11. 0
    I am a new medsurg nurse of a month n feel overwhelmed also,, always feel like i dont have enough time to do what i need to do, and i dont see how i can learn all the hospital and dr specific things before im on my own in another month, but im gonna hang in there till i hit the one year mark. Best of luck to u!


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