Advice For The New Nurse Entering Med-Surg

Specialties Med-Surg

Published

Here is your chance to give some advice and counsel to new RN's and LPN's entering their first clinical job as a nurse. What advice would you give them?

I am going to make this a sticky so that it is always available on the top of the forum for our newer nurses to see right from the start. Looking forward to seeing some of the great advice that our experienced nurses can lend to the newer nurses ..... :balloons:

Specializes in medical-surgical.

I am a new nurse and am almost off of orientation to my horror. One of my concerns is speaking with the doctors and I am learning to be prepared with my patient's info. when they call. I have also found that in taking verbal orders you need to be able to clarify exactly what the doctors wants because sometimes they do not say exactly how they want an order. For example- Tylenol 1-2 tabs q 4-6 hrs.

I always forget to ask if they want the patient to receive this from now on or as needed, which means that I am constantly calling doctors back to clarify something because I did not think to ask certain questions when they first gave the order.

Advice for new nurses entering medsurg: DONT. I have been at it 4 months and I hate it. Don't it isnt worth it. Trust me.

Some good advice here. :) I'm currently STILL looking for a job, but I know I definitely want to start out in med/surg since I don't know what I want to specialize in.

Smileysenior: I read a post from you about how you hated med/surg. I've also had people say that med/surg wasn't that great. Maybe it's just the facility that you're at. I wish you the best of luck though. Hoping you find something better.

Specializes in Med/Surg and still learning!.

I just graduated in August and have recently started my new job on Med/Surg. I really love it so far, and the only trouble that I have gotten is from a select few seasoned nurses. I really dont understand why you would want to give someone new so much trouble. But thankfully the nice nurses have out wieghed the bad.

I have had moments when I feel really stupid. I am not sure how to give report effectively, there are lots of drugs that I am fuzzy on, and a list of other things. I really appreciate the encouraging words, they have made me feel much better!

Specializes in medical-surgical.

Hello! I just got off my first 3-11 shift on med surg and I feel like quitting. I started on orientation 8 weeks ago day shift and that seemed like hell but then I sort of got in a routine and now I am with a whole new crew. I graduated from a BSN program in August, I just took my boards and passed a few days ago but but my state board hasn't made it official yet. Anyway, I don't know some of these postings are really uplifting and they give me the motivation to stick it out but the place thatI work for is NUTS! It is a very hostile work environment. Everyone talks about everyone, complains about everyone, rolls their eyes about every little thing. They will even do this to you on your first day on the job!!! Some of my classmates started there and verified this behavior as well, one even quit already between the behaviors and the overwhelming work load esp. for a new graduate. My final straw tonight was when a June graduate today not only invalidated my "unofficial passing the boards" results from Pearson Vue by stating, "well my results were on the State website in 2 days" (this is the time of year for my state to be held up with updates because they have reregistration deadline for Oct. 31. Her tone was very condesending. But she had to cosign an insulin with me and remided me about checking orders on it because she was new (I had the pt on dayshift before and knew the insulin was changed) But anyway I thanked her for the helpful reminder because I'm new too and I figured that this would foster coworker commaraderie (spelling?) well my mistake she jumped all over an order that I had verified on dayshift that followed her and she told me it wasn't done properly and all this was nonsense because my preceptor that day (and I've had too many preceptors on this unit ,6 all together) WATCHED WITH the order and had to consult pharmacy several times to put in the computer correctly. The same preceptor told me to sign the orders as verified and you know what this same preceptor pulled this girl aside on Friday and warned her to watch verifying her orders. This person made this statement in front of others she tried to say that "I'm not trying to tell you what do, I'm new too but that was wrong and confusing what you did." Well kiss my grits I'm getting REAL tired of being told this that and the other thing is wrong and I'm ready to quit because I have come to the conclusion and no offense out there a lot of nurses are just *itches, I know this is not true of every nurse and I've come across some very nice ones,

but enough already no wonder why there is a shortage. Thanks to all who have listened to this rant, and I'm not a quitter, just a real DISGUSTED GRADUATE NURSE SOON TO BE RN (AND POSSIBLY REGRETTING IT BECAUSE OF THIS MENTALLY ABUSIVE WORK ENVIRONMENT!!) :angryfire

Specializes in Med-Surg, LTC, Rehabiliation Nursing.
I am a nursing student entering my clinical rotation. We have been told to research and make-up Diagnosis Cards for common illnesses seen in med-surg nursing. Would anyone have suggestions of illnesses that are most common that i could start researching and completing my cards? Thank you for any help you can offer.

Hmmmm,

Lets see,

Renal Failure

Diabetes

Detoxification (alcohol and drugs)

Pressure ulcers/(falls under diabetes, but a whole different diagnosis/treatment)

Head injuries

Falls

Mental health problems(bipolar/depression/suicide attempts/there is a whole slew of these you will see)

All I can come up with off the top of my head, but I am sure the more experienced nurses on the forum can give you more.

Good Luck

KristyBRN

definately i hope everyone asks questions until they are blue in the face! i constantly come up with something or another to ask my coworkers. most of them don't seem to mind it, and sometimes it can lead to even more info sharing beyond the initial ???s. just be sure to call the rude people on their offensive responses to what they feel are stupid ???s. (there are no stupid ???s!!! ) i've discovered that a response like, 'i have alot to learn yet, and you've really helped me with this' works wonders. kill them with kindness. ( even though i hate to do it!)

btw, any tips on remembering insulin action times, i can't seem to nail this down in my lobes!

Specializes in Tele, ICU, ER.

I started out in med-surg as a new grad LPN, then RN and I am so glad I did - I truly did learn a lot.

About the eating our young thing... you know I think there are two things going on: 1) older "new" nurses, meaning those who're not new grads but have been at it maybe a year, may still be insecure in their own skills and therefore either try to feel more intelligent by pointing out newbie mistakes and 2) true experienced nurses who can forget what it's like not to know because so much is just automatic for them.

While I've met a couple of real "winners" in my time, for the most part, every nurse I've met has had at least one or two good qualities I can focus on. Learning not to take folks personally is a tough thing for a new nurse, while you're so insecure about every move you make. Just remember that someone cannot insult you if they do not KNOW you. They're just talking.

I liked the poster above's response in asking a supposedly dumb question. Wide-eyed sweetness is useful in getting the info you want, regardless of the reaction the nurse gives you. As long as you get the correct info, who cares what she thinks of having to provide it lol.

Only thing I'd say (and it's been said before), if you ask a question and get an answer, don't ask the same question again in the morning. Make yourself a cheat sheet for stuff you need to remember (like those insulin times). In time you'll need the cheat sheet less and less because things will start to become automatic... you'll know them. That just takes time.

And for things you need to know often, print them out very small on file labels and stick them to the back of your ID stuff. The hospital always gives you 50 stupid cards to hang on your ID (magnet goals, mission statement, whatever). Only decent use I've ever found for all those extra cards LOL.

Things really do settle down. Honest. Every best wish for you - I HATE to see new grads so discouraged and I honestly believe that we all need to to snuggle them up and teach them and support them. Who's gonna take care of US when we're finally done?

Specializes in cardiac, post-op surgicals,critical care.

Don't sweat the small stuff.

If you have to go into the bathroom to cry, don't be ashamed--we've all done it.

Don't let the docs or older nurses intimidate you.

Make sure you always pee or make time to eat.

Take care of yourself, not just your patients.

Get plenty of sleep, no one likes a grouchy nurse!!

There are no stupid questions--it's better to ask then to just do something you're not sure about.

Specializes in CCU, Orthopedics, Peds, Gen. Med..

Yay!!! I'm not a new RN,but am contemplating accepting a position in a Med/Surg. Ward of a very large hospital. These things you listed were just dandy and worth reading,and helpful in reminding myself of!!

Cheers,

chocolatepoppy

thank you so mush for all the helpful advice. i start my preceptorship tomorrow night at 2115-0745. i am trying to stay up extra late to hopefully sleep all day tomorrow. i am a bit nervous, but i will try to keep all the helpful advice in my head. :mortarboard:

I just graduated in May & recently started my first job as a RN.This advice really helps.Thanks. :smilecoffeecup:

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