Advice for the new nurse entering Med-Surg - page 9

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... Read More

  1. Visit  Terry87} profile page
    0
    thanks for the advice, I am starting my second placement on a medical ward on monday after reading your thread umpiron: I feel more confident thanx
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  3. Visit  morrison} profile page
    0
    i am a new grad nurse doing my first rotation in surgical ward. can anyone tell me how to remove the bellovoc drain. i am assigned in a small country hospital someone told me this afternoon there is a new way of removing it. how true is it?
  4. Visit  sunneeRN} profile page
    19
    I've been an RN for almost 2 years now. I was the most insecure nurse you'd ever meet at first (sometimes still am!), so here is my advice.

    1. Trust your assessment. If family is in the room, ask them to step out for a moment so that you don't feel the need to hurry. Assess your patient, head to toe. Ask them questions. Tell them the plan for the shift (if you know). ex. "Today, will will help you wash at the sink, physical therapy will see you, and you have a scheduled MRI." That way, when the time comes for that MRI, they aren't asking you why the heck they are going!

    2. IF you have downtime, even for 5 minutes, find another nurse to see if he/she has anything interesting going on with their patients, ex. inserting a foley, NG tube, starting a tube feed, etc.

    3. When calling an MD, have information readily available. I always grab the bedside chart for most recent vitals, previous nurse's notes, their I/O sheet, and their chart. That way, the doctor isn't on hold while you are running to find info. They appreciate this and it helps you to gather your thoughts.

    4. Find a nurse that you can trust with anything. When you are feeling overwhelmed and maybe insecure, talk with that one person. I still go to one particular nurse for ANYTHING and she loves that I trust her and she has helped me a great deal over the past 2 years.

    5. Don't be afraid to ask questions. I still ask a ton of questions, and I find that some questions that I ask, even seasoned nurses do not know...so we we look up the info together.

    6. When receiving report, have a system that is individual to you and use it every time. For example, I take report with a black pen and I highlight in pink things that need to be done first. Anything that happens on my shift that is new, (new orders, changes in physical assessment, etc) I write in red so that when I give report, I know this is a change and can pass it along.

    7. Something that I started doing when I was brand new was having a space on my report sheet called "my assessment." and I find this EXTREMELY helpful. I have my report sheet in chart form, so I have the basic info first. Name, MD, hosptial day since admission, diagnosis, Past medial history, allergies, IV fluids, PCA settings, Diet/Activity, VS, I/O, Accu checks, labwork. Then, I have a box for "report" where I write down info that the previous nurse gives me, and the next box is entitled "My assessment." After leaving a pt's room, I dont always have time to chart, so I jot down my assessment on my repor sheet..i only write things that are abnormal so that when I chart, i know everything else was normal. for example i jot down, crackles at left base, abd inc with steris, pain 8/10 in LLQ and i will write med. with 2 perc at 2130. That makes charting so much easier later. Also remember, that if your facility charts by exception, then CHART BY EXCEPTION! You are taught to write a full note in school, but charting by exception will save loads of time, especially when you still have paper charting. They made it that way for a reason. That doesn't mean that you didn't do a full assessment. If you check off respiratory, that means that you assessed respiratory and it was within normal limits.

    8. Finally, prioritizing is key but it TAKES TIME! I remember wanting to complete as many tasks as possible at first. Constantly running in and out of rooms wastes time. Before you start running off your behind, think ahead. Say to yourself "I have to give room 311 meds at 9. When I go in, I will take all the supplies for the 11 pm dressing change." That will save time later.

    My biggest advice, though, to a new nurse is this. If you have to go to the bathroom, GO! If you are thirsty and parched, get a drink! Take care of yourself. You don't want to hurry through administering medications because you can't hold your urine for another second...it is dangerous for you and for the patient. Take those 2 minutes for yourself. Even when I am so busy that I can't stop for a second, I take the time to pee....the 2 seconds away from the nursing world is needed to just stop, relax, and relieve yourself!!!!!
    sunflower350, Rebekah1882, arobins72, and 16 others like this.
  5. Visit  morrison} profile page
    0
    Thanks for the advice. I find it very valuable. As a new grad doing my first rotation in surgical ward, I find it overwhelming..... Honestly, I did not want to go back to the ward after two days of work. I am slowly settling in learning important lessons in my everyday experience in the ward. Cheers :roll
  6. Visit  hirami} profile page
    0
    What steps would I have to take to become a surgical nurse after obtaining a degree as a RN?
  7. Visit  Daytonite} profile page
    0
    Quote from hirami
    What steps would I have to take to become a surgical nurse after obtaining a degree as a RN?
    When you go looking for your first job as an RN, tell the recruiters that you want to work in the OR or on a postop surgical unit. Some recruiters and OR managers will not be very open and flexible about hiring and placing a new grad in the OR. Others are. You just have to shop around. Some will try to tell you that they want you to have worked at least a year on a med/surg unit first (that's what I was told as a new grad). However, I don't think that is necessary anymore because almost all the nursing areas have gotten so specialized. There is usually a period of training involved once you get hired into these kinds of nursing specialties.
  8. Visit  st4wb3rr33sh0rtc4k3} profile page
    0
    I am a new nurse going from LTC of one year to Med/Surg. I use to have 30 to 60 patients, and now I will only have 7. Are there any other differences that I should expect?
    Last edit by st4wb3rr33sh0rtc4k3 on Mar 11, '07
  9. Visit  danaheil} profile page
    0
    my husband just started in med surg less than 6 months ago. He is already being asked to charge, and he feels unprepared for this. He has received no orientation to charge, and has no desire to do so. Can he refuse this assignment. Advise??? Thanks in advance.
  10. Visit  morrison} profile page
    0
    as a new grad, we are not allowed to be in charge of the ward. we need at least a year of post grad experience before we can be in charge of the ward. surgical nursing is not easy, patients coming bac from theatre require hrly obs and close monitoring for possible complications. most of them have drainage bag and iv fluids and on Iv antibiotics.

    I was in the same position a month ago when the NUM left me with two EN's one afternoon. I could not sleep the whole night. the following day, i approached the NUM calmly and assertively and stated my case. she got the message. my other colleagues were very supportive.
  11. Visit  myellelpn2rn} profile page
    0
    I'm a new lpn and tuesday will be my first day on a med-surg unit work as a nurse, but I have ten years in the icu as a tech. I'm nervous is their certain things i should have with me when i start just in case noone wants to help? (you know that eat your young disease)
  12. Visit  nghtfltguy} profile page
    3
    ok.. i don't know if this has already been posted but i am going to post it anyway.. it is from a book called "training wheels for nurses"...
    i thought this was good advice.. the 4 S's....

    Shoes: Buy the most comfortable shoes you can afford to buy, and remember to replace them often..

    Stethescope: Listening to breath sounds is a skill, and having a good stethescope will help.

    Scrubs: Get a scrub jacket with lots of pockets.

    Scissors: A good pair of bandage scissors will last a lifetime.

    I agree that med-surg is a great place for a new nurse to gain a very broad spectrum of experience and become more proficient at many different skills.. It can also help you realize what sort of nursing might be the most rewarding for you.. I do PRN shifts on an Acute Med-Surg floor and I really enjoy it..
    marqc_rn, creativemom, and eznal like this.
  13. Visit  myellelpn2rn} profile page
    1
    Quote from nghtfltguy
    ok.. i don't know if this has already been posted but i am going to post it anyway.. it is from a book called "training wheels for nurses"...
    i thought this was good advice.. the 4 S's....

    Shoes: Buy the most comfortable shoes you can afford to buy, and remember to replace them often..

    Stethescope: Listening to breath sounds is a skill, and having a good stethescope will help.

    Scrubs: Get a scrub jacket with lots of pockets.

    Scissors: A good pair of bandage scissors will last a lifetime.

    I agree that med-surg is a great place for a new nurse to gain a very broad spectrum of experience and become more proficient at many different skills.. It can also help you realize what sort of nursing might be the most rewarding for you.. I do PRN shifts on an Acute Med-Surg floor and I really enjoy it..
    Thank u for the advice I didnt even think about the scissors
    eznal likes this.
  14. Visit  lpnhell} profile page
    0
    great advice


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