Advice For The New Nurse Entering Med-Surg

Elle.p.enn · Dec 2, 2006

I love this thread! :balloons:

Especially the asking questions, and not taking things personally part.

Any advice on how to talk to doctors?

I'm really having a hard time with this, I'm scared of them! :uhoh21:

Thanks for the advice!

augigi, CNS · Dec 2, 2006

What are you scared of? Just remember you are all on the same team, and there is nothing wrong with saying "I don't know, but I'll go find out for you" if that happens.

Daytonite, BSN, RN · Dec 2, 2006

elle.p.enn. . .i've listed a link to a old thread about calling doctors. one of the posters talked about the sbar technique. sbar is an acronym for situation background assessment recommendation. you can buy the program (it's a product that is proprietarily owned), but someone very nicely posted the whole idea of it on the thread.

https://allnurses.com/forums/f224/new-nurse-scared-talk-doctors-119029.html - the sbar technique is on post #43. i think you might find it very helpful in preparing to make a call to a doctor

also, i couldn't find an attachment of my report sheet ("brains") in this thread, so i'll put it here as well. feel free to download and use it. it was created on word using table commands if anyone wants to make any amendments to it.

[attach]5032[/attach] my report sheet ("brains")

DoniaRN · Dec 2, 2006

i am a new rn at my 6mth mark..i have started to pick up day shifts and its going well and helping me much with my organization and talking with dr's. my normal shift is 7p-7a. the 12's are nice but i like the pace better on days. thanks for this site

Elle.p.enn · Dec 4, 2006

Thanks for the advice! :balloons: :)

kito4149 · Dec 8, 2006

I am a newbie!! I just passed the NCLEX-PN!!! My question is, "How do you deal with "lazy" co-workers who sit around, do nothing, and talk about other co-workers?"

Daytonite, BSN, RN · Dec 8, 2006

I am a newbie!! I just passed the NCLEX-PN!!! My question is, "How do you deal with "lazy" co-workers who sit around, do nothing, and talk about other co-workers?"

There's not a whole lot that you as a newbie can do. Walk away and don't participate in the gossip. If you need help you'll just have to ask for it if these people aren't in the mood to offer any. My advice is to think about going back to school to get higher education so you can get into a management position where you can do something effectively about people like this. When I was a manager I stopped any gossip I heard immediately. I made it very clear to the nurses working on the unit I managed that I didn't like nor would I tolerate it. Right now you really don't have any authority to do anything like that with them. As long as they aren't picking on you or their behavior isn't adversely affecting patient care, all you can do is just go about your business and comport yourself the way you know is appropriate.

Congratulations on passing your NCLEX-PN! :yelclap:

DoniaRN · Dec 8, 2006

congrats on passing you pn!!!

Terry87 · Feb 7, 2007

thanks for the advice, I am starting my second placement on a medical ward on monday after reading your thread :pumpiron: I feel more confident thanx

morrison · Feb 15, 2007

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?

sunneeRN · Feb 15, 2007

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!!!!!

morrison · Feb 25, 2007

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