Advice for the new nurse entering Med-Surg - page 4

by RNPATL

177,289 Unique Views | 220 Comments

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... Read More


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    Quote from barefootlady
    Remember nursing is not a fashion show
    Hm, I disagree..I think that c. diff poop color on my shoes really brings out the blue of my eyes...
    :chuckle

    thanks for all these awesome, helpful posts.
    rebecca
    Paco-RN likes this.
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    I am not a nurse yet! but a student starting my 3rd semester in August. This will be my 1st med surg class & would love any tips or advice from the pros. I posted this in the student section & got a couple of tips but I would love to have advice from ya'll. Thank you in advance for your help.
  3. 0
    Quote from crb613
    I am not a nurse yet! but a student starting my 3rd semester in August. This will be my 1st med surg class & would love any tips or advice from the pros. I posted this in the student section & got a couple of tips but I would love to have advice from ya'll. Thank you in advance for your help.
    What types of tips are you looking for? There are many med-surg nurses that frequent this forum and I am sure they can help. Just let us know what you are looking for.
  4. 0
    Quote from RNPATL
    What types of tips are you looking for? There are many med-surg nurses that frequent this forum and I am sure they can help. Just let us know what you are looking for.
    I'm not really sure myself. Maybe what I should focus on learning before my classes start, I know fluids & electrolytes are a biggie, & I really don't know what to expect in class or clinicals. I know this year's senior class lost about half the class the 1st, 8wks so I don't want to join them! I don't mean to be vague but any thing ya'll remember/or wish you had known when starting med surg would be great! Thank you so much.
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    Quote from crb613
    I'm not really sure myself. Maybe what I should focus on learning before my classes start, I know fluids & electrolytes are a biggie, & I really don't know what to expect in class or clinicals. I know this year's senior class lost about half the class the 1st, 8wks so I don't want to join them! I don't mean to be vague but any thing ya'll remember/or wish you had known when starting med surg would be great! Thank you so much.
    Welcome and congrats in deciding to enter the rewarding field of nursing. Here's some tips: 1. Know why the pt is taking each medicine, if you don't know feel free to ask the pt- they will teach you so much. 2. Practice doing history's!- we didn't do any admission assessments or history's in nursing school but now I do them all the time- it will help you learn to be thorough and obtain very impt info. on your pts and provide teaching along the way. 3. Look for opportunities to learn- ask the nurse to let you know if there's anything going on that you can help with or learn but also give them example's- "any foley's, trach care, even priming tubing" etc.. Experienced nurses forget that everything is new and and exciting and even doing an enema is good experience. 4. Ask questions- no question is dumb. 5. After moving pts, make sure to put the bed back down and bed rails up- I can't tell you how many times I have found bed rails down and pts way high up 6. Be prepared- if you go the hospital to prep the day before, go in and introduce yourself to the pt, and do a history- it's much easier then trying to read the MD's handwriting, and/or ask the nurse caring for them. Track the history/events since their admission. 7. Most importantly- try and have fun!! Nursing school is challenging and difficult, but, your impact on your pts is life-changing, they will tell you things and trust you in ways they wouldn't with their own family/friends. Best of luck
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    Well thank you so much for taking time to give me those tips! In my 1st clinical we did not get our pt the day before & that made it really hard. I felt like I was spending all my time with paper work & not the pt. I asked my instructor if I could get my pt early & went to the hosp. the day before (on my own time). I cannot tell you how much this helped I knew the meds, dx, talked to the pt,the nurses & had my plan of care ready to go. I felt prepared as much as I could be for a student Thanks again
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    Hey everyone. I am on summer break between my 3rd and 4th year and have been given the opportunity to work as a Undergraduate Nurse in my local Hospital. I will be working on a acute medical unit/palliative ward and couldnt be more excited (and nervous). Can you give me some tips on how to be efficent and assertive when calling docs re: orders for meds ect. Just a bit of a dialogue would be great! I think that is what I am most nervous about, that and any skills that will come up I have not had the opportunity to do more than once (foley insertions on oth male and female pts!).
    Thanks all for your time and guidance, it is MUCH appreciated!
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    Quote from Bex_SRN
    Hey everyone. I am on summer break between my 3rd and 4th year and have been given the opportunity to work as a Undergraduate Nurse in my local Hospital. I will be working on a acute medical unit/palliative ward and couldnt be more excited (and nervous). Can you give me some tips on how to be efficent and assertive when calling docs re: orders for meds ect. Just a bit of a dialogue would be great! I think that is what I am most nervous about, that and any skills that will come up I have not had the opportunity to do more than once (foley insertions on oth male and female pts!).
    Thanks all for your time and guidance, it is MUCH appreciated!
    Calling docs as a new nurse was also one of those things I was fearful of. But, then I realized right away that they are interns and they are learning too. I found it amazing when they ask me which medicine to prescribe. It's very intimidating but also great that they respect our opinion. But, when calling the doc make sure you are calling the right person in the chain of command, also have pertinent info available. For example if you are calling b/c the pt has a fever, also have a full set of vital signs ready. If a pt is c/o nausea, ask the pt if anything imparticular worked before, then request this med- otherwise the MD may prescribe a med that the pt may not want. Also trust your instincts, if something doesn't feel right then go to a colleague or tell the doctor. Ex. on orientation, the MD ordered an antipsychotic med with pretty severe side effects and withdrawal symptoms if they stop it suddenly, the pt had not had a psych consult nor were they aware of this med- so I talked to my charge nurse about it then called the MD to ask why they were putting her on it- and he said that the renal MD had requested it and he wasn't sure why- well, that was sufficient so I told the MD that I wasn't going to give it and if he wants her to take it he needed to explain it to the pt and give it. Remember that your the pts advocate- they trust you. And, if you don't know why something is being done then you need to f/o why for your pts safety. Also, your ultimately responcible.
    As far as tasks- foley insertions- take another nurse with you. I am not good at female foley insertions- grab another nurse so they can hold the labia open while you insert- it's so much easier.
    Anymore questions let me know. Good luck!
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    Thanks so much for your responce NUrsing04! Much appreciated! I will let you know how things go my first week!

    Bexx
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    I agree with you totally! I initially liked nursing, then hated it, now I'm fine with it and definitely feel more competent (I have been a nurse for one year). Great advice!
    Quote from lady_jezebel
    My experience:

    I was thrilled to start working as an RN & initially loved my job, though I felt overwhelmed. Then I recognized all the communication problems within a hospital & started to feel a little depressed. Next I hated my job with a passion, and longed to leave nursing & do something else. By the 6 month mark I started feeling more relaxed & competent, and I began to enjoy it again. Now I'm at the year mark, feel MUCH more competent/capable as an RN, and am ready to move on to another area of nursing (such as ICU or research).

    My advice would be to STICK WITH IT for at LEAST a year. You will feel overwhelmed, bored & frustrated at various points, but the amount of learning you do in your first year is tremendous. I'm convinced that at least a year of med-surg is invaluable experience for any nurse, no matter what area you eventually decided to go into. You will not know if you like med-surg, or even nursing, until a year has passed.

    I agree with everything the previous poster already said. Very well-spoken. I'd agree that you should do all the blood draws & IV sticks you possibly can, ask questions if you don't understand something, write down anything new learned (so that you don't repeatedly ask the same questions over and over), keep a list of important phone numbers/lab values/facts that you will need to know (ie. stay organized), and offer to help out your co-workers whenever you have a free moment (be helpful and flexible). And above all, maintain your sense of humor! A good laugh will get you through some really tough moments...

    Oh -- would especially emphasize: 1) to stay calm/collected no matter what happens. You can't think rationally if you're in a panic, and the patients/families & your co-workers rely on you for your strength. Pretend to be confident when you're doing your first blood draws, IVs and catheters, too. 2) set limits with demanding patients. You have to prioritize every moment. If you can't adjust the bedding or get jello for a pt at that moment, it's OK to say "I have several patients and need to prioritize my work right now. I have an urgent matter down the hall. Once I'm through with that however, I'll come back & do X". Also, if a patient is particularly needy, emphasize that part of their recovery is to be able to do things for themselves. Tell them you would like to help them in becoming more independent. Finally, if someone is on their call-bell constantly, contract with them -- go through the priority speech again, but agree to return to their room in an hour (& then be there @ the time you set). You are not a slave or a waitress. Remember that!


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