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new grad starting on med-surg unit

  1. 1 I am a new grad starting my first job as an RN on a med surg unit. I am excited & terrified. Med-surg was not my best clinical in nursing school & I am worried that I will not remember anything I learned. I am wondering what others' experiences have been starting out in med-surg. Did you spend your off days studying procedures & disease processes? I will be working 5 nights a week & I have four kids. I don't feel like I will have any time to brush up on my knowledge outside of work. Will working with my preceptor be enough? Is there any one pocket sized book that I can get that will help me "fake it til I make it"? Thanks!
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  2. 11 Comments

  3. Visit  PunkBenRN profile page
    #1 3
    Keep this in mind - you are fresh out of school. You're equipped with fresh knowledge, and may find yourself knowing a lot more than you think. There is the initial aura that because nurse's will have been on the floor longer than you, they will know everything infinitely more than you. Not true, sometimes nurses will come to you with questions

    What you don't have is the intuition. Don't fret, that takes time and experience. Follow the lead of others, and ASK QUESTIONS! If you don't know, you aren't inferior - you can't know everything all the time. Its okay to ask a question. Its not okay to assume or "wing it" and put the patient at risk.

    Coming out of school, take a break. Take care of yourself and what fun you had before nursing school. Once you're refreshed, come back to education. I have a wall of nursing books that I read and re-read to maintain my skill set and understanding. Go after all of the certifications and classes that the hospital offers. Even if you don't use it on Med-Surg, just get it for the sake of knowing. I can't tell you how invaluable TNCC was for me, it really helped to hone my approach and assessment skills, and gave me confidence in crisis situations (even when trauma is not involved).

    Good luck! Its hard work on Med-Surg, but it is very rewarding
  4. Visit  tokmom profile page
    #2 1
    You will do fine if your preceptor is a good one. They shouldn't expect you to know the workings of the floor just yet.
    Once you get a feel of the floor, you will know what to brush up on if you need too. I'm sure your floor, (just like any other place) has a certain clientele it caters too. My med/surg is a lot of GI and cardiac, CHF.
  5. Visit  icechick profile page
    #3 0
    thanks for the replies
  6. Visit  MyUserName,RN profile page
    #4 1
    I'm a new nurse on a med/surg floor too. Still on orientation for 2 more weeks (8 weeks total) and I feel stupid most of the time. I am wondering what I even learned in school, because when it comes to the real world and applying the critical thinking skills to real life it's totally different. Some people have said I am too hard on myself though. Don't get me wrong, I love my job so far and am happy I'm here. The people I work with are great. I just can't wait to get to the point where I feel like I know what I'm doing...I've heard it takes about a year or two to get there.

    I am also looking for a good quick reference book or something that has an easy to understand layout of diseases/problems that a med/surg floor mostly deals with. I'm now starting to study a little on my days off. I'm going to start writing down the things I want to learn more about while on shift so I can look it up when I get home. I do ask questions when needed, but some things I feel like I can look up on my own at a later time without having to bother the other people so much. Of course I would never do this at the expense of patient safety, just on stuff I want to learn a little more about, so I understand why we're giving the care we are giving and not just doing it blindly forever.

    Good luck to you in your new job! Congratulations!
  7. Visit  MyUserName,RN profile page
    #5 0
    PunkBenRn, what is TNCC??
  8. Visit  SNIXRN profile page
    #6 4
    http://www.amazon.com/Diseases-Disor...3986609&sr=1-1

    Great reference. Small enough to fit in your bag.
  9. Visit  JosefVernon Hodgkins profile page
    #7 1
    Follow the good nurses. Listen to your nurses in charge, and use your gained knowledge from nursing school.

    -Joe
  10. Visit  jdickrn profile page
    #8 4
    Do not stress about med-surg not being your strong point in nursing school as nursing school is not reality at all, and med-surg is THE best place to learn. I remember my first 2 weeks on the floor (I started in med-surg 9 yrs ago and am still in med-surg) walking around thinking "they didn't teach me any of this s**t in nursing school". Being a brand new nurse is painful no matter what specialty you start in. I've said over and over again, I love nursing, but one thing I would never want to do over again is the first year of my nursing career. The first year is just insane, but when that year is over, all of a sudden, you will feel like you have a grip on things. There is a book out called "Your 1st Year as a Nurse". I used to buy it for each new grad I precepted because it helped me when I was new. Good luck with the beginning of your career.
  11. Visit  timster10 profile page
    #9 1
    Quote from icechick
    I am a new grad starting my first job as an RN on a med surg unit. I am excited & terrified. Med-surg was not my best clinical in nursing school & I am worried that I will not remember anything I learned. I am wondering what others' experiences have been starting out in med-surg. Did you spend your off days studying procedures & disease processes? I will be working 5 nights a week & I have four kids. I don't feel like I will have any time to brush up on my knowledge outside of work. Will working with my preceptor be enough? Is there any one pocket sized book that I can get that will help me "fake it til I make it"? Thanks!
    Use your smartphone at work. EVERNOTE is an electronic filing cabinet. It is free, or pay premium membership for added benefits. I have organized and continue to collect information from procedures to psycho-social interaction advice, etc... I pay the premium membership to share with ease with my other electronic devices. Also, there are very specific applications in today's technology one can use for reference.
    Picture a large filing cabinet. I open the drawer, and see the green hangars that hold the yellow file folders that hold the specific written pieces of paper/information. At first, I thought this as unnecessary, but as time went on, I soon discovered that I am able to easily recall any piece of information within 20 seconds or less. Evernote has given me confidence on the job and in my personal life. At 57 years old, I start to loose some of the short term memory function. I continually edit my Evernote. I use a pin number to secure information. Use caution with HIPPA regulations. One can edit the titles to their liking. Am I going on to long? I LOVE EVERNOTE. YEEEEAAAAA
  12. Visit  JustKeepSmiling profile page
    #10 1
    Develop a brain sheet that works for YOU. You have to have a solid way to stay organized.
    I also cannot function without a med/task grid. Basically columns with times & rows with patients. I put PO/IV/Insulin/dsg change etc to show what I have what due and when. Major important to me for prioritization.
    Write down your blood glucoses & insulin given, keep readily available for physician rounds.
    Always get your vitals/assesment in early - you never want to find yourself in a situation where a pt declines and the last vitals were on nightshift. Your pt's baseline is very important.
    Also write down the times you are in rooms so when you do document (if too busy to do in real time) you are accurate.
    Write your update information in a different color. This way if you give report to the same nurse again it will be much more efficient.
    Pass your own ice & water. Makes med pass faster & pts love you for it.
    Toilet your own pts as much as possible -- reduces fall risk, increases pt happiness & building teamwork with your CNAs is crucial.
    Medsurg is difficult. Make it less stressful by actually talking to your pts, be kind. I make it a point to narrate my care and talk to them like I would to a friend. It makes the craziness of nursing less painful!
    Good luck!
  13. Visit  NewNurse91D profile page
    #11 0
    I was literally just googling this EXACT topic! I am a new nurse and am about to start my first RN job on a medsurg- Medicine Stroke unit at a big hospital. And I'm REALLY worried that I won't remember my nursing school information.

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