What is your best tips for new grads starting on med-surg

  1. am starting on the unit next week. It is a post op surgical care unit. I will admit I am NERVOUS probably a little too nervous. This particular unit has lost quite a bit of nurses recently and now they are extremely short staff. I don't want to end up with 10-12 patients as a new grad but I fear it will happen. I want to do my best to keep an open mind. I don't have hardly any experience as a nurse tech or assistant with adults. ONLY babies and children. Only the clinicals we had through and you all know how limited those can be in some schools. So med-surg nurses what are your best tips especially for new grads

    Thank you
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  2. 25 Comments

  3. by   janleb
    hi Tonya, Long time no see. It has been a while. I am also a new nurse. The best advice I have gotten so far is use all of your resources. Pharmacy, respiratory, dietary, ICU residents, RN's that have been doing this job for many years.
  4. by   AndyLyn
    The best thing I did 5 years ago when I started as a new grad on a med floor was to develop a routine that helped me remember what I had to do, and when. (I still start the day out the same way! Get report, list my meds, see each patient and check their IV's and oxygen) I carried around a little notebook, too, with phone extensions, notes on admitting and discharging a patient, computer clues and things like that so I didn't have to keep asking the same questions over and over again. I had a med book and looked up new meds religiously. It won't be long and you'll have the basics under your belt!

    Good Luck,
    Andrea
  5. by   gwenith
    Great tips!! One other comment-

    Buy a pair of comfortable shoes...........
  6. by   jayne109
    My best advice to you (graduated Dec 2002) do not be afraid to ask questions. Most Nurses don't mind answering questions and no question is a stupid one. I know. My favorite question is "Why?"

    Good luck!
    Melissa
  7. by   canadiannurse21
    Hi peaceful!
    Andy gave great advice re: developing a routine. I am a new RN as well; routine is everything. When you start on the unit, you will get orientation shifts with help from an experienced nurse. Memorize his/her routine, and add things you think he or she is missing! Write it down if you have to in case you think you will forget to do something. Ex:
    0630--take report
    0700-write down meds with unusual administration times & record IV meds for the day
    0705-check all pts IV's, O2, foleys, etc.
    0720-take vitals and prn ac glucometers
    0740-set everyone up for baths and assist prn; make beds, and prepare for breakfast
    0830-give am meds

    Know that this is only an example. A typical medical floor will follow this routine. Surgical is a little different but not much--you will have to check drain and wound sights or PCA pumps.
    Review all of your procedures from your school notes, and always ask questions!!!!!
    All the best of luck to you!
  8. by   Rapheal
    Get report, check charts for new orders, a quick look see at any patient who may not be stable. Administer meds. While administering meds, check IV's foleys, ect. I recommend you get your meds in before you check on your stable patients because you can see them as you administer the meds and chances are-if you check all your patient's first-they will be be requesting you to get things for them and check on tests and such. Of course all these things need to be done, but can be done after the meds are given.
  9. by   rileygrl11
    Seems so simple but difficult to perfect,.....time management skills! Cluster your activities. At beginning of shift, check "urgent" pts first but then check your med sheet,.....does a pt have a med due now? Pick that med up and take it with you when you first go to assess that pt. Check what time they last had pain meds (I write this down so I can answer the pt who asks "is it time for my pain med yet?"). This saves extra steps. While assessing bowel sounds or lung sounds, glance over at their IV site for obvious S&S of infection/infiltration and the date it was put in (in case it is old and needs to be restarted). Write things down in a different color of ink that need to be flagged for whatever reason. For example,...I write things in red ink that others are doing that I need to follow up on like accuchecks, stool or urine specimens that the PCT is obtaining for me. Things for me that are really important I may highlight in yellow (like a reminder to call a dr with H&H result when it comes back). The most important thing is to get a routine. I've been an RN for only 1-1/2 years and I STILL find myself fine tuning my "system." I am hoping that eventually, after maybe 20-30 years,....I'll get it down pat! :roll
  10. by   live4today
    Congrats Tonya on going to a post surgical unit! That is my first love in nursing! Did it for years! Lots of teaching goes on from the nurse to the patient and family members who may end up caring for a post surgical patient once discharged from the hospital.

    I know things have worsened in nursing over the past six years during my absence, so much of what I am seeing now that Iv'e returned is mind boggling to say the least. However, do NOT allow the system to get the best of you, but stay in control of what is best for yourself and give only that which you are trained to give. Watch and learn from the nurses who are like the kind of nurse you want to look up to. I still see many of them present and accounted for in nursing...a very good thing indeed!

    Brush up on how to do an adult assessment, and adult vital sign norms, etc. Adults are bigger bodies than babies and kids, and their organs are more spread out, and they have a mouth to actually tell you what you aren't able to observe with your own eyes....unlike with the little angels we care for.

    Any questions, feel free to email me. Best of everything to you. :kiss
  11. by   renerian
    Keep your med book handy............renerian
  12. by   RNikki
    Ditto peaceful. I graduated right out of nsg sch to home care. Thought I'd love it, but the paperwork & constant pressure from friends& family who are RNs drove me back to med-surg and get it over with.
    I'm torn btw starting at a community or teachin hosp (like the VA in Brooklyn) Any opinions on either I did all my clinicals @ teaching hosp and I know you see more and MDs, but I don't wanna give up comm nsg I guess..who knows maybe I will luv medsurg and decide to stay longer than the obligatory 13mths (1mth extra for good measure).. right and maybe Eminem & Tipper Gore will fall in love and reproduce
  13. by   jnette
    Great thread, great info... please keep it coming and feel free to add any tidbits of helpful info as you think of them.

    I am taking a closer look at the medsurge forum because I shall soon be doing some medsurge PRN in a nearby hospital in NC which I dearly love. Just a small hopital..200 or so beds, but under current reconstruction and expansion to incorporate more specailty units, etc. My best friend has worked on their medsurge unit for many years, and she will be one of my preceptors during orientation... a nice plus !

    While I am in no way ready to give up my current employment at my dialysis facility, I have known from the get-go that once I graduated I would want to broaden my horizons and scope of practice. There is so much yet to learn and see and do, and medsurge does have enough to hold my interest for quite some time ! It certainly has a little something for everyone !

    It's going to be scary as I've not done anything but dialysis for years... and this is the precise reason for wanting to do more. I'm anxious to begin utilizing other nursing skills and learning new things.

    I'm in the process now of obtaining my NC licensure by endorsement.. Va. won't be a compact state until late next year.
    Once I have my NC licence, I begin the orientation. That ALONG WITH holding down my regular shifts at my dialysis clinic... which means I'm going to be working some 70-80 hours a week for 4 weeks! But just for the month of orientation... after that I'll be PRN status and can work at the hospital as often or as little as I want.

    So it's going to be a hairy month...probably October when I do this. Don't expect to hear much from me around here that month.. I'll be collapsing on the bed as soon as I hit the door ! :zzzzz

    After the month is over, however, I'll be back bugging the heck out of you medsurge ppl for info and insight !
  14. by   RENAE
    THIS IS WONDERFUL NEWS TO HEAR... . THIS PAST AUGUST WAS MY YEAR ANNIVERSARY ON THE MED SURG UNIT. HERE IS SOME REALLY GREAT ADVICE FOR YOU :
    1. DON'T BE AFRAID TO ASK QUESTIONS. IT IS BETTER TO ASK QUESTIONS AND KNOW WHAT TO DO THEN TO GUESS.
    2. TAKE ADVANTAGE OF YOUR PRECEPTOR OR THE NURSE THE ORIENTS YOU TO THE UNIT. SHE WILL BE VERY VALUABLE TO HER.
    3. GO TO YOUR MED. LIB IN THE HOSPITAL IF YOU HAVE ONE AND KEEP READING BOOKS AND LOOKING AT VIDEOS ON IV INSERTION, CENTRAL LINES, BLOOD DRAWS, AND ASSESSMENTS. TAKE ADVANTAGE OF YOUR RESOURCES.
    4. DON'T FEEL INTIMITATED BY OLDER NURSES. AND WHEN YOU FEEL OVERWHELMED "SAY SO" REMEMBER THEY WERE NEW NURSES ONCE ALSO NO MATTER HOW HARD THEY TRY TO FORGET.
    5. DON'T BE AFRAID TO ASK FOR HELP. AND IF ONE NURSE DOESN'T HELP YOU ASK ANOTHER. DON'T BE AFRAID TO EXPLAIN TO THE NURSES THAT IF THEY SHOW YOU DIFFERENT PROCEDURES YOU WILL BE ABLE TO DO IT BY YOUR SELF NEXT TIME.
    6. DON'T BE AFRAID TO SPEAK UP. SOMETIMES THEY TRY TO LOAD WORK ON THE NEW NURSES TO SEE HOW MUCH THEY CAN HANDLE. DON'T BE AFRAID TO TELL THEM THAT YOU ARE AT YOUR LIMIT.
    7. GOOD LUCK . WE NEED MORE NEW NURSES IN OUR FIELD TO BE EAGER AND READY FOR NEW ADVENTURES. P.S PLEASE PLEASE PLEASE TRY TO GET AS MUCH EXPERIENCE AS YOU CAN. IF YOU SEE A PT . THAT ISN'T YOURS GETTING SOMETHING DONE TO THEM THAT YOU HAVE NEVER SEEN BEFORE GO IN AND ASK THE NURSE FOR HELP. BECAUSE CHANCES ARE NEXT TIME THEY WILL EXPECT YOU TO KNOW IT.

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