New grad starting on Surgical/Ortho floor

  1. I'm a new grad getting ready to start orientation Monday on a surgical/ortho floor. Luckily, I did 2 semesters of clinicals at this facility & had 2-3 shifts on this floor. Just trying to go over what I should be reviewing specific to orthopedics. They have a lot of knee/hip replacements if I remember correctly.

    Sooo....I'm pulling out my ortho module from school to review: CPMs, positioning, 6 P's, dressing changes, & of course pain control is the biggie. For pain, I recall morphine pca and norco being used mostly for the pts I had. Any other drugs you routinely use for ortho that I should brush up on (I'm sure there are quite a few)? Pitfalls to avoid? All suggestions are welcome! Thanks!
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    About RainMom

    Joined: Sep '11; Posts: 1,147; Likes: 2,273


  3. by   DalmatiaRN
    I'm on a surgical ortho floor and love it! I have a great team and I love the surgical population.

    For pain control we use scheduled oxycontin 10-20mg typically and then for PRN we usually have available percocet, norco, and toradol. I have to say Toradol is a favorite, but it is hard on the kidneys.

    Typical issues you will deal with is blood pressure/nausea/pain issues POD #0 and #1. It's not unusual for a patient to have scheduled pain meds, PRN narcs for AM PT/OT and a load of BP meds all scheduled together. Beware

    Different MD's have their own bag of tricks. Anticoags like warfarin or Lovenox or both are common and SCIPS protocol is something you will want to become familiar with depending on your facility.

    Drains of all types are used depending on MD preference. We rarely ever use PCA's for our orthos.

    Of course you will wants to review hip precautions etc. Good luck to you.
  4. by   SheilaORN
    I also started on ortho/neuro as a new grad 2 yrs ago and I love it, the Ortho docs have specific meds they order for the patients, as you work on the floor u will learn on meds ordered by specific docs. While u orienting u will be more familiar, good luck. Sometimes the unit can get heavy but u manage your time and prioritize and u will be fine
  5. by   RainMom
    Thanks for the advice! I just finished my first week on nights after 2 weeks on day shift orientation & so far it has been pretty good. Gets super busy at times, especially towards shift change, but I think I'm doing well. I'm expecting it to get a lot more busy though after my last week of orientation next week. The other RNs keep commenting how much nicer it is since I'm basically an extra RN scheduled during the shift & their workload is decreased a little, but then it will be back to normal after I'm off orientation. Everyday I learn a little more & do things a little better!
  6. by   mrstRN
    I am also a new grad and the information you all have provided has been wonderful! I am a little nervous with starting orientation in a few weeks because it is my first job as an RN and I only had one clinical rotation on this unit that lasted 6 weeks in nursing school. Thanks for info again and I am very excited
  7. by   RainMom
    Congrats mrstRN!! So far, I still am really liking ortho & am feeling more confident every week. Still trying to keep all the different dr's protocols straight! Since I have the same type of pts over & over, that helps, but then again, sometimes I feel like I'm not getting exposed to a lot of other pts/skills that I learned in school. However, occasionally I get floated to med/surg which is a nice change, but nerve-wracking! Makes me feel completely out of my element! Good Luck to you!
  8. by   mrstRN
    Thank you so much nu rn! I look forward to working there and I will keep you all posted with either questions or comments about my experience! Love!
  9. by   sarahsmile44
    Love this thread! I'm also a GN on an Ortho floor and I haven't started yet. Thanks for all the great posts. I'll be bookmarking this thread =) Congrats on the new jobs, ladies!

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