New ortho nurse

  1. Hello,I'm a new ortho nurse just off of orientation. I had one month of orientation on a med pulm floor then 3 weeks on my ortho floor. My nurse manager is starting me off with a lighter load of 4 patients(the usual is 5). On any given day we can have up to 20 new surgical patients. That means frequent VS, CMSTs, pain management, and other things. On orientation I did well with time management and charting in a timely manner but now that I'm on my own I feel like I'm running nonstop, literally not having one minute to sit. I've had to stay over to finish up charting. My coworkers tell me it gets better with time but I'm worried that it won't. It is only my 2nd day off of orientation so I maybe jumping the gun but I'm just curious if you have any advice for a new ortho nurse to help the transition from orientation to being on my own go a little smoother. Thank you!
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  2. 8 Comments

  3. by   Sour Lemon
    The strategy that helped me most as a new grad was learning to efficiently cluster care. Instead of giving an antibiotic at 20:00, I'd wait for that patient's 21:00 Lipitor to arrive from pharmacy, gather some supplies needed for their dressing change, grab (and fill out) a consent they needed to sign, and head in to knock it all out at 20:30. If the patient had asked for jello/ice/crackers earlier, I probably told them, "I'll bring that to you in a little while with your medication." I did my head to toe assessments during med pass, too.
    I also had to get over not wanting to "bother" patients. Before I managed to do that, I might have given a synthroid at the very last minute to avoid having to wake a patient up. Unfortunately, other unpredictable things usually happened in that last minute, as well ....then I found myself falling behind. Eventually, I learned to simply warn the patient when they could expect to be interrupted again and why. "Goodnight Mr. Smith. I will be back at about 1AM for your next dose of Zosyn and someone will be around to take your vital signs close to midnight." Patients tend to be more tolerant when they know what to expect in advance.
    I also made charting a priority over non-urgent tasks. It's easier to run around tying up loose ends without charting hanging over your head. And while a task can be passed on, if necessary, your charting can not.
  4. by   RNperdiem
    An ortho nurse needs help from the CNA. How well staffed are you for assistants? Pay attention to how much and what your coworkers delegate to the CNAs. If you are doing everything, then something is wrong.
  5. by   mmc51264
    If you are helping a pt to the bathroom, chart in the room while you are waiting for them.
    I chart as much as I can when I pass meds in the am, bring the water and the miralax with you.
    I'll keep thinking....
  6. by   Been there,done that
    Agree
    Quote from cmcgraw28
    Hello,I'm a new ortho nurse just off of orientation. I had one month of orientation on a med pulm floor then 3 weeks on my ortho floor. My nurse manager is starting me off with a lighter load of 4 patients(the usual is 5). On any given day we can have up to 20 new surgical patients. That means frequent VS, CMSTs, pain management, and other things. On orientation I did well with time management and charting in a timely manner but now that I'm on my own I feel like I'm running nonstop, literally not having one minute to sit. I've had to stay over to finish up charting. My coworkers tell me it gets better with time but I'm worried that it won't. It is only my 2nd day off of orientation so I maybe jumping the gun but I'm just curious if you have any advice for a new ortho nurse to help the transition from orientation to being on my own go a little smoother. Thank you!
    New nurse, old nurse...ortho or any other area...you will be busting your AZZ for the man. They will give all the work you can handle.. and add some more.
    A 5:1 ratio is sweet ! Agree with RNperdiem... delegate to PT and the CNA's.
    ..
    Last edit by Been there,done that on Aug 31, '16
  7. by   cmcgraw28
    Most of the time we have 2 CNAs for almost 30 patients. Things like frequent vitals (which eat up most of your time) we cant delegate those. At times it does feel like I am doing everything but we are very understaffed when it comes to CNAs especially on my shift(2nd shift).
  8. by   cmcgraw28
    Thank you all for the advice, it's all very helpful
  9. by   TheCommuter
    Moved to our Orthopedic Nursing forum for more responses.
  10. by   cupcakeluver
    I'm a new ortho nurse...with about 4 months experience. I've been off orientation for a little over 2 months. I work the weekend night shift rotation and there's usually just me and one other nurse. Sometimes this works out great if there's not many patients...other times it's crazy hectic and I have 9 patients. We have no cna's on weekend/nightshift.

    I agree with previous posters about clustering things together. I start the shift by trying to organize tasks and plan accordingly. It doesn't always work out that way but it does help. And it really is true....you get better with time. I'm still slow but I'm much better than when I first came off orientation!

    Bathroom trips are the most time-consuming for me. I've learned to help someone get situated and make sure they can reach the call light. Then I have them call me when they're ready. That freed up a lot of extra time.

    Good luck. Most days, I really like my job. Wishing you the best.

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