What's it like working an Ortho unit? - page 2

by jbee

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I'm an RN with 1.5 years of experience who is planning to move within the next month. I have a job interview for an Ortho position next week- however, I know absolutely NOTHING about orthopedics. Can anyone tell me a bit about... Read More


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    Moved to our Orthopaedic Nursing forum. Take a look at wonderful posts here.
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    WOW, thanks for the great answers, everyone! I've never done anything ortho-related, I've never even had a clinical on an ortho floor, so I really didn't know what ortho was all about (all I knew was what I've heard from fellow nurses: HEAVY HEAVY HEAVY).

    How often does an ortho patient need to be sent to IMCU/ICU? In my current position I send approx. 2/month... would this be the same on an ortho unit? I suspect that preoperatively ortho patients tend to be healthier than the clientele I currently work with- I'm guessing that this would decrease any IMCU/ICU admissions post-op.
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    Quote from jbee
    WOW, thanks for the great answers, everyone! I've never done anything ortho-related, I've never even had a clinical on an ortho floor, so I really didn't know what ortho was all about (all I knew was what I've heard from fellow nurses: HEAVY HEAVY HEAVY).

    How often does an ortho patient need to be sent to IMCU/ICU? In my current position I send approx. 2/month... would this be the same on an ortho unit? I suspect that preoperatively ortho patients tend to be healthier than the clientele I currently work with- I'm guessing that this would decrease any IMCU/ICU admissions post-op.
    I work on an ortho/ neuro floor and we probably send at least 2 to the ICU in a month. Often times, the hip fractures are elderly and fragile. Some times they need to go to the ICU after surgery. We just had a man the other night code and was sent to the ICU and died a week later. He had surgery to fix his hip and then had a heart attack. We had another lady who actually coded on the table. She was only 64. It is more common than you think.
    sweetgeorgia likes this.
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    jbee,

    I have worked ortho for about 7 years and am nationally certified in it as a speciality. It is heavy work - literally. This isn't to discourage you. But to prepare you. There is lots of bending, lifting, etc. as these folks can't do for themselves. Many are bigger people who need hips or knees replaced partly due to their size. So they are harder to move around. If you have a strong back, and good knees yourself, go for it. You will learn a lot. There are things you will be doing that other floors will call and want your expertise (Solcotrans, overhead trapeze, etc.)

    Good luck! Hope you get the job!
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    Hanging blood. Getting post-ops rating their pain 10/10. Helping people move (very RARELY is anyone up ad lib). Lots of heavy lifting. Giving suppositories. Hanging antibiotics. Changing dressings. Pulling pain pills. Pulling drains. Pulling Foleys. IV starts. The occasional re-admit with site infection.

    Pain pills. PCAs. Pain pills. PCAs. And repeat.

    We send about 1-2 people a month to the ICU. Usually older hip fracture with pre-existing conditions.
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    Quote from sistasoul
    I work on an ortho/ neuro floor and we probably send at least 2 to the ICU in a month. Often times, the hip fractures are elderly and fragile. Some times they need to go to the ICU after surgery. We just had a man the other night code and was sent to the ICU and died a week later. He had surgery to fix his hip and then had a heart attack. We had another lady who actually coded on the table. She was only 64. It is more common than you think.
    Sistasoul,
    You are the second person I've encountered today that has dealt with the Ortho/Neuro floor. I am getting ready to start my hospital orientation there on the first of November. I have been out of school for almost a year and a half, but am still considered a new grad because it is my first job. I really feel I'm forgetting everything that I learned in school because of the gap in time. Can you offer advice on what types of things I should know already going into it? What should I review? What types of things will they know I won't know? I was told they get a lot of new grads on that floor for nights (I'll be working nights), so I definitely see this as being in my favor and am really happy about it! I'd really love your help! Thank you so much!
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    Quote from uscgal09
    Sistasoul,
    You are the second person I've encountered today that has dealt with the Ortho/Neuro floor. I am getting ready to start my hospital orientation there on the first of November. I have been out of school for almost a year and a half, but am still considered a new grad because it is my first job. I really feel I'm forgetting everything that I learned in school because of the gap in time. Can you offer advice on what types of things I should know already going into it? What should I review? What types of things will they know I won't know? I was told they get a lot of new grads on that floor for nights (I'll be working nights), so I definitely see this as being in my favor and am really happy about it! I'd really love your help! Thank you so much!
    Congratulations on getting a job!!
    Ortho- review hip and knee precautions. You will be getting a lot of those types of patients. Also, we get a lot of kyphoplasty for the back. Also, because a lot of our hip patients are elderly you have to watch for post op confusion. Their systems take longer to rid their bodies of the anesthesia/ pain meds than younger people so it is common for them to be confused and pulling IVs and foleys out. With this population they can be very sensitive to narcotics and get confused. A lot of old folks do well with a tylenol/tramadol order every 6 hours.

    For neuro review strokes and change in mental status. A lot of our patients are elderly and come in with change in mental status. Sometimes it is from a UTI but it could be due to dementia or delerium. Young people sometimes have change in mental status also but it is a lot less common. For neuro also review how to do a neuro assessment to check for changes. A stroke can worsen with in the first 24 hours so we do neuro assessments every 2 hours for the first 24 hours. Also, review caring for the elderly as this type of unit gets a lot of elderly. I love my elderly peeps.

    Neuro/ ortho can also have other types of diagnoses thrown in there. We get COPDers, abdominal pain, PNA and the dreaded detoxing patient. Detoxers are probably one of the hardest patients to deal with in my opinion. Review the CIWA and COW scale. These are withdrawal from narcotic and alcohol scales.

    Good luck. Remember there is always a team around you and it is normal to feel overwhelmed at first. Being a nurse is very rewarding and challenging
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    Thank you for this information. I just registered with this site and so happy to be a part of it! I, too, am starting on an ortho unit as of Nov. 2. I am so excited and a bit nervous. Thank you for your input!
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    Quote from dbenjaminRN
    Thank you for this information. I just registered with this site and so happy to be a part of it! I, too, am starting on an ortho unit as of Nov. 2. I am so excited and a bit nervous. Thank you for your input!
    Good luck to you on your new job in Ortho. Keep us posted, and welcome to the forum!
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    Glad to have found this thread. I start on an ortho floor Dec 13


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