Any advice for a new ortho nurse

minnib · Mar 22, 2005

Hi New Nurse,

I am an LPN on my ortho unit(rehab not acute, although I work on acute at times) and I love it! Our patients are mostly stable but be on the lookout for the surprize pt that goes bad. PLEASE be aware if you are on the acute side you have a whole different set of rules because these pts are postop, sent from PACU and you have vitals usually q 4 and drains and bleeding, infection to worry about esp. in the 1st 24hrs

Anyway lets see here...my best tips are...

1. buy yourself a good ortho nursing book, understand all of the ortho procedures(e.g. difference between arthroplasty and a total hip replacement)

2. know your a&p, some carry those 1 page laminated anatomy sheets.

3. know how to position, transfer your ortho pt based on what they had done.

4. know s/s of what can go wrong with whatever procedure that done.

5. INSPECT that dressing!!! and MAKE SURE you understand the Docs questions about the dressing changes, usually the surgeon does the 1st one

6. understand what parameters are set to call the DOC e.g. high temp, bleeding amount, increased pain, etc.

7. teach your pts about CDB, i can't tell how many pts miss this part..never assume.. always reinforce post op, safety, and whatever else you think pts need to know.

I am sure I can think of lots of others..but I am getting sleepy..so email me if you want.good luck!

Always ask the experienced ortho nurses, they are great and are use to teaching!

sincerely,

minnib

minnib · Mar 22, 2005

Sorry I ment to write...Hi Nice Nurse :coollook:

Tweety, BSN, RN · Mar 22, 2005

Welcome!

Great post above. I work in trauma med surg and take care of a lot of ortho patients.

Always be on the lookout for pulmonary embolism and dvt. Take seriously anti-embolism treatment.

Learn and be wary of compartment syndrome.

Good luck!

nancimarie · Jun 3, 2005

Hi all

I'm a nurse on the OB unit and interviewed yesterday for a clinic orthopedic nurse position. It's sound like an awesome job, any other clinic orthopedic nurses out there to talk to?

Hi everyone. I would appreciate any helpful tips and advice for a new ortho nurse. Your experience can make definitely help me learn. Thanks for your time!!!!!!

LittledebX2 · Jun 3, 2005

Hi everyone. I would appreciate any helpful tips and advice for a new ortho nurse. Your experience can make definitely help me learn. Thanks for your time!!!!!!

hi there,

i think i have insight to ortho patients, because i myself have had 15 separate surgeries all ortho.

myself as a patient, pain control was the biggest issue, these pts have more pain than most esp if they have back surgery. i think these are your most challenging pts. as far pain, infection, mobility, and other complications.

most importantly, if a patient asked you for something for pain, it should take you no longer than 5-10mins to go and get it and to give it. nothing was more frustrating as a patient to ask for pain meds and have to wait for 30 mins or even longer sometimes. unless you have an absolute emergency, that should be your priority. just go and get whatever med it is right away.

also, turning, coughing and deep breathing is very important to all othro patients, but esp true for the older population.

i worked on an icu step-down unit and unfortunately we received alot of pts from our ortho unit, mainly because the nurse would go in give a pt some sort of narcotic, and then walk out of the room and not go back to check on them. never, and i mean never give a narc and walk out, you should stay in the room a minimum of 5 mins to make sure they are doing ok.

anyway i hope it helps.

jax · Jun 3, 2005

I agree with many of the above posters.

Know the signs and symptoms of compartment syndrome.

Assess each and every pt for dvt/pe signs - use the teds and encourage triflow/deep breathing.

Understand the mobility status of your pts, and make sure they understand.

Know the signs of drug/alcohol withdrawal ask your pt's what they use/drink.

Make sure they've got a buzzer handy.

Start them on a bowel programme as soon as they roll in the door, especially your multitraumas.

Even if both arms are in gallows slings, their pelvis has sprung open, and they have casts on both legs - encourage any independence possible.

good luck

nancimarie · Jul 30, 2005

Well, I took the job and start August 6th, still no advice from anyone out there?

Help....

Hi all
I'm a nurse on the OB unit and interviewed yesterday for a clinic orthopedic nurse position. It's sound like an awesome job, any other clinic orthopedic nurses out there to talk to?

**RosesrReder, BSN, MSN, RN** · Jul 30, 2005

Not a nurse, but do want to wish you the best of luck. :)

PMHNP10 · Jul 30, 2005

Hi everyone. I would appreciate any helpful tips and advice for a new ortho nurse. Your experience can make definitely help me learn. Thanks for your time!!!!!!

Excellent points from all, but I have a couple I feel I should add. Don't lift/turn a patient by yourself. Also, learn (if you don't already know) body mechanics for lifting/turning patients. It'll save your career because you will be doing alot of it. Hopefully you will get an orientation with PT; pay very close attention, offer to be the guinea pig to demonstrate if the opportunity arises.

AtlantaRN, RN · Jul 30, 2005

My first position in the hospital setting was an ortho/neuro unit. I was precepted by an experienced ortho nurse, and learned, learned, learned! Ask ALOT of questions!!

Find a mentor that can help you, an experienced nurse with an upbeat attitude

Congratulations to you!

atlantarn

Riseupandnurse · Aug 18, 2005

I have been an ortho nurse for 16 years. PAIN is such a big issue with ortho patients. One trick I found out on night shift was that if your patient was given morphine or Demerol and is still having unacceptable levels of pain, often you can stop it simply by adding tylenol. Also, ice everywhere it hurts. (30 minutes on, 30 minutes off). Buys you time for the medicine to kick in. And there is a lot more blood than in many other specialties. When I first started, I was concerned about so much blood on dressings. I would ask the ortho surgeons about it, and finally one said, "Don't bother me about bleeding unless it's dripping on the floor and making a big puddle!" Of course we watch their b/p and their H&Hs, especially after total knees and fixators. But dressings, we reinforce and go on.