Experienced LTC Nurse Moving Onto Med Surg... And Terrified!

[BosLav, MSN]

I have been a nurse for just over 6 years, having worked in pediatric LTC and home health for 4 years, and geriatric LTC and hospice for 2 years. I've also always worked night shift, and love it!

My local hospital was looking for a FT med surg nurse for night shift, and so I jumped on it, and was hired. I start in 3 weeks, and am SO nervous. Although I've been a nurse for a while and am comfortable in my skillset, this is a whole different realm of nursing for me.

I also currently work in an unskilled LTC setting (no IV infusions, no G-tubes, J-tubes, trachs, vents, etc). Most residents are on PO meds, and you may have the occasional dressing change... But no skilled nursing. And so I feel like some of my skills needed for med surg are either non-existent, or really rusty.

My new manager is completely aware that I'm coming from an unskilled nursing home, and assured me that I would have 6-8 weeks of orientation, with additional training if needed. But I'm still so nervous! Any tips, pointers (or even just some words of encouragement!) would be much appreciated.

Thank you! ?

[Nursegrape7000, BSN, RN]

Breathe, you'll be fine. ? If it is a job worth staying in, they will give you opportunities to learn - they can't expect you to be a Med-Surg nurse if you've never been one! Just show up, learn everything you can, look for opportunities to see new things, ask questions. Take notes, and study a bit on your off time.

Before you get there, refresh yourself on the patho of the types of patients you will see on your unit. Review common meds, skills, and processes (eg. BLS, common lab values, types of IV fluids..). There is a ton of great information on the internet for free, even on Youtube if you learn better visually.

Med-Surg work is typically busy so mentally prepare yourself for learning time management stuff from your co-workers. For me, a big part of this was to show up early to look up my patient, their meds, and create a to-do list for the shift. Most importantly, understand at times you will have to slow down and make yourself take big deep breaths when you are feeling overwhelmed. Make sure you take your full break! It gets easier and you will find your system.

Working nights, you may find you have extra time for asking questions and looking things up too! There will be less people there and less commotion, generally. When I switched from Med-Surg to ICU I did nights first and it helped immensely.

Good luck!! :)

[Guest1149026]

Hey BossLav,

You’ll be fine! This was my exact position last year. My entire career (LPN & RN) prior to last year was in LTC and rehab. I decided to take the plunge into med surg (nights just like you) and don’t regret a moment of it. I got 5-6 weeks of orientation and I felt okay to function.

First of all, the knowledge is the same. I initially thought I would be ill-prepared due to a lack of experience with things like IV placement and other skills but I came to realize that I could function due to the other skills I had as a nursing home nurse. We know how to manage time better than anyone, assess large volumes of information in a short amount of time, and prioritize care due to the large volume of patients seen on one shift. Those skills are valuable to acute med surg and you’ll pick up the skills along the way.

Prepare yourself by purchasing a pocket med surg guide- I found a great one on Amazon. It helps you to review the lab values, assessments, and other tools you’ll need in med surg. Have tools like a penlight, stethoscope, and a clipboard for shift handoff report

Finally, accept that you won’t know everything so be prepared to learn. Since it’s a new place, policies and skills will be different. But acknowledge what you don’t know, research it, and be prepared to attack it with an open mind. It’s been 1 year for me and I’ve trained new grads and floated to different med surg units. Just breathe and be confident in yourself :-)