Please give me so idea of your experiences-- med surg

[sunbug]

sorry for the mis spell...ment to say please give me some ideas of your experiences!!

I have my first clinical rotation on Med/surg floor next week.. In our school we have only one chance to pass the clinical rotation by a careplan and assesment test.

Oh so lucky for me... I get the test on the first week of first clinical rotation!!

Need some Ideas of what to expect as part of Med/surg so I can be at least half way prepared.

Im thinking some cath care, maybe some wound care??? Im I on the wrong tract?

Please let me know some of what you experienced on Med/surg so I can get my thinking goiing in the right direction.

My school is pretty messed up...Its an accelerated 9 month ...that means we did medsurg book LAST semester.

And our teacher doesnt give us any practice skills to do! just one test and we passed for the caths, thats it.

So this is kind of like a self taught 9 month school it was very competative to get into

but...didnt realize that it was basically self taught untill it started and found I had a first year teacher that is still going through her masters program!!!!

ANY HELP as to what I need to be expecting to assess or do would be greatly appreciated..

[JennNJ83]

it depends on your instructor, i did a lot of bed baths and oral care, some of my classmates in other groups did a lot of iv's caths and wound care. Good luck!!

[Morgan0429]

I work on med/surg unit and it is a lot of foleys, drains, ostomy care are a few of the things we have a lot of.

[CMille14]

Most of the patients on the med surg floor during the clinicals I recently completed were COPD or CHF. We also saw patients with various stages of renal failure, pancreatitis, and cancer.

[sunbug]

thanks for all the replies!

I did my rotation.

My patient had apendectomy...which ment drains, jp and pennrose, picc line, urinary cath.

Also shadowed for lots of chronic liver failures,

was able to : (we will be able to do meds next semester so for now this is what I got)

the normal full patient assesment

q2 q4 hr patient assesments

lab analysis

asses for psychological/social needs

Asses medication effects, (i had lots of drying mucus membranes and thirsts)

Know your patients MEDs and SIDE EFFECTS.. they will sometimes freak out thinking they have a new symptom...

I got a droid phone and downloaded Esocretes drug ref. so I could easily look up SE for whatever.

pallitive care

post mort care

drain d/c

cath d/c

iv d/c

watch line flushes

watch central line blood draw for culture

wound care, cleaning, dressing, assesment

first ambulations after surg

enemas

vitals, adls

glucos monitoring

I/O monitoring

patient teaching/keeping their mentality stable!! (lots)

teaching family...including them in care

It was a great experience,

All my training DID kick in!

ESpecially with Blood Pressures , pulse , RR ,O2, pco2 levels and input output, glucose levels,signs of infection

( I also suggest you know how to educate the patient on pain management, and ambulation, and what the goals of both are. They do so much better when they understand it and you can remind them what you talked about. Especially male patients and the pain management!)

If you dont know anything else....Get these things Down-- I wrote these on an index card , just in case I did forget... what ever helps you.

The other stuff, the nurses or instructors are there to help with.

You get everything on MED/sURG!!! LOveD IT

[jjjoy, LPN]

I think a lot of nursing programs tend to fall into the "self-teach" model. I know that it's impossible for nursing school to prepare students for everything and students do need to learn to teach themselves, but some schools seem to provide little in the way of instruction or guidance, just offering the clinical exposure and evaluation. I know at my school, lectures just seemed to be a rushed cramming of the text, without any extra depth or explanation, no time for questions. We were turned loose on our first patients having only practiced make-believe bed baths on each other. And each instructor's care plan expectations only expressed by ripping apart the first one or two turned in.

It seems that they could've paired us with a CNA to do a whole morning of bed baths before sending us in to do it on our own, and that instructors could've given out sample care plans to follow so that you knew how they wanted theirs structured. I know that they don't want to students to learn bad habits from experienced staff who may cut corners or mindlessly copy a care plan, but I don't see that having students fumble through, having to 're-invent the wheel' each step of the way is a better method.

Despite any frustration you may have about your school's teaching methods, it sounds like you're on a good start of making the most of your clinical experience!

[sunbug]

Yes JJOY,

Im loving the clinical because it makes the books seem more sensible , and all the semi- random numbers and memorizing just seem to come together there in the hospital.

I agree the school couldnt prepare students for every thing.

On the careplan thing!

I guess "thats just how its taught"

Im still on shaky ground about those. But as a problem comes up then I take the oppourtunity to pick my

instructors brain for what she wants. I kind of end up getting the "answer" from her, and have found I am starting to "get it". (an example sheet would have been nice !!)

My instructor is nice,,and I think doing best she know how at this point in her teaching career. Shes definitly trying to help us pass her class.

Im there to get the most out of what I can before I have to go do this for Real!!

[Fiona59]

thanks for all the replies!

I did my rotation.

My patient had apendectomy...which ment drains, jp and pennrose, picc line, urinary cath.

Also shadowed for lots of chronic liver failures,

The other stuff, the nurses or instructors are there to help with.

You get everything on MED/sURG!!! LOveD IT

OK, that is NOT a typical appi. A typical appi is done via laprascopic procedure and should have none of the above bar an iv site. It sounds like you had a patient who had a hot appi or other pre-existing conditions.

A routine appi comes back with an iv running, is dangled by four hours post op, up and walking to the toilet. Drains equal infection and a need for drainage. PICC never heard of an appi getting one, for starters they are far to expensive, and why on earth was a foley in situ?

Need to know more about this patient.

[sunbug]

Yes..it wasnt typical

it was open surg.

patient had been on a 40 day fast (some determination in that person).....lemon juice, cayane pepper , and maple syrup..and wbc went way down and everything was way off

had an appi explosion,, also found cyst they removed, possible parisite infection also.

i got patient when first came out of surg. had them for a week.

they were going to be in there longer, a few weeks or so..the PIcc line was given.

had lots of stuff to watch for with this patient.. it was nice intro to med surg