Help!

medsurg is hard for a new nurse..but if you can make it there you can make it anywhere

do anything ahead of time, i don't know what kind of charting you do..but if you can make notes to yourself as you go along that helps..talking to patients and assessing as you go..admits and emergencies are something that you have to deal with . never gets to be fun but if you can get a 'system' you can get the info for charting and for giving report

good luck i know you will get the hang of it

I work Med-Surg, too, and we still do paper charting. That takes a lot of time! There are a few things I've found that work well for me. Here they are:

Once the Dr. has reviewed the nurses notes on rounds I retrieve them and lock them away in the room-side medication cabinets. Then, I just chart as I go.

Even this has taken awhile to develop and keep up with, however, it's so much better than not having the opportunity to open a chart until shift is over or nearly so. It also eliminates a lot of wasted time by having to write the information twice...once for my notes, and again on the pt.'s chart.

On admits I do the majority of my head-to-toe assessments while preparing the pt. for transfer to the in-pt. bed. In that initial meeting I try to remember to ask as many in-take questions as I possibly can. I've found this takes much less time than having to return to the pt. later to gather this info. This way I also learn a great deal about my new pt. in a very short amount of time.

Here, on new admits, the Nurse has a HUGE stack of papers to shuffle and complete! I take a few minutes to sort-out and separately paper-clip the pt. information sheets, the sheets I must fill-out, and the pt. history information. This gives me a sense of organization and seems to make things much simplier.

As far as discharge, the majority of mine take forever again due to the paperwork. It takes as much paper to get out of the place as it did to get into it! Once I get the Dr.'s orders and before I can begin the process I talk to my pt. about their orders, review their condition and treatment and ask them if they have questions. I also tell them the process takes time to complete. This way they generally arn't "biting at the bit" and pacing to leave. They KNOW the process takes time. Then, by the time everything is in hand I just review the discharge information with the pt. Nine times out of ten the pt. has thought of a few new questions to ask and feels much more comfortable with his/her discharge. I do, too!

I hope some of these examples are of benefit to you.

I'll be checking into this thread to see what others do to organize their pt. cares. Lord only knows that Med-Surg Nurses move fast and every minute counts!! I'm not dissing any other specialty. I'm just acknowledging the chaos in my own.

Med/surg is very tough for a new nurse! The best thing to do is develop a good "brains" system. I made sheets on my computer at home, then made copies and brought them to work. On the front, I included report info, head-to-toe assessment, etc. On the back, I had it organized by hours of the day, and I would write in what needed to be done for a pt. (So then for each pt, I would have a full plan for the day.) Then when an order was completed or the med was given, I would check it off. (Otherwise, I would never be able to remember what I did/didn't do.)

Throughout the day, new things come up that you can't anticipate, but I would always have my original brains that I could go back to, which helped me get back on track. And when the new orders came in, I would just insert them onto my masterplan, and check them off when they were done.

Honestly, it will become easier the longer you do it. You will become more familiar with things and you'll be able to anticipate things better, making you more efficient. Plus, with experience you'll be also to zero in on what's important, and what is less of a priority. That all will come with time. Just try to stick it out for now.

As you get organised and know the routine of the ward it does become easier, I am looking for WEB sites about Pharmacological Management of patients by a Registered Nurse, can anyone help!