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jmiraRN jmiraRN (Member)

joining Med-Surg after 5 years

Med-Surg   (1,231 Views 8 Comments)
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Hi AN friends,

Looking for tips and tricks, and recs for study tools or courses to help make a smooth transition into medsurg.

I am making the switch to Med-surg 5 years now into my career as an RN. I worked as a CNA as a float, and then once an RN I went straight into acute psych. My most recent job took lots of patients with chronic medical issues, medical detoxers, pts with IVs, and even PPN and straight cath when needed. it wasnt every day but usually at least 1 with an IV. I have had the urge and desire for a bit now to make the leap back into medical patients. I want to grow and change and utilize myself in different ways. I also am somewhat burned out on psych. Theres only so many times one can be hit, called a Fu#&ing Bi&@h, and get threatened to be killed before it gets old.

Long story short I always admired Med Surg nursing, to me thats the heart of nursing. MedSurg nurses are rugged and do it all, and I chose the medsurg position over both neuro and oncology becuase this is where I feel I am being pulled at this time. and Im EXCITED about it.

I want to be as prepared as possible on the floor and do my best. just looking for some good advice to help me prepare best. Thanks!!

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Well, I'll give this a shot. I've been a nurse for a LOOOONG time, and I've done all sort of things at various levels. But I've never been "just" a Med/Surg Nurse. I say "just," because I always had to be Supervisor, ER Nurse, etc in combination with taking a regular assignment. I've also taken time off from nursing-a couple of times without the intention of coming back. Anyway, I just started a job as a Med/Surg Nurse on a 18+ bed floor. Yes, I'll have to do Charge, but it'll rotate. Anyway, after a couple weeks of orientation, it seems to me that there are some things you'll want to have pretty good command of: basic assessment skills: v/s, level of orientation, breath sounds, heart sounds, pulses, wound classification, IV insertion and maintenance, and the meds-especially the cardiac and b/p meds. Also, BLS. I don't think it's a good idea for new/returning nurses to do ACLS too soon. Learn your BLS and let the more experienced folks do the ACLS until you get more experience. Also, get yourself a good stethoscope and an organizing tool that works for you. It should allow you to keep track of 4-8 patients, and include pt's name, rm#, DOB or age, date of adm, adm diagnosis, code status, brief list of Prior Medical History, BRIEF History of Present Illness, Systems Review, v/s trends, pertinent problems, and a place to list the things you need to do during your shift, organized by time. Leave yourself room to write notes regarding your shift's events. With all that in place, you'll be in fine shape. Keep us posted! And

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how is it going? Im leaving hospice after 5 years to go back to med surg. really nervous as I have been away bedside for so long.

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how is it going? I'm leaving hospice after 5 years to go back to med surge. really nervous as I have been away from the bedside for so long.

I was away from Medical-Surgical Nursing for 6 years and returned to it several years ago without a huge problem. In fact, nurses who told me that they left a particular specialty for a long time, recalled and likened returning to that particular specialty as similar to relearning to ride a bike..... It all comes back to you through muscle memory and past experience... Review the things that you have forgotten and practice the things at which you are a bit rusty and you should be fine. Remember, you are not a new graduate nurse, so you have more potential to be successful then you did when you first started out in nursing. Good luck!

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On 12/4/2018 at 2:43 PM, SavvyRN2018 said:

how is it going? Im leaving hospice after 5 years to go back to med surg. really nervous as I have been away bedside for so long.

Hi 👋🏼 

actually not a tough transition. Been doing good. All those years of experience definitely help on the floor. A lot of what We do like assessments and meds and dealing with drs and family members is just like dealing with them on any floor. There are things like equipment or tubes that I have no clue about but I just ask someone who does and have them watch me do it and then I know. I try to jump at opportunities so that I can learn them. I’m not the best IV start but I give it my best and there’s always a couple IV masters on the unit that are more than happy to jump in. 

With all that said, it is busy busy busy, even crazy busy some days on Med surg because it’s a heavy patient load and just remind yourself you can only do what you can do. Offer help to your aids and fellow nurses when you can because a team is integral 

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On 12/4/2018 at 7:35 PM, SummerGarden said:

I was away from Medical-Surgical Nursing for 6 years and returned to it several years ago without a huge problem. In fact, nurses who told me that they left a particular specialty for a long time, recalled and likened returning to that particular specialty as similar to relearning to ride a bike..... It all comes back to you through muscle memory and past experience... Review the things that you have forgotten and practice the things at which you are a bit rusty and you should be fine. Remember, you are not a new graduate nurse, so you have more potential to be successful then you did when you first started out in nursing. Good luck!

Yes!! I thought for sure I would have lost some of my skills and knowledge but nope it really is like hopping back on that bike! My years of psych have helped me a lot now in med surg, and as far as hospice we do comfort/peaceful transition cares all the time. I can imagine how helpful that hospice experience will be 

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On 9/5/2018 at 10:27 PM, bd2rn said:

Well, I'll give this a shot. I've been a nurse for a LOOOONG time, and I've done all sort of things at various levels. But I've never been "just" a Med/Surg Nurse. I say "just," because I always had to be Supervisor, ER Nurse, etc in combination with taking a regular assignment. I've also taken time off from nursing-a couple of times without the intention of coming back. Anyway, I just started a job as a Med/Surg Nurse on a 18+ bed floor. Yes, I'll have to do Charge, but it'll rotate. Anyway, after a couple weeks of orientation, it seems to me that there are some things you'll want to have pretty good command of: basic assessment skills: v/s, level of orientation, breath sounds, heart sounds, pulses, wound classification, IV insertion and maintenance, and the meds-especially the cardiac and b/p meds. Also, BLS. I don't think it's a good idea for new/returning nurses to do ACLS too soon. Learn your BLS and let the more experienced folks do the ACLS until you get more experience. Also, get yourself a good stethoscope and an organizing tool that works for you. It should allow you to keep track of 4-8 patients, and include pt's name, rm#, DOB or age, date of adm, adm diagnosis, code status, brief list of Prior Medical History, BRIEF History of Present Illness, Systems Review, v/s trends, pertinent problems, and a place to list the things you need to do during your shift, organized by time. Leave yourself room to write notes regarding your shift's events. With all that in place, you'll be in fine shape. Keep us posted! And

Thank you for replying, your responses are great. Organizing is key! Sometimes between discharges and transfers and admits we go through 10 patients and gotta know everything about all of them, a good brains is very helpful 

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