Med Surge

futurecnm · May 24, 2007

Hi, I'm just wandering if anyone can tell me about med surge. I am just starting my clinicals and I am scared to death. I heard whatever this is makes you or breaks you. Could someone explain what this consists of doing? I am a fairly good student, but I get nervous under pressure. I really want to know, is it as bad as I am hearing?

I'm not sure what you mean by makes or breaks you, I hadn't heard that. Med-surg is where most students start clinicals because it is general adult acute care. You will see a lot of different types of patients with various reasons for being in the hospital. It is a good starting point for getting exposed to hospital care. You will start out doing basic cares of your patients - vital signs, bed baths, bathroom cares, etc. You will then move on to doing dressing changes, catheter care, IV care, more of the medical stuff. You will work on documentation a lot, very important!

In our first semester we did not pass meds but we did our 2nd semester. Then you will get to pass oral meds, do injections, change IV bags.

YOu will learn as you go.

suzy253, RN · May 24, 2007

You'll certainly see a variety of cases, patients, ailments. It's all part of the learning experience.

colleennurse, ASN, RN · May 24, 2007

As some of the other posters said, you will see a variety of medical diagnoses and surgical patients. It is a good area to see all kinds of stuff. Don't be nervous about your clinical, you are there to learn and you will not be alone. I think people say bad things about med/surg because you get a wide range of things vs being in a specialty area such as psych or OB/GYN where you generally deal with things that only pertain to that specialty. Med surg is also pretty fast paced and the employee turn over on a med surg unit is probably higher than in a specialty area which makes it difficult for the nurses working there. But as a student you do not need to worry about things like turnover, you are there to learn. Personally med surg was my favorite clinical because that is where you get to do the most hands on nursing stuff :) Good luck and relax!

Faeriewand, ASN, RN · May 25, 2007

Don't be afraid, it is so much fun! I am in my first med-surge clinical and I was so scared and not looking forward to it. Now I absolutely love it! Let me tell you about mine so you get an idea from a new student perspective. I am in my second semester of school.

I have already learned how to pass meds on a meds rotation for one week, then came back to this facility to take care of my patient and pass her meds. We only have one patient this rotation. Most students have two but not with our teacher this time. I go in early in the morning and get my pt's vitals and ask about pain level. do an assessment. Then it is usually time to pass the trays (breakfast) in between we answer call lights. Very busy in the morning. cleaned up two people the other day before I could even get in to see my pt. All the students help each other out, especially if the pt is large. We need to know when was the pt's last BM. We need to give our pt a bed bath or help someone else give a bed bath.

Today I was the first student on our rotation to get to do a TWE. Everyone asked if they could watch! LOL! I had plenty of help! The teacher stood way back so as not to get hit :) Well that didn't occur but everyone was very excited to participate LOL Our instructor stands right with us to check our meds. We have to go in the day before to read the pt chart and get a list of their meds. Then we have to look them all up and write everything down. On clinical day I have my list ready and ask the nurse to unlock the cart and I pull the meds and put them all in order. The instructor comes by and we check them off together in the MAR and I crush what I can and put them in applesauce, the liquid ones are mixed in with orange juice. We go together into my pt room to give them. Then we go back to the MAR and sign off that they were given. The instructor is always available. I've done blood glucose checks and given injections of insulin for coverage. Also heparin, and darbepoetin alfa. Meds need to be passed by about 9am but its ok to go a little early or a little late.

There are CNA's that work there and they are a great help to the students. And they really appreciate the students being there and making their work load a little easier. The nurses love us too. They are always asking us to go do an Accu check for them (blood glucose). I was with an RN today and she showed me and the rest of the students how to change the dressing on a PICC line which was a sterile procedure. Every student has to do a care plan on their patient due every week.

There are a lot of older people as patients. Many have wounds. Some have had falls and gotten a hip fracture. The wounds are taken care of by the wound care nurse and they have a vacuum attached to them to help heal them. Yesterday the wound care nurse came in and removed the dressing and sponges from my patient's sacral decubitis ulcer and it was soooooo large. Definitely a stage 4.

You will do lots of things for lots of people and you will stay busy. :) What fun! After this you will be able to do anything!

Psqrd · May 25, 2007

Having just passed second semester and moving on of my ADN, the most important advice I can give is to get a good time table sheet that you can put all your activities that you need to get accomplished on and at what time they need to be done.

We called it our brains...you could put med admin times on it as well as vital that you have taken instead of a piece of scratch paper...the people that had a hard time in med surg where the ones that had poor time management skills.

Good luck, don't be scared...be open to new things and learn as much as you can.

P2

here is an example that I used...I modified one provided by my CI to fit what I liked and you can change it anyway you want as well...its for you, to help you.

Timeline.doc

Faeriewand, ASN, RN · May 27, 2007

Thanks for the timeline document Psgrd. I think that may help me and my fellow students a lot! :)