Advice For The New Nurse Entering Med-Surg

Specialties Med-Surg

Published

Here is your chance to give some advice and counsel to new RN's and LPN's entering their first clinical job as a nurse. What advice would you give them?

I am going to make this a sticky so that it is always available on the top of the forum for our newer nurses to see right from the start. Looking forward to seeing some of the great advice that our experienced nurses can lend to the newer nurses ..... :balloons:

Specializes in Medical-Surgical.
I don't want to scare you but I'm in my 4th week of training on a Surgical floor and I couldn't imagine being on my own after just a few days! In school one of our teachers told us that if a job was not going to offer you sufficient training time then NOT to take the job, you're only setting yourself up for failure! Again I'm not trying to scare you and I wish you all the luck in the world! Just thought I would share! :)

How are you doing now?

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Need help here.....I've just become an RN after a long career in another field. I've just been hired to start on a med-surg floor and have now completed my 6th shift with my preceptor.

I'm very frustrated with myself and can't help but think that my preceptor is going crazy, even though I continually get positive feedback.

I'm finding that there is so much to "take in" throughout the day, while I normally keep up, I know it's only because I have someone "holding my hand.

I feel as though I'm always asking some of the same questions before it finally "sinks in", while I know I'm slow because I'm scared to death that I'm about to kill my patient by giving the wrong med, wrong time, etc.

During hand-off there seems to be so much info given that much of the info starts to get lost on me, and I feel as though I'm shutting down before I even start the day.

I really want to succeed at this, but am wondering if the stress of this is worth it at my age.

Any advice out there?

Thanks in advance

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Specializes in ICU / PCU / Telemetry / Oncology.
Need help here.....I've just become an RN after a long career in another field. I've just been hired to start on a med-surg floor and have now completed my 6th shift with my preceptor.

I'm very frustrated with myself and can't help but think that my preceptor is going crazy, even though I continually get positive feedback.

I'm finding that there is so much to "take in" throughout the day, while I normally keep up, I know it's only because I have someone "holding my hand.

I feel as though I'm always asking some of the same questions before it finally "sinks in", while I know I'm slow because I'm scared to death that I'm about to kill my patient by giving the wrong med, wrong time, etc.

During hand-off there seems to be so much info given that much of the info starts to get lost on me, and I feel as though I'm shutting down before I even start the day.

I really want to succeed at this, but am wondering if the stress of this is worth it at my age.

Any advice out there?

Thanks in advance

The problem with med-surg is that there are too many patients per nurse, and too many details to keep track of. Ask me if so-and-so has COPD and I will literally pause for 5 seconds to think if that is true. Patients are also sicker now than they were 30 years ago and medications are also more diverse and complex. To get more than 4 patients these days I feel is already substandard care. When the job becomes more about "getting crap done" and less about "lets think about what we need to do to get this patient better care," it's not nursing anymore. And I do think many nurses are simply not programmed to work with more than a couple of patients at a a time. I've been a nurse for 3 years and I still detest having anything above 3 patients. I was once floated to a cardiac stepdown with 3 patients to care for and I felt like I could do it forever. I don't mind being busy at all, but give me a manageable and realistic workload, damnit! This is one reason I want to transition more towards critical care.

Anyway, to answer your question: it takes time to get it. Be more patient with yourself. Your experience sounds a lot like mine when I started and I am also a 2nd career nurse. It's not easy starting over, but the rewards are awaiting you. I now sit here very glad I got to where I am through perseverance and positive thinking, and you can too. Eventually you will get to the point where you will finally get it!

Sent from my iPad using allnurses

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Thanks Pacu, I've just posted this in a new thread, but I certainly appreciate your advice. I'm hopeful that I someday get to that point where I'm confident and that "I do get it".

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I love all the advice here, thank you.. I can't even sleep at night knowing that my first shift on a MS-Post-op floor starts this Tuesday! I am a new nurse, and currently in a speacialty training program that 7 weeks long on my unit. I am just so afraid of making a mistake or not meeting my patients needs.

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Great information, thanks for sharing!

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I have been a nurse for almost 2 years now but just made the big switch to the hospital setting working on a MedSurg floor. I love being a nurse but there are days that I feel like I am so small and don't know anything. I loved reading all the comments of advice from the nurses. It helps make me feel human and normal.

The advice that I would give any new nurse starting on any hospital floor is to ask questions, ask questions, and ask questions!!! It is okay to not know the answers to something and you are not expected to know the answers but you should always ask questions even if you think it is a dumb question.

Asking for advice from a more experienced nurse is important too! There have been many shifts that I just needed some advice to make sure I was making the right decision and they are more than willing to listen and help you out.

Also, if you need help ask for help. Asking for help does not make you a bad nurse. There have been many time that I needed help because my day has been crazy, the most important thing is patient safety. Also if you ask for help there will come a time that you will be able to return the favor. This show that you are a team player and your shifts will get better and better.

Lastly, your nursing assistants are so important and valuable. They need to be shown respect and trust. Having a nursing assistant that is helpful will make all the difference in your shift. They are your eyes and ears when you aren't there and some times they find things that you may have missed. When you show respect to the nursing assistant they will in turn show respect back to you!

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I just want to thank everyone for the awesome advice. I have been working in psych/addictions over a year now and got a little bored so wanted to get into med surg. I'm on a stoke/tele/GM floor. I'm still on orientation but will be on my own soon and am TERRIFIED! Thanks everyone for all the good advice.

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I have been a nurse for almost 2 years now but just made the big switch to the hospital setting working on a MedSurg floor. I love being a nurse but there are days that I feel like I am so small and don't know anything. I loved reading all the comments of advice from the nurses. It helps make me feel human and normal.

The advice that I would give any new nurse starting on any hospital floor is to ask questions, ask questions, and ask questions!!! It is okay to not know the answers to something and you are not expected to know the answers but you should always ask questions even if you think it is a dumb question.

Asking for advice from a more experienced nurse is important too! There have been many shifts that I just needed some advice to make sure I was making the right decision and they are more than willing to listen and help you out.

Also, if you need help ask for help. Asking for help does not make you a bad nurse. There have been many time that I needed help because my day has been crazy, the most important thing is patient safety. Also if you ask for help there will come a time that you will be able to return the favor. This show that you are a team player and your shifts will get better and better.

Lastly, your nursing assistants are so important and valuable. They need to be shown respect and trust. Having a nursing assistant that is helpful will make all the difference in your shift. They are your eyes and ears when you aren't there and some times they find things that you may have missed. When you show respect to the nursing assistant they will in turn show respect back to you!

Thank you so much for posting this. I am a new nurse in MedSurg and feel so slow and incompetent. I have only been on my own for 1 week. Already, there have been days that I feel as though I've made a mistake and days that I love it. I work with an amazing team, but feel as though I am not as competent as the other nurses, including the new ones. I hope that I get better and soon!

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Is it better to round with the doctors when they come to the floor so we know the plan, or is it better to get ur meds and get them passed on time?

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Thank you! I'm a brand new nurse who is older and I start my first job in two days. I wanted med-surg for the skills and experience that I will gain as a new nurse. I'm so scared and excited! I will be serving our nation's veterans. Hoo-rah!

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Specializes in Med-surg, telemetry, oncology, rehab, LTC, ALF.

Learn how to take and give report quickly and efficiently. You don't have to write down everything that your coworker tells you when they give you report, but you should always have on hand: when the pt was admitted, their admitting dx, their code status, their treatment team, what we're treating them for, any drains/tubes/lines, any upcoming tests/procedures, any fluids running, their diet, how they ambulate, etc. You can always write down more later if you wish, but these are the basics. You want to learn the art of giving a complete and accurate report without holding up that nurse with an overly long report that will also hold up your coworkers needing to give report to the same nurse. It takes practice, but it's totally possible.

Stick as many people as you can until you become comfortable at doing it. Offer to do the blood draws for central lines for your coworkers. Volunteer to insert Foleys. Volunteer to take the difficult patients - the patients that nobody else wants because they're needy, drug addicted, in restraints, whatever it may be. Do as much as you can and experience as much as you can during your first six months on the unit. You won't regret it, I promise. It's the only way to gain the skills that you need to work any area of acute care.

Ask your coworkers for advice, and be prepared to use what they tell you. You might be surprised at what you hear, but you will likely be a better nurse for knowing where to improve or how to handle a certain situation.

Most importantly, don't panic - even when you have to call a rapid response or code blue. No situation is made better by panicking.

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