Advice For The New Nurse Entering Med-Surg - page 7

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... Read More

  1. by   Daytonite
    hi, alisa!

    er and or are pretty much considered specialty areas/intensive care areas. do you think you are ready for the stress of working in them? they require special orientation and training. i don't recommend telemetry units as a starting unit for any new grad. i worked for many years on a telemetry/stepdown unit. they are a derivative of med/surg, but semi-intensive care oriented. i've seen too many new grads go down in flames on these units. most hospitals have difficulty staffing telemetry units and a lot, because of their staffing needs, seem to have no qualms about putting new grads there and then failing to give them the support they need to thrive. my recommendation: a nice surgical unit, either a general post-op surgical unit or orthopedic unit. things are more routine on these units which is a help when you are trying to learn to perfect your time management skills and prioritizing. medical units can be ok too if you have good support, but they can be hectic since you will see a very, very wide variety of medical conditions.

    ultimately, you have to make the final decision, but don't put all your eggs in one basket. go back and tell these hospitals that you've made a decision and want _______. you won't be limiting yourself. you need to be on one unit for at least a year learning the above skills (time management and prioritizing) in addition to honing the other hands-on nursing skills you only touched upon in nursing school. after a year or two of seasoning you can move on to another type of nursing unit within the same institution. you will have also proven your worth as a good employee by then as well, so keep your attendance record clean.
  2. by   Daisey357
    I am a nursing student entering my clinical rotation. We have been told to research and make-up Diagnosis Cards for common illnesses seen in med-surg nursing. Would anyone have suggestions of illnesses that are most common that i could start researching and completing my cards? Thank you for any help you can offer.
  3. by   cdunnahoe
    You guy's have pretty much helped me to continue my Med/sur career. I love all of the uplifting advise. I hope I will be adding more in the new future. Keep up the good work.
  4. by   kathykaye
    thanks for this thread... i just started working last monday (1 week).. i graduated last yr and didnt work in a hospital immediately after my graduation and local board exam here in the philippines. i concentrated first on finishing the NCLEX and TOEFL/TSE exams before i start to find a work. i was very anxious, scared and excited coz it's my first time to work.. during my first week, i feel so frustrated, depressed and dumb.. i feel like i dont do my work efficiently.. i always feel i missed something.. im so anxious that i might do a mistake...

    is it normal to feel this way during your first time at work? but little by little im coping and adapting..
  5. by   HeatherRN2006
    All of these posts mean SO much to me!

    I just graduated nursing school in June. I just passed my boards and currently looking for work. I am anxious, nervous, excited, and scared. Luckily I have a wonderful nurse who precepted me last semester at school who gave me her home and cell number just to call whenever I'm feeling upset, happy, mad...

    I am not as assertive as I'd like to be and I am scared most of being eaten alive OR not trusting my gut and doing something stupid to put a patient at risk OR burning out. I hope most that I will be able pull through my first year...
  6. by   HeatherRN2006
    Quote from DClark327
    Thank you for all your advice. I will need all the advice I can get. I just started my preceptorship and I am scared as hell. I am trying to keep my composure but it is difficult at times. Many of the RNs on the Med-Surg unit are not very nice to me and when I ask questions they make comments that make me want to crawl in a hole. My Preceptor is nice but she doesn't seem to want the position. I think she was kind of pushed into it by a superior. To make things worse my clinical instructor/Liason is hard to get a hold of. I feel very alone and am trying not to give up. Any advice?
    I'm not sure if this will help because everyone is different but I'll tell you what I did in a similar situation. I chose ICU as my preceptorship. After doing a couple days I was so burnt out that I felt like crying during and after my shift. The RNs there including my preceptor were not incredibly welcoming and made comments about other nurses (new RNs, floats) that were not familiar with the floor. I couldn't help but think what they thought of me. I ended up confiding in my clinical instructor. We had a meeting with the preceptor and clinical instructor. I chose to transfer to Med-Surg. It was the best choice I made. Ultimately, I realized that being burnt out was not going to help my patients in the ICU.

    The only advice I could give you is do you what you feel right. If you are unable to contact your clinical instructor confide in a professor and see what they say. Maybe if you're comfortable, talk to the preceptor.
  7. by   aquarius11
    I am a new nurse and am almost off of orientation to my horror. One of my concerns is speaking with the doctors and I am learning to be prepared with my patient's info. when they call. I have also found that in taking verbal orders you need to be able to clarify exactly what the doctors wants because sometimes they do not say exactly how they want an order. For example- Tylenol 1-2 tabs q 4-6 hrs.
    I always forget to ask if they want the patient to receive this from now on or as needed, which means that I am constantly calling doctors back to clarify something because I did not think to ask certain questions when they first gave the order.
  8. by   smileysenior
    Advice for new nurses entering medsurg: DONT. I have been at it 4 months and I hate it. Don't it isnt worth it. Trust me.
  9. by   DolphinRN84
    Some good advice here. I'm currently STILL looking for a job, but I know I definitely want to start out in med/surg since I don't know what I want to specialize in.

    Smileysenior: I read a post from you about how you hated med/surg. I've also had people say that med/surg wasn't that great. Maybe it's just the facility that you're at. I wish you the best of luck though. Hoping you find something better.
  10. by   AprylLPN
    I just graduated in August and have recently started my new job on Med/Surg. I really love it so far, and the only trouble that I have gotten is from a select few seasoned nurses. I really dont understand why you would want to give someone new so much trouble. But thankfully the nice nurses have out wieghed the bad.

    I have had moments when I feel really stupid. I am not sure how to give report effectively, there are lots of drugs that I am fuzzy on, and a list of other things. I really appreciate the encouraging words, they have made me feel much better!
  11. by   Madame Poppy Pomfrey
    Hello! I just got off my first 3-11 shift on med surg and I feel like quitting. I started on orientation 8 weeks ago day shift and that seemed like hell but then I sort of got in a routine and now I am with a whole new crew. I graduated from a BSN program in August, I just took my boards and passed a few days ago but but my state board hasn't made it official yet. Anyway, I don't know some of these postings are really uplifting and they give me the motivation to stick it out but the place thatI work for is NUTS! It is a very hostile work environment. Everyone talks about everyone, complains about everyone, rolls their eyes about every little thing. They will even do this to you on your first day on the job!!! Some of my classmates started there and verified this behavior as well, one even quit already between the behaviors and the overwhelming work load esp. for a new graduate. My final straw tonight was when a June graduate today not only invalidated my "unofficial passing the boards" results from Pearson Vue by stating, "well my results were on the State website in 2 days" (this is the time of year for my state to be held up with updates because they have reregistration deadline for Oct. 31. Her tone was very condesending. But she had to cosign an insulin with me and remided me about checking orders on it because she was new (I had the pt on dayshift before and knew the insulin was changed) But anyway I thanked her for the helpful reminder because I'm new too and I figured that this would foster coworker commaraderie (spelling?) well my mistake she jumped all over an order that I had verified on dayshift that followed her and she told me it wasn't done properly and all this was nonsense because my preceptor that day (and I've had too many preceptors on this unit ,6 all together) WATCHED WITH the order and had to consult pharmacy several times to put in the computer correctly. The same preceptor told me to sign the orders as verified and you know what this same preceptor pulled this girl aside on Friday and warned her to watch verifying her orders. This person made this statement in front of others she tried to say that "I'm not trying to tell you what do, I'm new too but that was wrong and confusing what you did." Well kiss my grits I'm getting REAL tired of being told this that and the other thing is wrong and I'm ready to quit because I have come to the conclusion and no offense out there a lot of nurses are just *itches, I know this is not true of every nurse and I've come across some very nice ones,
    but enough already no wonder why there is a shortage. Thanks to all who have listened to this rant, and I'm not a quitter, just a real DISGUSTED GRADUATE NURSE SOON TO BE RN (AND POSSIBLY REGRETTING IT BECAUSE OF THIS MENTALLY ABUSIVE WORK ENVIRONMENT!!) :angryfire
  12. by   lvs2nrs3535
    Quote from Daisey357
    I am a nursing student entering my clinical rotation. We have been told to research and make-up Diagnosis Cards for common illnesses seen in med-surg nursing. Would anyone have suggestions of illnesses that are most common that i could start researching and completing my cards? Thank you for any help you can offer.
    Lets see,
    Renal Failure
    Detoxification (alcohol and drugs)
    Pressure ulcers/(falls under diabetes, but a whole different diagnosis/treatment)
    Head injuries
    Mental health problems(bipolar/depression/suicide attempts/there is a whole slew of these you will see)
    All I can come up with off the top of my head, but I am sure the more experienced nurses on the forum can give you more.
    Good Luck
  13. by   Nurse`Chief~Chickie
    definately i hope everyone asks questions until they are blue in the face! i constantly come up with something or another to ask my coworkers. most of them don't seem to mind it, and sometimes it can lead to even more info sharing beyond the initial ???s. just be sure to call the rude people on their offensive responses to what they feel are stupid ???s. (there are no stupid ???s!!! ) i've discovered that a response like, 'i have alot to learn yet, and you've really helped me with this' works wonders. kill them with kindness. ( even though i hate to do it!)

    btw, any tips on remembering insulin action times, i can't seem to nail this down in my lobes!