Typical Med-Surg Day?

[SleeepyRN]

Hello everyone. I was hoping some of you could answer a question for me. I obtained my RN licensure August of 2012. Since then I have worked in a pediatric pulmonology office, and a short time in a SNF. I have an interview coming up for a part time Med-Surg/Telemetry entry level position. I have not had floor nursing experience since Fall of 2011 when I had clinical on a telemetry unit. I have actually forgotten what Med Surg/telemetry nurses do since it has been so long. I was hoping you guys could walk me through a typical day. The position is for nights, but I also welcome feedback from those on other shifts as well.

I remember getting report, doing rounds, check chart for new orders or lab results, head to toe assessments along with administering meds. Chart throughout the day, pass meds again and of course watch the telemetry monitors and patients...and that's all I remember. As a student I never dealt with an admission or discharge.

I can see having to insert a foley, an IV, change dressings, document I&O, and basically anything that goes wrong, like a change in patient condition, call M.D. and fo my own nursing interventions.

I know med surg is hectic, hard work. Would anybody be willing to walk me through a typical day?

[nursejami]

I think you pretty much cover it! I also work nights, and my typical shift goes something like...

Look up orders/vitals/hx

Get report

Assess patients

Obtain vitals from tech

Give meds (scheduled and prn)

Sign off tele strips

Look up more info on patient (H&P, imaging results, MD progress notes, Social Services notes, etc)

More vitals

Put out fires as they occur (resp distress? Crazy vitals? Bad IV? Jumper?)

Get admissions as they come

Give morning med

Get blood sugars

Give am insulin

Report critical/borderline am labs to MD as needed

Give report

Obviously, throughout your shift you're doing rounds, caring for your patients (bathroom, water, repositioning, etc), and giving needs as needed. Things like dressing changes rarely happen on nights, unless they're out of necessity. With everything else we're subjecting these patients to they're having a hard enough time sleeping without a random 3am dressing change. Being on nights, you will have to learn to prioritize about when something needs to be done NOW and when doing it NOW would not be beneficial to the patient. Skills you'll probably do include IV starts, catheter insertion (Foley and straight), drain and catheter removal (in the morning), suctioning, tube feeding, etc.

[SleeepyRN]

I think you pretty much cover it! I also work nights, and my typical shift goes something like...

Look up orders/vitals/hx

Get report

Assess patients

Obtain vitals from tech

Give meds (scheduled and prn)

Sign off tele strips

Look up more info on patient (H&P, imaging results, MD progress notes, Social Services notes, etc)

More vitals

Put out fires as they occur (resp distress? Crazy vitals? Bad IV? Jumper?)

Get admissions as they come

Give morning med

Get blood sugars

Give am insulin

Report critical/borderline am labs to MD as needed

Give report

Obviously, throughout your shift you're doing rounds, caring for your patients (bathroom, water, repositioning, etc), and giving needs as needed. Things like dressing changes rarely happen on nights, unless they're out of necessity. With everything else we're subjecting these patients to they're having a hard enough time sleeping without a random 3am dressing change. Being on nights, you will have to learn to prioritize about when something needs to be done NOW and when doing it NOW would not be beneficial to the patient. Skills you'll probably do include IV starts, catheter insertion (Foley and straight), drain and catheter removal (in the morning), suctioning, tube feeding, etc.

Thank you for answering my question :-)

I didn't get the position, but if I do in the future, I know better now what to expect.