Specialties Med-Surg
Published Feb 6, 2015
MassED, BSN, RN
2,636 Posts
It has been a long time since I've been back on Allnurses. I had a Hysterectomy on 1/19. My experience was wonderful, overall. As a nurse (and one who worked on a Med/surg floor years ago) I have a few suggestions to the general population.
As a patient, those SCD's are awful. They get sweaty, they squeeze at different intensities and they slip. Ask your patient if they need adjusting or if you need some air under there.
Offer to readjust your patient, even if they're younger and fit, they just had major abdominal surgery and can barely move (some of us just don't ask.)
Remember to ask if they want their door closed. There is so much noise, LIGHT, and activity out there in the hallway that it is difficult to sleep.
With regards to pain: Please let your patient know their options for pain control, for scheduled and break through pain options. Not just a nurse speaking here, but for someone who was given pain medication and couldn't keep it straight (for obvious reasons), please update each time you enter the room. "your last dose of Oxycodone was at such and such, etc."
If a patient says they are dizzy (I had been hypotensive in the 80's repeatedly and they still had me sit up and walk to the chair with little help), please support them while walking and sitting, you never know if they are going to fall. I didn't fall, but common sense dictates to be on guard.
I think being attentive in the first 24 hours of a major surgery is key. It has been a long time since I worked as a med/surg nurse. I work ER now, but I can say that being scheduled and attentive are key features of a good nurse. I had one nurse who never offered me pain medications unless I asked. That was not helpful to me, or to someone who may not ask or feel like they're "bothering" the staff.
Being a patient always helps a nurse to reflect on their own nursing practices.
BIG lesson here: Toradol BURNS like nothing I have ever felt. I let each nurse know, but none of them did anything but say "yeah, it burns." They all diluted it, but they should have been as far away from the Catheter insertion site as possible and not pushed it so fast, especially when someone says something burns. It also causes redness around the IV site. Just a good note for myself in my own practice, although I was always taught you dilute and infused secondary over 15 minutes.
I also should add that as a nurse I will remember how nice it was to feel valued by the staff. That may sound so silly, but I really appreciated when people were sincere to me. I know in my own profession I can be rushed and maybe clipped when I'm hurrying from room to room, but this made a profound impact on me. I will remember to be more sincere with people and that they may be scared.
Anyway, 18 days postop and I'm ready to get back into it!
Exhaustipated, ADN, BSN
440 Posts
Thanks for this reminder. I'm currently a 4th semester nursing student with clinicals on a med-surg floor. With your permission, I would love to print and share your post with my clinical group.
Sure! Whatever helps the process. Good luck in school!
SierraBravo
547 Posts
I had one nurse who never offered me pain medications unless I asked. That was not helpful to me, or to someone who may not ask or feel like they're "bothering" the staff.
I assess my patients for pain q4h along with VS, or more frequently if necessary. Based on my assessment, along with my H&P, I come up with a plan with the patient for pain relief. But I do not automatically offer pain medication. There are sometimes non-pharmacological alternatives which are useful and there are some patients that don't like "taking pills".
I want my patients to tell me if they have pain, if the regimen we are using is effective, and if I am meeting their pain goal. I don't want patients thinking that just because their opioid pain reliever is ordered for q1h that they sit there and wait for the exact minute that they can get it again. If they are having pain and it is too soon to get another dose of the ordered medication, it takes me all of 1 minute to speak with the provider and get something else ordered or revise the patients current pain regimen. With that being said, my patients are not post surgical (with the rare exception).
tokmom, BSN, RN
4,568 Posts
At our facility all pts are up the first two days with assist. Prn otherwise. Pain meds written on board and offered to the pt as ordered. Some refuse (we put it back) and others will take it. This actually reduces call lights and a pt appears to have a higher pain tolerance. It's working well for us. All post op are on saturation monitoring for 24 hours and we try your give legs a rest with scd and off the next day. Oh and our patients love us. I think a 3-4 patient and a 1:10 cna ratio has a lot to do with our abilities to do great care .
this hospital on this floor, the nurses did all of their work with their assignment. They did not have CNA's to assist. I think that must be difficult. It was primarily an Ortho floor, but even then, it's nice to have ancillary staff to assist with walking, toileting, dressing, etc.
BTDT with the no CNA thing. It makes it very difficult when you have to choose toileting VS pain meds. It's a no-win situation.
Caffeine_IV
1,198 Posts
I hope you continued to recover well.
I had not heard of toradol causing burning and we don't dilute it or have a policy to do so. I always push slowly anyway at a far away port. Thanks for letting us know!