New Grad on Ortho Floor

nneokill175 · Dec 5, 2014

I am also new grad on an ortho floor. I will start in 2 weeks at night shift. Any tips to make me shine so that I would be a more valuable asset on day shift instead?

Lev, MSN, RN, NP · Dec 5, 2014

Read up on safe positioning and transfers, different types of pain medicine, and neurovascular checks. Also good to know about different types of antibiotics and SCIP measures.

mmc51264, BSN, MSN, RN · Dec 8, 2014

We get a lot of post-ops late in day shift and I hear a lot of stories about pts becoming unstable not long after coming up from PACU. Monitor your VS carefully.

Also, many pts get really confused that first night post-op. They are in a strange place, probably on a decent load of narcotics, plus coming off of anesthesia and may wake up and forget where they are.

Don't be afraid to wake them up to give them their scheduled tylenol at midnight-it DOES help. Also it helps to remind them if they have a PCA.

Neuro-vasc checks are a must.

RN403, BSN, RN · Dec 15, 2014

One of your biggest concerns as an ortho nurse will be pain control. Make sure that you are keeping your patients medicated appropriately to keep their pain at a tolerable level. It is important so that they will get up and move and work with PT.

Also, be comfortable moving and transferring hip patients, knee patients, shoulder patients, and so on. Make sure you become familiar with the types of surgeries you see most on your floor. Research them when you go home so that you are familiar with what is expected and what might indicate complications.

You will get really good at dressing changes and dealing with surgical drains.

Make sure you know hip and knee precautions. Lots of threads here on the site.

Become familiar with the pain meds most used on your floor...look up their S/E, warnings, etc.

Basically be a sponge. As you start to work with your patients look up their conditions, meds, and don't be afraid to ask questions about their care. This is the only way you will learn. In a few months you will be surprised and pleased at how much you have learned and how far you have come.

Good Luck! Ortho can be a great starting point...you will definitely get good at time management!

nneokill175 · Dec 16, 2014

HI, thanks for the tips!

So i thought i was getting 3 months trainings (thats apparently what everyone was saying, turns out its only 2 weeks and a half, and then theyre going to put me by myself.... whatt...... I don't think I will be ready. They said theyre going to see how I will be thinking critically, PUtting in IVs and stuff. (I have never put in an IVs before, and Currently studying for an IV test)

Is there a certain way I am suppose to think on this floor? I just got this job so I am pretty scared of losing it. Any more tips to help me get on my feet quicker so I don't mess this up for myself? This is insane!!!

Lev, MSN, RN, NP · Dec 17, 2014

Two and half weeks is NOT enough! You need to ask for more orientation.

schnookimz · Dec 17, 2014

Well anyone coming from surgery should have IV access already so I wouldn't worry too much about that.

mmc51264, BSN, MSN, RN · Dec 17, 2014

Dang, I had 6 months. We have an IV team, so I don't have to do that either. And we are only joints, no spine. Ask ALOT of questions. See if you can get more time. there is no way you will be ready-not that you won't be a good nurse, there is just SO much info.

Lev, MSN, RN, NP · Dec 17, 2014

Well anyone coming from surgery should have IV access already so I wouldn't worry too much about that.

Don't be too sure about that! Those big #18s stuffed into small hand veins don't always last as long as you'd like.

RN403, BSN, RN · Dec 17, 2014

As for putting in IVs...I never placed an IV in an actual patient until I started working. You learn quickly after doing them a few times.

nneokill175 · Dec 27, 2014

whooops, its been like my 2nd day and they started giving me patients to do by myself while my preceptor just watch. FIrst day I got 5 patients with 2 discharge. Second day, I got 4 patients, 3 discharge and 4 admits... yeah.. FML. and holly cow do I feel retarded. I dont know how to do anything. so i constantly come back and forth asking my preceptor questions. I was stuck 2hrs after work to finish my charting. our computer charting system sucks and so tedious. I don't mind them training me this way actually, pressure makes diamond. I'm learning a lot, even though i stay there for 14hrs , I don't get a headache because I kinda do enjoy doing the clnical skills, I just wish i was more fluent with my skills because I don't know jack. Lets see how I do with last week next week. Overall, I feel so stupid ahha, I was so afraid of asking questions; but i thought to my self "IDGAF, the time to ask stupid questions and make mistakes is now". OVerall, I definitely know I can work a lot more efficiently once I get all my nursing skills down and fluent. GOOD LUCK TO ME AND YOU!