New graduate job offer in a surgical floor.

**NickiLaughs, ADN, BSN, RN** · May 20, 2011

I think it would be sort of like your Interim Permit, you'd probably be training with another nurse until you are on your own. And you won't be on your own until you pass your boards.

In any case, congrats on finding a job in this rough economy!

GARN912 · May 20, 2011

Here in GA, graduate nurses are nurses who don't have their license yet but have graduated from school. They are able to orient to the floor (usually under a preceptor) and chart as a grad RN, but not do things that only a licensed nurse can do (give medications by yourself, initial physical assessments, etc). As far as the surgical floor part, I'm assuming you'll have a lot of pre-ops that you'll be getting ready to go for surgery, and a lot of post-ops that you'll have to monitor after surgery. Depending on what kind of surgery it is, you'll be checking dressings, monitoring vitals, emptying drains, neuro checks, and helping the patients regain mobility. You'll probably also have to do a lot of education and reeducation with patients before and after surgery. Basically this position should be kind of like the practicum or preceptorship you did while in school.

One thing I would find out is how long you have to take the NCLEX after you are hired. At my hospital grad RNs/LPNs have 90 days to take it. If they haven't or cannot pass they are made into patient care techs.

Hope this helps and good luck!

MikeyBSN · May 20, 2011

Some states allow nursing students to practice as "graduate nurses" until they pass their NCLEX; my state does not. Personally, I think "graduate nurses" are a bad idea. You will basically be working with a preceptor and you will be able to pass certain meds and practice much like you are on orientation, in most states.

As for a surgical floor, that is not really my thing. Being a completely miserable, nasty and depraved individual seems to be a prerequisite for being a surgeon, at least at the places I've worked. You will have to deal with these people every day. You will be monitoring patients after surgery, usually checking for complications such as bleeding and infection. You will have to know all of those nice tubes they will put in your patients and how to use them (chest tubes, wound vacs, etc.). You will also have to prep patients for surgery. The surgeons will tell you that the patient is going for surgery the next morning and the OR will call 20 minutes later and say "where is our patient?", at which point you will be expected to drop what you are doing and prep the patient for surgery.

Congratulations on your job, I hope you like surgical nursing. One more thing, please do not tell the ER nurses to hold the patient down there until they go to the OR, this makes us angry. Good luck!

SweetLikeSugar · May 20, 2011

I worked as a graduate nurse on a med-surg floor until I passed my boards. I worked with another RN during my orientation and then I was on my own for a couple months until I became an RN. I guess some states don't allow this...I don't know.

I have been working on a surgical floor for 5 years now and I love it! You'll learn so much more than you would on a regular medical floor. We do a lot of dressing changes, monitoring output and drainage, TONS of teaching, lots of experience with foley cath's and NG tubes, PEG tubes, chest tubes, IV insertion. Some of our patient's are on heart monitors. The best part is that the patient's don't stay too long and you can see their improvement and healing process within a matter of days. There are a lot of admissions and discharges, so you'll learn time management skills pretty quickly. I think the particular unit I work on would be great for a new grad and I'm sorry I didn't start out there when I graduated.

Someone mentioned the surgeon's being miserable individuals and while some of them can be a pain in the a** to deal with, our surgeons aren't that bad and generally know and trust the staff on our floor. Many of our surgeons have been known to call our floor while they're still in the OR and request a bed on our unit because they don't want their patient to go to another unit. It's nice to have that level of trust! Congratulations on your new job!

sr1984 · May 20, 2011

Thank you guys for all the replies... Thank you for telling me all of your experiences!! I am looking foward to start my nursing career!!

NoviceRN10 · May 20, 2011

I'd rather work surgical than med-surge any day! Med-surge is like a nursing home at my hospital, and surgical has a population of younger pts (as in less than 70) that are usually stable. I think you will get a good start on a surgical unit. You still learn med-surge nursing skills but the pts are better.

07302003, ASN, RN · May 21, 2011

I started in surgical as a new RN, and it was awesome.

Lots of experience with wounds, ostomies, chest tubes, fistulas. Overall young and healthy patients. It was a GREAT start to a nursing career. Critical thinking is needed when a patient is "going bad", which does happen after surgery.

And, where I was, the census floated up and down, so I had the chance to be pulled to other floors and learn more about pulmonology, nephrology, cancer, etc. Nurses b$tch about being pulled to another floor, but in the end it's a great learning experience.

Congratulations on your job! You'll learn a lot.

sr1984 · May 21, 2011

Thank you so much!! I really do hope that I will get a lot of experience!!

socalRN3 · May 21, 2011

CONGRATS!!! :yeah:

I started out on a pediatric surgical floor and what a great experience that was. It is a busy floor and patients and families can be very demanding, however, this will be a great starting point and you will learn a ton about different procedures and surgeries. There will be a large focus on pain management, post-op care, teaching and discharges.

Good luck to you! let us know how it goes

HoneyDinkley · Jun 9, 2011

I'm a PCT on a med-surg floor and I am absolutely miserable. I wish I had known ahead of time they have a high turnover rate, and average 15-18 patients a night, where over half of that number are "total" patients (the ones that are incontinent and cannot get out of bed or move on their own). Do you or anyone else reading this think 18 med-surg patients is an average or approprate number for a PCT or CNA to take care of? I am exhausted every night after my shift, and never have time to finish everything I am expected to do. I honestly feel the PCT's that are able to finish everything are doing it half-assed and contributing to the hospital acquired infections. Most of the RN's don't want to help, and it's hard to get help from the other techs since we usually only average about 3 techs with over 50 patients. Someone please give me some constructive advice. I am so ready to leave that place!!

I worked as a graduate nurse on a med-surg floor until I passed my boards. I worked with another RN during my orientation and then I was on my own for a couple months until I became an RN. I guess some states don't allow this...I don't know.
I have been working on a surgical floor for 5 years now and I love it! You'll learn so much more than you would on a regular medical floor. We do a lot of dressing changes, monitoring output and drainage, TONS of teaching, lots of experience with foley cath's and NG tubes, PEG tubes, chest tubes, IV insertion. Some of our patient's are on heart monitors. The best part is that the patient's don't stay too long and you can see their improvement and healing process within a matter of days. There are a lot of admissions and discharges, so you'll learn time management skills pretty quickly. I think the particular unit I work on would be great for a new grad and I'm sorry I didn't start out there when I graduated.
Someone mentioned the surgeon's being miserable individuals and while some of them can be a pain in the a** to deal with, our surgeons aren't that bad and generally know and trust the staff on our floor. Many of our surgeons have been known to call our floor while they're still in the OR and request a bed on our unit because they don't want their patient to go to another unit. It's nice to have that level of trust! Congratulations on your new job!