New Med Surg Nurse Drowning

Published

Specializes in Public/ Home Health- New to Med Surg.

Hello Everyone!

I am a recent RN grad- May 2005, and I landed a job for our county public/ home health fresh from college.

Previously I had worked as a CNA then LPN at a LTC. I completed my preceptorship in OB- L&D at a small hospital, and some in public health. I truly loved OB and want to work in OB. I thought that I would never land a job in OB- it seemed as if that is what most nurses wanted, especially if I never had any hospital work expereince. A few weeks ago- I gave up my job with the county- I loved the work- but worked with a very very difficult nurse who landed the supervisor job- and I am not one to speak up. I interviewed at a very small local hospital for med surg and they were thrilled to hear that I eventually wanted to do OB. They hired me a few days later- I have to work med surg for a few months to become more accquainted to the hospital setting before transferring to OB. I stumbled upon this website searching for some general advice- in other words I AM SO LOST IN MED SURG!! So I would be truly grateful of any help I can get from here because today I asked a question to the nurse I was orienting with and she gave me this look like OMG- who have they hired? So I am a little scared to ask certain questions that I know could be stupid? Am I confusing?

Anyways my question is - TKO- to keep open- what exactly are the parameters for this- or what does it mean besides to keep open?

Up Vote Up Vote ×
Specializes in Gerontological, cardiac, med-surg, peds.

TKO, depending on the facility policy and procedure, is usually 30 ml/ hr for adults - just enough flow to "keep the vein open." Hope this helps :)

Up Vote Up Vote ×
Specializes in cardiac/critical care/ informatics.

Our tko is 42ml/hr check your p/p manual. you need to be able to ask questions especially if you haven't worked med-surg before. So try to ignore her looks and ask, and maybe say you know I am new and haven't worked med-surg before isn't better to ask instead of doing without knowing. Good Luck

Up Vote Up Vote ×
Specializes in ER (new), Respitory/Med Surg floor.

I've never seen that abreviation before TKO. But with the OP and next one is it the same as keep vein open (KVO)? I thought abbreviations were more universal. Are some facilities different? For KVO it's policy standard rate to keep a vein open with whatever med or fluids. Mine is 20-30cc/hr which seems to generally be what many facilities use. Just keep asking questions. Don't be afraid of looking stupid by asking or you will not learn and make things worse. Honestly it's more scary being with someone who doesn't ask or feels they already know everything. Sometimes people can be a little harsh. Sometimes it's merrited but all depends. Either way people need to be taught and that's not the way to go.

I remember one time calling ct scan asking where the po barium was for my pt's ct scan of her chest. As I said it I started laughing out loud! Because it's IV. Po makes no sense at all since it would only travel GI tract hence using it for abd ct scans. And the guy on the other end was like what and laughed but that are you kidding me laugh. Anyway.... OH or the time I wrote PE on my report sheet for pleural effusion. I told report to nights who said PE????? Asked pleural effusion or pulmonary embolism. Pulmonary embolism I see abbreviated PE now but at the time I'm like oooh I can't remember. THE nurse had this utter SHOCK on her face!!!! I'm not stupid either. I just forgot what I wrote and at the begining I know I would have gone further if it was a clot. So ask away or you'll have even more problems later. You are new.

Up Vote Up Vote ×

Edited because I really shouldn't post when I'm really wishing I was asleep.

Up Vote Up Vote ×
Specializes in Public/ Home Health- New to Med Surg.

Thanks Everyone- I will check the p/p book to see what it is here- I really appreciate your responses. Jacque

Up Vote Up Vote ×
Specializes in Rehab, Med Surg, Home Care.

KVO where I work is 10-20 cc's/ hr.

Up Vote Up Vote ×
Specializes in ED.

How long is your orientation? Mine was 3+ months and I just came off it in med/surg (being a brand new nurse also). At first I was almost panicked thinking I would never be able to get all of this stuff by the end of 3 months. But by the end of two I could see the light and was taking a hallway of patients by myself most of the time.

Give yourself a break hunny, you'll get it! Just don't give up at it.

Up Vote Up Vote ×

Always ask ! Always ask either a friendly, helpful, and approachable nurse, or your charge nurse.

It is so much easier for all the staff (and your patients,) if you ask first .

It is ten times more difficult to attend to a mistake that is made.

Ignore the rude nurse. She was a newbie once upon a time too.

It takes a while to " put it all together".... you will manage it. Your teachers at school had faith in you or they would not have allowed you to proceed.

So, have confidence in yourself. After your shift, review your day.

Try to analyze your strengths and weaknesses. Maybe jot them down.

It will become clear to you where you need to review, or ask questions, or volunteer for new experiences . Hang in there !

Up Vote Up Vote ×
Specializes in MED/SURG/ICU/OB/LDR.

You've gotten good advice so far... I too started right into a busy Med/Surg floor at an ACU unit in Caribou ME. In that facility KVO was 30cc/hr for peripheral access but only 10cc/hr for central access (IE: PAC line). I also had a real hard ass nurse for orientation and it lasted for 3 months of sheer hell. In the end though it made me a better nurse and because I stuck it out I gained the respect of my co-workers and the nurse who oriented me. Hang in there and remember, NO QUESTION IS STUPID... IT'S STUPID NOT TOO ASK!!!

Up Vote Up Vote ×
Specializes in Pediatrics, Telemetry, ICU.

wow i wish my orientation was 2-3 months....i took my boards on june 2, started orientation the very next day. i was done june 28th i think a total of 15 days!!!! i was a student aide through out school...but the roles are completely different...

another girl that was in oo with me...is still on we started the same day...

its seems to be going ok...i go at my own pace and have seemed to keep up ok. i had my thirty day orientation as a rn and there were no complaints...

i cannot believe the differnet in times of orientation

Up Vote Up Vote ×
Specializes in Public/ Home Health- New to Med Surg.

Someone asked how long my orientation was- well tommorrow is day 3- at this particular hospital med surg orientation is about 2 months- but due to the fact they want me in OB- the supervisor told me that I will only orient for 1 month in med surg, and then I will be transferred to OB- and there I will have a about 1-2 months orientation. They just want me to have a lil med surg experience to get familiar with starting IVs and IV meds, and patient/ time management....Home health was sooo much easier to learn than med surg so far and I have no idea why. My orientation nurse answered my question cheerfully- but I could tell by her expressions she was thinking this is gonna be a wild ride- and I just didnt want to ask about TKO to her and have her think OMG another easy question that she is clueless about...!

Thanks Everyone

Up Vote Up Vote ×
+ Join the Discussion