Newbie in Med Surg

RNPATL, DNP, RN · Aug 9, 2004

Hi,
I started working in a Pre and Post Op unit in the hospital 2 weeks ago and I am supposed to be on a 6 weeks orientation. But last week, they started giving me 2 patients then it came to 4 patients by Friday. The other 2 RN's also had 4 patients each. Is this safe for a new RN? I have been an LPN for 3 years and been working in a long term care facility but a hospital setting is very new to me not to mention using the computer for documentation. I guess my question is that -- when can I have a patient on my own without someone supervising me? My preceptor worked with me for 2 days and last Friday, she had her own patients to take care of because another RN called in. I stayed another hour to finish my documentation and they let me handle a patient who is schedule for a lap chole. I have not done this before. I was not even sure what to teach her prior to surgery. And after 3 hours later, she came back from surgery and so I have to readmit her back to our floor. I did give some teaching regarding splinting and using the incentive spirometer but I am not certain if there was anything I needed to do. My preceptor just told me to check her VS when she comes back but I also did listen to lungs, checked her pedal pulses. But I always ask questions and I am afraid that they will get tired of me asking questions. I purchased a handbook for medical surgical nursing and I have been reading it this weekend. I don't know how to handle this situation. I will be back on the floor tomorrow and I hope they don't give me a lot of patients to start with. Maybe 1-2 is fine. Please help. Thanks in advance. Cheers.

First of all, welcome to allnurses! We are thrilled you are here. In relationship to your question, as a new grad RN (regardless if you were an LPN or not), you should be afforded an orientation that meets your professional practice needs. If you are released by your preceptor to the floor before you are ready and you are uncomfortable, I would recommend sitting down with your preceptor and discussing this with her/him. Communication about your skill level as well as comfort level is important.

If you find that your preceptor is not open to hearing this, I would then talk to your education department or your nurse manager. It is very important for you to get the orientation you need to transition from student to Registered Nurse.

Here are some additional suggestions to help you along:

1. For diagnosis that you are not familiar with, I would recomend taking some time after work or the next day to reference your med-surg book and look them up.

2. Once you have found the diagnosis, look for nursing care considerations as well as teaching that should be done with these patients, especially as a post op patient.

3. Review your assessment skills and make sure you use them when dealing with any new patient that you admit, post op or for patient's that has had a change in condition. You will not need to always do a head to toe (like you did in school), but understand and learn to use focus assessment skills. Whatever the case, always assess .... that is the first part of the nursing process and regardless of what anyone tells you, you need to do this, especially on a post op patient. If you don't assess, how can you tell if the patient is experiencing post operative complications?

This is the information that will help you learn more. Also, use this web site and post questions to the experienced nurses .... for example - here is a suggestion for a new thread here on the med-surg forum ...Help with teaching for IS. Or .... What post op complications should be assessed when a patient comes back to the floor?

When you post a thread .... there are hundreds of nurses that can respond and give you feedback and help.

Please talk to your preceptor or to your nurse manager and make sure they know you need more orientation time. Most of all .... good luck!