Organ Transplant / Med-Surg unit

[ORRN0808]

Hi all!

I accepted a position on an organ transplant/med-surg unit (kidney, pancreas, and combo), in addition to other renal patients (TURP's, etc. to my understanding) that happen to be there as well. I have been a RN for 2 years, but was in the main OR one year and then outpatient cardiology practice the next. Therefore, it's kind of like I'm starting brand new to nursing again, at least in regards to floor nursing (not too mention the clinicals I had in nursing school a few years ago were def not the best). I start in a few weeks but am trying to refresh/study as much as I can before beginning this new position (I'm very excited, but also very nervous).

1) Does anyone have any specific recommendations on what basics I can prepare for in regards to the organ transplant patients?

2) How about prep I can do that will help me with transitioning to med-surg (I feel like there is so much to cover studying wise, and not enough time to teach myself everything all over again!) Any tips on keypoints to focus on to help prepare me to start at least?

Thank you in advance, I love this site and all the support it helps us nurses provide to one another!!

=)

[danggirl]

Congratulations on your new position! It sounds like a double challenge transitioning to a med/surg floor nursing role AND learning about transplant patients. I worked on a transplant unit for two years but came there initially as a travel nurse with zero experience in organ transplant. Your OR background may help because, regardless of WHAT they had done, they had surgery...so you have all the considerations of taking care of a post-op patient in general plus then the specific surgery. The patients SHOULD be fairly stable once they come to the floor if they went to the ICU first though don't let your guard down...they can change status very rapidly and the warning signs are often very subtle...especially with the diabetic patients. I had a decade or more on a regular med/surg floor so I didn't really have to review my physiology but you may want to refresh yourself on the normal physiology of kidneys, livers, pancreases and brush up on diabetic care (medications have changed a lot in the past few years). Another huge consideration of transplant patients is infection. Their immune systems are going to be suppressed and so you have to be diligent in monitoring them/protecting them from infection...they won't necessarily exhibit classic infection signs since the medications suppress immune response. Learn about the medications also...the patients generally get put on a particular regimen that is time specific and they get levels tested fairly frequently also time specific to their administration times.

As for going to the floor in general...You will most likely be your own worst enemy. My best advice is to practice time management and prioritization. Things will inevitably get hectic but if you can remember that you are ONE person and remain calm, it will go much more smoothly. I'm assuming you didn't have a ton of patient interactions either...you will find your style. But always always...introduce yourself, treat the patient with respect, TELL them what you are doing (including the medications you are giving specifically), LISTEN to them, and remember you are not there to judge them - you are there to provide them with the best nursing care you can within the scope of your practice, hospital policy, physician orders, and the law. Good luck to you, I hope you enjoy it as much as I did!!

[ORRN0808]

Thank you SO much, danggirl!! I really appreciate you taking the time to review all that info with me and write such a thoughtful and informative response. I will take your suggestions and experience to heart and review all I can before I start. Thank you again!!!