Ortho Nursing

[Nurse Niki]

Hi, I have been working in a psych facility for a year now as a nurse and just got an opportunity to interview for a orthopedic floor at the hospital, 3rd shift. I have never had any experiance on an ortho floor. what is a 3rd shift like as a nurse on that floor 7p-7a. What is the main duty as a nurse for that floor? Whats it like?

Thanks for your help :)

[SNIXRN]

Hey, I am a new grad working on an ortho floor and I love it. My day consists of CMS checks, vitals, administering pain meds and depending on the surgery, getting the patient to dangle their legs or up and walking. Occasionally I will also have to straight cath someone. I definitely love being on an ortho floor though. :)

[proudnurseRN]

I work on an ortho floor. We float also, depending on census. I notice 2 major things about ortho compared to other floors (this is my hospital, my experience). We give lots of pain medication compared to other floors. The other thing is that we seem to work together more. It often takes 2 people to get a fresh hip to the BSC, or walk a new surgery patient.

I really enjoy my job, for the most part.

[Kitty Hawk, ADN, RN]

Hey! I'm just heading out soon finishing up a string of 7p-7a before flipping back to daylight for awhile.

Aside from the usual assessments, neuro checks, pain meds etc...These are some of the more common duties that I have pretty much every time. We're a very busy post op so even though most of the discharges are gone when I come on, we'll get either people still coming from post op or direct admits from the ED.

If they come up with an autovac infusion machine that blood will need to be hung within the time frame and switching that over to a hemovac. If they come up with an orthopat, then you keep track of when that blood needs hung, or if they're turning out a lot of blood, running back and forth to keep flipping bags, because the bags are filling up before the 4 hour limit that we have. If they're knees they go into their CPM's for 2 hours or so.

In the morning we need to convert certain orthopats over to hemovacs and take down the machines. As well as pulling foleys if the output was sufficient.

If the ED admit goes to surgery in the am, then we're responsible for getting them bathed and pre-op things done. We also try to get some others bathed too if we can. If we have someone with a central line, we're responsible for the am lab draw.

That's some of the more detailed stuff I can think of aside from the usual bladder scanning and determining if they need straight cathed or not. Also, we try to watch for new labs for daylight but anymore they don't come in until later but we try. Doctor's are rounding and sometimes they put the new orders in or give a heads up, but often that happens a bit later too.

The only time it's "maybe" slow is around 1am-3am. Depending on the patient needs and if we have sundowners. We'll get ED admits within that time too, so that can affect things.

[shhhh]

I agree with everyone else! I will add this: it depends on how much clout your orthopods have at the hospital and how paranoid (in a good way!) they are, but you usually don't have any isolation patients on Ortho and it's considered a "clean unit". MRSA in a new knee is really bad news. I don't know about anyone else, but donning PPE multiple times a day to enter an isolation room isn't my idea of fun, so that can be considered a bonus.

[Orange Tree]

I've noticed a few things about my floor:

1. we give enough blood on a weekly basis to fill up a swimming pool

2. we have lots of confused elderly patients with one broken hip trying to crawl out of bed and break their other hip

3. when we medicate these patients for pain, they either go completely crazy or their blood pressure bottoms out

4. there are a lot of morphine PCAs, I often find myself standing over a patient waiting (and hoping) for their next breath to occur

5. half of our patients have UTIs and the other half are getting lactated ringer's at 100ml/hr, so every five minutes somebody needs a bedpan

I'm organized enough to deal with it all, now....but when I get assigned to another area, it almost feels like a night off! Some of those things may be a bit exaggerated, but ortho is hard work.

[blue heeler]

lots of pain, blood transfusions, drsg changes, removal of hemovacs, stryker drain reinfusion, making sure patients are peeing, straigh caths, post surg puking, orthostatic hypotension post surg, fall risks, 2 people to get people up.

[RNperdiem, RN]

I was a CNA in orthopedics.

Learn to work well with your assistants.

You are heavily dependent on them in ortho. None of the patients can move unassisted. So who is going to help you but the CNA.