Is ortho a good area for a new grad RN?

  1. Ok, so I just resigned yesterday from my first nursing job after the 10th week of orientation on a neuro ICU. I realized that this was the complete wrong fit for me and that going to a less acute floor would be a great benefit to me so I can develop prioritization, critical thinking, and other nursing skills. Anyway, now I am looking at my options and ortho happens to be one of them. I can't say that I have a lot of ortho experience from school and don't want to get myself into something I am going to hate. I guess I want to know if ortho will give me a well-rounded start to my career so, that if I decided to move onto something else, the skills I will have acquired will be of use to me. Also, for those of you who work in this area (whether you started as a new grad or with experience), overall, do you like it? My previous job left me so drained both physically and emotionally (I cried practically every day!). The pt outcomes on my previous unit were usually very poor and I felt like all my hard work really never paid off b/c most of my pts were in comas or the family would want to withdraw care...I became very depressed. I have been told that ortho pts are very hard and heavy with lots of lifting, etc, which kinda scares me a little. I know that no job is going to be perfect or stress-free but, I'd like to atleast have a job that I can kind of enjoy. Any thoughts are appreciated...thanks!
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    About AJ BSN 2008

    Joined: Nov '08; Posts: 20; Likes: 4
    R.N.; from US
    Specialty: neuro, tele

    29 Comments

  3. by   SandraCVRN
    Iwent to an OrhtoMed floor as a new grad and loved it. Of course it was a a very organized place. The trick with ortho is having good techs to help with all the moving. Good luck
  4. by   melsman1904
    I'm a new grad (May '09) working on an ortho floor. Give it a shot. I am loving it so far. Ortho was something that wasn't covered thoroughly for my class and I am learning loads of stuff.
  5. by   DManAZRN
    I would have to advise avoiding ortho. Dependent on the facility and ratios of course. Lots of heavy equipment, anyone here enjoy moving CPM's all night? More likely to pull something and ortho docs think they're really special, well, they are. "Don't wake me up for that nurse" and then the next day, "Why didn't you call me with this?" etc...
    Go to TELE get ACLS work a year or two, get EKG down and THEN go to ICU or stay put.
    The ratios are the only thing I will consider anymore PERIOD.
  6. by   melsman1904
    Our CPMs aren't that heavy. And, where are you moving them all night? Ours stay in the room with the pt. The only moving we do is from a shelf to the bed @ 0600.
  7. by   cjcalimer
    I started Ortho fresh out of nursing school a year and a half ago and I love it. As a new nurse, it was nice not to be dealing with life and death issues on a regular basis. As far as experience, what you learn is pretty specialized. I can say I've lost a lot of skills from nursing school. I've only seen some things a handful of times (trachs, NG tubes, PEG tubes, colostomies, etc.) You do get great experience in treating pain. Ortho patients can be great (you can have a normal conversation with them) but they can also be VERY demanding (sometimes they forget they're in the hospital and not a health spa). You do still see some sad stories (people with chronic infections, dislocations, etc.) and rarely, people loose a limb. But in the last two years on my very busy ortho floor, we've have one code. It can be a lot of lifting, but that should encourage you to learn to do it the right way. I think the heaviness also brings people together to work as a team. No one can take care of all their patients by themselves, so everyone has to pitch in for everyone. As far as the docs, I work at a teaching hospital. We have the same group of 7 residents for two years responding to our pages. We actually get to know them and they get to know us. As in, they know our names. And call us by them. During the day, we have nurse practitioners who handle our pages (and all of them started as staff nurses on our unit). Of course that kind of thing is dependent on where you work. There are some drawbacks and I don't think I'll stay forever, but over all I'm happy I started on Ortho.
  8. by   jdub3
    If you want to run around pushing pain meds every 5 minutes, transferr to commode and ambulate hips, knees and backs. Sure.......
  9. by   OrthoRN09
    I started on a busy Ortho Trauma unit as a new grad. I've been there 6 months and so far I really like it. Not all the patients are heavy lifts. And we have ceiling lifts to save our backs. Plus we have PT and OT on our floor who always gets our patients up for the first time after surgery and twice daily. And our PCA's are extremely helpful...I couldn't do my job without them! I am at a teaching facility so we do have to deal with new residents a couple times a year. But there is always someone in house to page with questions/concerns. And so far, I have never been yelled at for calling "at this time of night". They are usually awake anyway. As far as loosing skills, I'm sure it's just like any unit, if you don't do something all the time, you will forget how to do it. But we do float to other units when our census is low so while I don't feel proficient in all the skills I learned in school, I do get some experience in them. And for the most part, the units I have floated to have been very good about helping with things I am not sure of. We get very few scheduled surgical patients on our unit, most are trauma. And since a lot of them tend to be elderly, they have a lot of co-morbidities so we do get a lot of expereince with that. All in all, I have found Ortho a great place to start. Will I stay there forever? Probably not. But for now, it's a good fit for me.
  10. by   pangyaw
    I started my nursing job in Ortho/Neuro, I love Ortho pts than Neuro pts. For ortho pts, its challenging though and I will not say that its stress-free, giving routine or prn pain meds, hanging blood if hgb <9.0, assisting them to bsc using walker or cane, cpm's for knee sx pts to run 2 hours per shift. I worked 6a-6p, I called surgeons anytime...they have on-call anyway. There were bad nights especially if foley cath was dc'd, pain were uncontrolled, and most of all if pt has complications...but you are not alone, we have a rapid response team that will arrived in 2-3 minutes to check pt quickly based in your assessment that something is wrong. My experience to neuro pts were not all bad, I am not comfortable taking care of seizures and confused pts. It drains me I think its nice to try different areas, try Ortho...you just get used to what surgeons want for their pts. They will be nice. They have bad times too like us. Just remember, nursing is interruptions!!!
  11. by   NeoPediRN
    I have just under a year of experience and started on a post-op/ortho floor in July. I absolutely love it. There is quite a bit of turning with two assists so as long as you plan it out you're in great shape. You can help your tech turn and reposition/give skin care and it gives you a chance to assess your patients' skin, listen to their lungs, change their dressings, etc...our equipment is pretty modern so it's not that big and bulky. I was expecting the Orthopat drains to resemble some kind of huge medieval device but they are much smaller than I anticipated! The surgeons can be stinkers but a lot of them are very nice, just anal and know what they want from you. Time management is what I'm working on right now. I'm up to handling four patients (we max at 5, including admissions/fresh post-ops from PACU) and they have many needs and issues, lots of hypotension, transfusions, abnormal labs, and nursing interventions. It's fun but requires a lot of running your butt off and prioritizing. Sometimes I get too sucked in by addressing family members' concerns and there just isn't time for that 20 minute conversation when there's so much to be done. I'm also an anal-retentive control freak and it's been hard to give up my scheduled routine way of doing things from my other job to go with the flow and get my assessments whereever I can whenever I can, and there are always stat interventions that need to be done that prolong my routine things. I often feel like I'm chasing my tail, but for the most part I'm out by midnight on a 3-11 shift so I'm not doing terribly, and my patients maintained safety. It just seems so easy for them not to! The other night I had a patient filled to the brim with crackles despite Lasix s/p chest tube removal and I have the doctor on the phone, meanwhile they're grabbing me because my other patient has audible wheezing and is sweaty and needs an inhaler treatment. It's never just one patient at a time. The ortho stuff is a breeze, it's just everything else! It's awesome though, your assessment skills will be way up there in a year or two. I've only been on the floor a few weeks and we've already had a couple of rapid responses. Just make sure that your patient to nurse ratio is feasible, I'd say no more than 5 on days or evenings, and that you have a good team. Good luck, let us know what you pick!
  12. by   lookingabroad
    HI

    I preceptored on ortho/trauma and I've been working there full time for about 9 months. It is a heavier floor, but there are perks. Pt's come in all broken, we fix them, and generally they go back to their normal lives. Of course there is a big geriatric/hip/dementia population as well that can be a bit of a challenge. I have 4 pt's on days and 5-6 on nights. Its a fast paced floor, but so far the other helth care professionals help out a lot and the docs are pretty good. There are a lot of back injuries though that you have to be careful about. All in all I'm finding it to be a good place to pick up fundamental nursing skills, but I don't plan on staying longer than a year. One last bonus is that there are very few codes (on my floor anyways) if that freaks you out. Good luck
  13. by   P_RN
    Ortho was "IT" for me. Get them after surgery already worked up, In and out in maybe 5 days max...and they hardly ever die. Your already tried neuro and didn't like it. If you don't like ortho go try something else. I stayed 22 years.
  14. by   nurselori001
    I've been an Ortho nurse for 5 years and love it. Yes, it is heavy work, yes, you do push a lot of pain meds and yes, ortho patients can be very demanding, but you get to see your pts WALK out of the hospital.
    We have a joint replacement program on our small floor and this is the majority of patients we see. Out of bed hours after surgery and discharged on the 4th day. We do not use CPM's anymore (problems with immobility and skin breakdown) foley's are d/c'ed post-op day #1 at 6am, as are PCA's and IVF's. and NO BED PANS! After that they must walk to the bathroom. We have no techs on our floor so the 2 RN's cover up to 6 patients each and give half the patients baths, bathed and clothed and OOB for b'fast. Seem Busy? How about very, very few codes, very little pts in distress (except pain), very few rapid response, very few calls to ortho docs in the middle of the night (there are standing orders for everything under the sun), time to actually talk to patients and get to know them and quite a few night that you can sit and read the news paper and do a crossword.
    You do get to keep your skills up in other areas because you do have patients with all kinds of medical hx, COPD, DM, CABG, etc. and we do have remote tele. And we get all different kinds of med/surg pts when census allows. Really check out with your hospital and see what type of Ortho floor you have. Other hospitals in my area have Ortho/Oncology, Ortho/Trauma, etc.
    Give it a try, you just might love it!

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