overwhelmed med/surg nurse

sbostonRN · Nov 24, 2013

I think they wanted to get me up and running before the holiday next week. There are some days that are really great - I finish my work, give great patient care, take an actual break and leave on time. I feel like rockstar nurse those days. But yesterday my preceptor and I were each running in different directions trying to get it all done and I felt so scatterbrained. There's just so much that is different than LTAC. I was told "if you can work LTAC you can work anywhere" so I was expecting the transition to be easy but the learning curve is still there. Even on evenings, patients are always going down for testing or to the OR, tons of admissions and discharges. And the nurses have so much autonomy! Which is nice, but it means that I'm expected to have that judgement.

dadweeb · Oct 29, 2015

I know this is an old post, but this is exactly why I go allnurses.com; the emotional support. I am in the exact same situation at this time. I have been in an LTACH for 3 years and was told "if you can do this you can do anything". Yeah, not so much. I have been orienting for 6 weeks now (three 12 hour shifts per week), and most days I feel like a complete idiot. I am constantly overwhelmed with the expectations. The ratio is 1:6 with constant discharges and admits. One PCA for every 12 patients, if we are lucky. Most days its one PCA for 12 patients and if there are 20 on the floor the nurses are responsible for their care. You all know the drill. Fall risks, up to bathroom, incontinent patients, isolation patients, orders to check every 15 minutes. AND the docs expect you to read every note they write. The portable phone never stops ringing, whether it is a patient asking for water or telemetry tech telling you the leads are off again (for the 12th time!). Administration expects you to chart in real time, how can you do that?! and not stay after your shift ends. UGH! I know it takes time to adjust, but I feel like crying at the end of every shift. My preceptor is an excellent nurse, but she expects everything done the way she does it and feels every other method is wrong. I need someone to tell me that this will get better.

PurposebyDesign · Nov 30, 2015

How is it going ? I'm in the same boat. I came from a Rehab at a SNF.

Rissaroo713 · Dec 21, 2015

I graduated last Dec, and started on a MS floor in March. I'm still working on getting it together, but having certain goals for each day makes things easier. On my floor, we have 5-6 post surgical patients, 1-2 discharges, and 1-2 admits each day. Yay, high turnover! Here are some of the goals I have for each day:

- When I get bedside report, I look at the IV pump and note what time the IVF is gonna run out. I write this on my brain sheet so I am not in the middle of doing a dressing change and getting calls about beeping IV pumps. If my pt has TF going, I do the same.

- Assessments charted by 1000

- Flow sheets (individual mini assessments on things like lines/tubes/drains that are required for each patient) charted by the time techs start doing evening DFS

- Chart as close to real time as possible

- When I do my q2h roundings, I also update the I&O chart

- When I give sedating meds, I have to chart the pt's POSS score then and later (30min for IV, 60 for PO). I make a note on my brain sheet of when I need to go back and try to time one of those things near a q2 rounding.

Keep your chin up. Med Surg is freaking hard. When I graduated I told myself that it would be hell for 2 years. It's getting better sooner than that :)

blackribbon · Dec 25, 2015

How on earth do you pass all your meds and assess 6 patients and still have the assessments charted by 10? I am happy if I finish assessing and passing meds by 11pm...sometimes I can chart as I go but too often the patient is asking questions which means I have to go in and out of that screen and it looks like I changed my data if I jump off the assessment chart before I complete it so I prefer to do it outside the room when I have time to do it from top to bottom.