Post-op surgical med surg/tele new grad? What to expect?

[bluewhale3]

Gonna be a little bit long so please bear with me!

Hi all I am a new grad to a post op med surg floor. I've only been only been on the floor for 4 days but feeling overwhelmed. So far I've been taking 2 out of the 4 patients and I am struggling with time management and charting, understanding what to expect, to the point where my preceptor does a lot for my two patients. I have several questions so please answer whichever ones you can. A few things I've noticed:

-I don't think we work with post op orthopedic surgeries because the hospital has an ortho floor.

-So far it appears the pt ratio is 4:1, but I will be working night shifts after I'm off orientation so I'm expecting that to change

-We do get post op transplant and bariatric patients. So far I've seen post op lung lobectomies for cancer, Wipples, grastrectomy. We also get post op tele patients. I heard they do blood transfusions often.

-Drains that I've seen are chestubes, bili and JP drains, NG tubes, foleys. PCA pumps, Epidural PCAs

My questions are:

1.) Complications, what to expect, meds , tips, tricks, or anything that you can offer me about those mentioned above would be much appreciated! I've never worked with this patient population before so I don't know what to expect.

2.) Those who have worked on a similar unit, what other surgeries should I learn about? I want to study as much as I can about this so that I don't have to waste time looking them up during work becuase my time management already sucks and I always feel behind.

3.) Some meds that I should be aware of? pain meds, treatment meds, etc.

4.) Labs? What are some big lab values that I should monitor for? Right now I'm trying to focus on sepsis but what other complications and lab values/components are there that would raise red flags.

5.) I know early ambulation is important and we follow the ERAS protocol (Enhansed recovery after surgery), but the patient is in SO MUCH PAIN, how do I know when it's not appropriate to push/encourage them? I hesitate with pushing them too much

Basically just anything and everything that you can throw at me, I would really appreciate. Just being a nurse in general. I still feel like a nursing student with my preceptor monitoring my every move becuase I am still making mistakes and I really appreciate them for that. Thank you so much allnurses community!!!

[Been there,done that, ASN, RN]

"I still feel like a nursing student". That's because you are. The only difference is ,you took a test, and had 4 days of training. You can only take in so much at a time. Try writing down your main questions every night, do a little research and discuss with your preceptor the next day.

You really don't need a gazillion responses to all your questions.. it will hurt your already overloaded brain. I will tell you that ambulation is priority and the key is to medicate for pain an hour before.

Good luck.... it will happen.

[bluewhale3]

27 minutes ago, Been there,done that said:

"I still feel like a nursing student". That's because you are. The only difference is ,you took a test, and had 4 days of training. You can only take in so much at a time. Try writing down your main questions every night, do a little research and discuss with your preceptor the next day.

You really don't need a gazillion responses to all your questions.. it will hurt your already overloaded brain. I will tell you that ambulation is priority and the key is to medicate for pain an hour before.

Good luck.... it will happen.

TY! for the suggestion! I haven't been writing down my questions because and I really have been forgetting so I'll start doing that.

As for the nursing student part, you're right in the sense that I don't have any experience. But I do feel like since I'm now in the role of an RN, I have all the responsibilities and consequences that come with being an RN, regardless of my of my lack of exierience. My license is on the line so I HAVE to know more, even if it'll overload my brain. I feel like I can't think and behave like a student anymore

Like you said it will happen and it will come with time, but I want to be as knowledgeable as I can so I'm hoping ill get more tips. trying to be proactive here LOL