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

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by bluewhale3 bluewhale3 (New) New

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

Has 33 years experience.

"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.

Edited by Been there,done that

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