Post Surgical Unit

[alwaystheoptimist]

I'm just looking for some input from more experienced nurses. I am a new grad, just licensed (yay!) and will be starting out on a post surgical unit. It is a part of an acute care residency program and when I was offered the position I was told that it was a step down unit, then upon further researching I saw that it is post surgical.

My question is this: if it's not PACU, not SICU, what types of things might I see? I want to prepare myself beforehand and I'm also wondering if there are specific things I should brush up on?

Any advice is appreciated!

[Lev, MSN, RN, NP]

It sounds like an inpatient surgical floor. Drains, blood transfusions, ambulation , education, and IV pain medication galore! Great place to learn! You will come out of that unit a strong nurse with great time management skills.

[Concerto_in_C, BSN, RN]

There will be lots of cases like appendectomies, bowel obstructions, and cholectomies. I'd say those are probably the most common surgical cases in a typical post-surgical unit. We are very much a "stomach nation" with lots of intestinal and gallbladder ailments, likely due to our unhealthy lifestyle.

I love medical-surgical patients because most of the time you get fairly young ones who are mostly independent and resolute. They may have a tummy incision, but otherwise they are independent and their expectations are reasonable.

The patient-controlled analgesia pump will be your best friend there because many patients will be self-administering Dilaudid/Morphine by clicking a button, which makes your life easier. Thank god for those pumps.

By the time the patients get to you they are mostly recovered from anesthesia (PACU takes care of that) and they have good vitals, but you have to watch them carefully because now and then they have complications. You can get somebody who is unable to void (very common after surgery) and you have to call the surgeon to report no urine output.

Or you can get somebody who looks fine for the first 2 days but then develops an abscess behind the incision. All kind of things happen.

Good choice of a unit, for a new grad med-surg is optimal. Do it for a couple years and you will be a superior nurse, able to function just about anywhere.

[alwaystheoptimist]

Thank you both so much! My mom is a nurse as well and she agreed with the both of you; she said that I will be able to really refine my nursing skills and become confident with my time management and priorities. I think I was mostly thrown off because I was told, "step down" but like I said, found job postings and such which read, "post surgical". I wasn't sure if there was a step down post-surgical unit! Haha! Thanks again, it's appreciated!

[Lev, MSN, RN, NP]

Thank you both so much! My mom is a nurse as well and she agreed with the both of you; she said that I will be able to really refine my nursing skills and become confident with my time management and priorities. I think I was mostly thrown off because I was told, "step down" but like I said, found job postings and such which read, "post surgical". I wasn't sure if there was a step down post-surgical unit! Haha! Thanks again, it's appreciated!

It could very well be a step-down surgical unit. Sometimes patients who have trouble recovering from anesthesia (breathing difficulties) or had bad vitals or heart rhythms during surgery or after or lost a lot of blood and needed massive transfusion will go to the step down unit or ICU after surgery instead of coming back to us. "Step-down" is a step up from your typical inpatient surgical unit, but a "step-down" from ICU. What is the nurse to patient ratio? That can give you an idea of the level of acuity.

[alwaystheoptimist]

Okay, awesome. Thanks. I'm not sure what the ratio is yet. I have to meet with HR in about 2 weeks, and I planned on asking all of those questions then. I should have asked when I received the offer, but I was too shell-shocked to think straight!