tlh65

I work Med/Surg - no specialty unit. We get EVERYTHING AND ANYTHING! It is a very fast-paced environment. With adequate orientation, you should be fine. Hang in there. There will be times you will get discouraged (because you are new and you have lots to learn). You will gain a huge amount of experience and knowledge starting out on a Med/Surg unit. Renal is a good place to start as you will have patients with many common preexisting problems, such as diabetes, hypertension, heart disease -- the list goes on and on. Go in with a positive attitude...watch your preceptor....ASK, ASK, ASK questions!! GOOD LUCK!

Before my brother was listed for transplant, the committee met frequently to discuss his case. They felt he was a good candidate - and they were right. He got his life back, has a great family with children, does not drink, stays busy. He's a different person and he is so thankful he got a second chance. I wonder if some of you would think differently if this hit you on a personal level? When I am working, I ALWAYS try to empathize and put myself in the patient and/or family position. I try very hard not to be judgmental.

My brother had alcoholic cirrhosis. He met all the requirements for transplant, was in an ICU bed for 2 months before a liver was found for him. He had a successful transplant (liver) almost 5 years ago. He has not had a single drop of alcohol since then and is doing wonderfully. I thank God everyday that he wasn't denied because he had had an alcoholic history only 6 months before that.

My father-in-law is on Coumadin. My in-laws constantly call it Couma-dent....Coumadent. Annoys the heck out of me!!

Neither do I. I do it the same way as above. One patient at a time. My meds stay in my med cart locked up during administration.

We have a Pyxis machine. I pull meds for all my patients at once. We have ziplock bags. I pull meds for one patient, put them in the bag and label the bag. I then go to patient #2, do the same. We have MAC carts (Medication Administration) for computerized and scanning of the meds via a bar code. We scan the patients meds and there ID bracelet and the computer will tell us if there is a discrepancy. I ALWAYS follow the 5 rights while giving meds as computers tend to have errors - BUT YES, i pull my patient meds all at once within 30 minutes before. I do not pull narcotics at this time. I pull those separately.

I transferred within the system from one hospital to another and it is night and day! My new hospital has all private rooms each with daybeds for family, flat screen TV's with DVD/VCRs, private baths that have auto lights that turn on when you walk into the bathroom and turn off when you walk out. Room service - each room has a menu that the patient calls and orders their meals. We have service where dietary calls the patient or we call for meals for patients who cannot do it for themselves. This is called Dining On Call. There is wireless internet service in each room. All rooms are on one side of the hallways, no rooms across from each other. Cubbies with desks on each hallway so we can sit and do our charting and each cubby has a tele monitor so we can see what is going on with our patients and not have to run to the nurses' station to see. We have laptops on carts that we can wheel to patients rooms - computerized charting, and medications, scanner, etc. Pyxis machines and med rooms with easy access to patient rooms. 5:1 ratio for nurses, 2 secretaries, charge nurse with no assignment. We also usually have a "float" person that helps us out through the shift. Hmm, can't think of what else but it is a world of difference from where I was.

>>>1) What methods do you find helpful in organizing your time? (tips and tricks) 2) How is nights different from days? 3) What are the most important things to remember as far as prioritizing? (Ex: meds 1st etc) 4) What kind of pt's and skills do you see and do MOST in med-surg (so I can re-familiarize myself) 5) What is your advice for me to best prepare myself? Congratulations on your new job. I think Med-Surg is a great place to start and it sounds like you are ready! In answer to your questions, 1) It is really hard to answer the organization question because I have to say organization is something you will master more and more with practice. While you are on orientation, watch your preceptor, get tips and hints from them and see each nurses different styles or forms of organization. You can take bits and pieces from each one. I would have to say that is the best way to find your own way to organize. Time management is very important but it also takes practice. 2) I don't work nights so I will pass on that - day shift is probably busier in the sense that there are more "people" around, i.e. - administration, docs, social workers, PT, OT, etc. When I say busier, I mean more distractions - also most of the patients are awake on day shift. 3) Prioritizing - again - it is individual. I usually come on and get report, look over my orders, labs (results), VS, and then what meds I am to give. I then will do all my assessments. Sometimes I will save my harder patients for last so I can have more time. Walkie-talkies are the easier ones if they do not have any specific needs at the time of my assessments. Again, it all depends on the type of patients, etc. 4) You will see ALL kinds of patients/skills on a Med-Surg unit. I see everything and all age groups (including Peds). Ortho, any respiratory problem, heart problems, diabetes, GI probs, surgeries, -- etc... 5) Take it slow - watch and learn from your preceptors. Ask for help when you need it - don't try to do everything yourself if you are unable - and ask questions anytime you are unsure of anything. Don't guess. YOU WILL BE FINE - GOOD LUCK TO YOU!

Wash hands, glove, remove dressing (if there is one), make sure the hemovac or JP is sutured/not sutured. If sutured in, you will need a suture removal kit and cut away the sutures. Once this is done, take a 4x4 up against the drain site and pull the drain in one slow steady motion until it is removed. Hold 4x4 on site, make sure the tip is intact. Redress site. DOCUMENT.

At our hospital, nurses wear either all white or white and navy (not all navy). The CNAs wear teal green, secretaries wear burgundy, respiratory royal blue....I like it better this way and the patient's know who's who.

Hi Rachel - I was pregnant while in nursing school, graduated and took my nursing boards at about 35 weeks pregnant. It all worked out fine. Good luck to you.