BookNerdRN

There is a group of us that keep in touch from our ADN program that graduated in December 2008. Some of us work together so it makes it easier. Also, the same group of us started a BSN completion program at a local university in Fall 2009, so now we see each other all day every Tuesday and we're stuck together for another two years.

I work on a surgical floor and typically most of the nurses come in about 20 minutes early to looks at their patient's charts/history etc. I've been an RN for about a year now and I like that. It gives me a more well-rounded view of the patient's overall health and history, not just the reason why they are on my floor. This time also gives me a chance to look up labs and treatments that need to be done on my shift, any funky orders or if they have chest tubes, NGs, drains, etc, and what meds I'll be passing. I think it's very helpful. Even our nurses who have been working for 20+ years come in early to do the same. I think the expectation is that we know our patient's background and the verbal report we get from offgoing nurses consists of the facts we need from the prior shift (IV credits, I and O, problems, etc.)

I'm a relatively new grad from an ADN program in December 2008. From what I've seen of my classmates so far, those of us who had previous healthcare experience have fared somewhat better than those who didn't. I myself did a year as a CNA while getting the first year of the program done and then my last year of the ADN program I worked as an LPN. That last year was priceless in my book. I worked at a nursing home and became proficient and comfortable with passing meds, giving insulin and other injections, respiratory treatments, doing wound care, caths, charting and time organization. You have to be when responsible for 30 residents on the floor! When I graduated and accepted a staff nurse position on a ortho/neuro/general surgery floor at one of the local hospitals, I wasn't completely terrified of the basic stuff because I'd been doing it for the last year. And after being a CNA as well, I didn't feel that I needed to go track down a patient care tech to take my patient to the bathroom or change the bed linens or give a bed bath. I'm not saying that I wasn't stressed after getting off orientation and being on my own, but my previous experience made it so much easier. I think there is a lot to be said for a new grad these days who was a CNA or PCT previously. Besides, what better way to assess an elderly person's butt for skin breakdown when you're wiping it for them!

I would have questioned the order with the MD personally, but that's just knowing my own ortho surgeon's typical preferences for staple removal. Usually on our ortho/neuro/general surgery floor, our total knees have a surgical dressing and ace wrap on until postop day #3 and then a Primipore dressing that is changed PRN until the surgeon takes the staples out during an office visit around 7 days after discharge. I suppose it depends on the surgeon though. We have 4 orthopods at my hospital and they all generally follow the same postop procedure. I would have questioned the order so at least I could understand the reasoning behind the order, if nothing else. :-)