nurseniki511

#1- get a good preceptor!!!! they will be a good resource FOREVER i work nights so please know that this is for 7p-7a! i get to work 15-20 mins early to get in work mode and feel out the mood on the floor. i print out my papers that i need. i use physician progress notes that have a mar, vitals from 12 hours, diet, weight, blood sugars, labs, what radiology tests were run etc... search and see if you can get your hands on this! i write all meds to be passed in at least 4 hours and put in ziplocs for each patient i write if the need foleys in or out, blood sugars, cpms on or off, iv's on or off, etc... grab vital sign machine, meds (i passed 2100 meds around 1930 unless too close to last dose or something like vanco) another bag of fluids. for rounds, i would assess, do vitals and pass meds if possible. replace fluids while doing this, ask about surgery or phys therapy. listen to clues for possible problems (shortness of breath, chest pain- PE...dizziness when standing- low H&H...tight feeling and ^pain- compartment syndrome). ask if they want pain meds around the clock or only when asked for. don't ignore the family. these are the nurses when they go home!!! make them happy. explain as much as you can and they ask fewer questions. when done, explain that you are going to do the same thing to the other patients. this lets them know you arent just sitting around and about how long it will take you. assure them that you are a buzz away but it might take a second since you are at the beginning of shift and that it will calm down. offer juice, crackers. always tell them thank you when you do something. ortho patients love to be well taken care of. learn all you can...we teach every time we go into the room. know good body mechanics!!! ORLive, Inc.: Online Surgical and Healthcare Video and Webcasts had videos of all kinds of ortho surgeries. watching these puts a perspective on why things hurt and clue you in on how to move people. the work can get repetitive but be on your toes! things can go downhill quickly on a post-op patient. and people don't always tell you their full history. read the physician progress notes in the charts for a clue as to where treatment is headed. docs don't often spend time explaining things to you or patients. ASK QUESTIONS!!!! you are not a good nurse if you don't know anymore than the patient. we get paid to ask dumb questions :) have fun. we have the most fun patients that want to get better and do things for themselves again.

go for it!!!! ortho is the only floor specialty i will ever take! you will be so great at time management and have an unbelievable bedside manner. things can get hairy quick but after a couple near-codes, you can pick up and intervene quick! good luck

i would have done the same thing plus thrown on 2L of oxygen and a continuous pulse ox, left the door open and rounded often. knowing these types of patients, they can handle a lot of meds...

we don't usually give toradol on back patients due to the chance for vertebral hematomas. i usually ask for an alternative med if there is any chance of renal risk. families are not always great historians. however i seriously doubt one dose of only 15mg is gonna knock someone into ARF...