Subacute Rehab to Med Surg

[Googlenurse, ASN, BSN, RN]

What are some skills I need to touch up on?

My subacute unit had 10 patients and one CNA. I worked nights. We really didn’t have too many IV, never started one even if they did, and occasionally  worked with PICCS. I am proficient with pico wound vacs, all feeding tubes, foleys,  cardionet, all respiratory equipment except ecmo (I have 20 years experience working with ventilators, trachs, Cpap and bipaps, pulse oximetry, Cpt vest, cough assist, trach collars, suctioning, IPV during my Pdn stints)  

I am nervous about going into acute care after working non acute care for so long. I feel like a new grad. The hospital is willing to give me 7 weeks orientation, which I feel isn’t enough. 

I am really worried about drips and titration. Never did that in my nursing life ever.  Surprisingly, I’m not afraid of the electronic paperwork. I guess if you can work with OASIS, nothing else scares you anymore.

ETA: I really can’t stand working with the old fashion wound vacs where you have to cut out the foam, but I don’t see those in subacute rehab and doing skilled visits. I see Pico wound vacs and I can’t remember what it’s called but the ones where when the canister gets full you have to change it.)

[mmc51264, BSN, MSN, RN]

I went from ortho rehab to inpatient rehab. Depending on facility, I don't draw labs or place IVs. We have dedicated teams for that. We don't change the WVs either. 

I found going from rehab to the hospital easy! I had great time management skills having 15+ pts and having to write charting. 

7 weeks should be plenty of time. That's what our new grads get (7-10). As far as gtts and things, you aren't going to be expected to be able to do all of that right away. The only gtt I see regularly is insulin and heparin. Cardiac gtts are on the cardiac floors. 

You can do this!!

[amoLucia]

mmc5 - great positive support for OP. Have to ask what is WV? Wound vac?

[Googlenurse, ASN, BSN, RN]

You don’t change wound vacs?
You don’t start IV?

You don’t draw blood? 

Sign me up at that hospital! 

Do you have telemetry monitors at your hospital? Do you have to monitor them?

[mmc51264, BSN, MSN, RN]

Yes we have tele monitors that we monitor. Used to have central tele, but changed to monitors in the room and portable monitors. 

It's a large hospital and we have IV team, phlebotomy, transport. We can do the lab draws and IVs if we want/need, but it is not a skill we use every day. At least on my unit (step down unit, not ICU)