Surgical Nurses - Need your advice!

Hi!

I work on a surgical service line floor at my hospital and have been there about two years. I really enjoy how diverse the patients are and the multitude of issues they come in with.

Our specialities include major abdominal surgery, ENT surgeries, urology surgeries, mastectomies, and sometimes major wound debridements or amputations and occassionally gynecologic procedures. However, we also do receive many medical patients, and also persons with reports of abdominal pain, bowel obstructions, etc from the ED. We both receive patients from the recovery room after surgery, and often end up sending our patients to the OR.

There is a huge mix which makes every day interesting. It's also neat because each patient is different. I may have someone who has had an emergency open appendectomy who eventually gets a bowel obstruction and then is diagnosed with an abscess and so on and so forth, but then have someone else with an appendectomy who is well within a day or two to go home. We have an extremely high turn-over in that most of our patients only stay 1-3 days, and even have had people leave the same day as their surgery, but we've also had people come and have to stay for months. It's extremely busy, and when you come on the floor you might discharge six patients and then admit another six throughout the day. All people of all ages and backgrounds often have surgery, so you are faced with challenges regarding each age group.

It's neat because you get to basically do everything! Having good assessment skills is extremely important because each person's body reacts different to surgery. I've admitted a person directly from the recovery room sent with flying colors and basically stable, only to have them fade within an hour of being on the floor due to complications from the surgery or in regards to their medical history.

My typical day is receiving report in the morning @ 0645, usually ending around 0715 with a patient load from anywhere from four to six patients depending on staffing and assignments. From there, I often discharge anywhere from 1 to all of the patients throughout the day depending on how far along they are on their surgeries and so on and so forth. Sometimes discharges are extremely simple, and other times very involved depending on what all needs to occur at discharge and reaching all of the medical, GI, nephrology doctors etc involved in their care. It also may involve working with care management and social services if, for example, you have a homeless man with a brand new colostomy who will definitely need outside help or a 96 confused man being sent to a nursing home for the first time. Or it can include teaching the patient and family about how to empty the JP drain they are going home with or how to care for their foley catheter or wound at home. After discharges and rooms clear out I often have to get report from the recovery room on the patients I am receiving, whether they are a cataract surgery, exploratory lap, mastectomy, wound debridement, etc. Once the patient arrives to the floor I am responsible for admitting that patient into their room, do a primary assessment and work on comfort and pain control etc. I also often have to speak with the family and so on. Between these admissions and discharges is caring for my other patients, whether that includes their assessments, medication administration, documentation, sending them off to CT scans or other medical tests, working with respiratory or cardiology for pre-op clearances,administrating nutrition needs like TPN or PPN, etc etc. The day ends with giving report to the next shift.

I think that if you want experience that surgical nursing would be a great opportunity. However, what I just explained may be completely different than how your facility works, but I saw your post and wanted to try to give some info from what I've experienced. Let me know if you have any questions or anything I can help you with. Hopefully my post makes sense!

Take care, goodluck!

Hi!

I work on a surgical service line floor at my hospital and have been there about two years. I really enjoy how diverse the patients are and the multitude of issues they come in with.

Our specialities include major abdominal surgery, ENT surgeries, urology surgeries, mastectomies, and sometimes major wound debridements or amputations and occassionally gynecologic procedures. However, we also do receive many medical patients, and also persons with reports of abdominal pain, bowel obstructions, etc from the ED. We both receive patients from the recovery room after surgery, and often end up sending our patients to the OR.

There is a huge mix which makes every day interesting. It's also neat because each patient is different. I may have someone who has had an emergency open appendectomy who eventually gets a bowel obstruction and then is diagnosed with an abscess and so on and so forth, but then have someone else with an appendectomy who is well within a day or two to go home. We have an extremely high turn-over in that most of our patients only stay 1-3 days, and even have had people leave the same day as their surgery, but we've also had people come and have to stay for months. It's extremely busy, and when you come on the floor you might discharge six patients and then admit another six throughout the day. All people of all ages and backgrounds often have surgery, so you are faced with challenges regarding each age group.

It's neat because you get to basically do everything! Having good assessment skills is extremely important because each person's body reacts different to surgery. I've admitted a person directly from the recovery room sent with flying colors and basically stable, only to have them fade within an hour of being on the floor due to complications from the surgery or in regards to their medical history.

My typical day is receiving report in the morning @ 0645, usually ending around 0715 with a patient load from anywhere from four to six patients depending on staffing and assignments. From there, I often discharge anywhere from 1 to all of the patients throughout the day depending on how far along they are on their surgeries and so on and so forth. Sometimes discharges are extremely simple, and other times very involved depending on what all needs to occur at discharge and reaching all of the medical, GI, nephrology doctors etc involved in their care. It also may involve working with care management and social services if, for example, you have a homeless man with a brand new colostomy who will definitely need outside help or a 96 confused man being sent to a nursing home for the first time. Or it can include teaching the patient and family about how to empty the JP drain they are going home with or how to care for their foley catheter or wound at home. After discharges and rooms clear out I often have to get report from the recovery room on the patients I am receiving, whether they are a cataract surgery, exploratory lap, mastectomy, wound debridement, etc. Once the patient arrives to the floor I am responsible for admitting that patient into their room, do a primary assessment and work on comfort and pain control etc. I also often have to speak with the family and so on. Between these admissions and discharges is caring for my other patients, whether that includes their assessments, medication administration, documentation, sending them off to CT scans or other medical tests, working with respiratory or cardiology for pre-op clearances,administrating nutrition needs like TPN or PPN, etc etc. The day ends with giving report to the next shift.

I think that if you want experience that surgical nursing would be a great opportunity. However, what I just explained may be completely different than how your facility works, but I saw your post and wanted to try to give some info from what I've experienced. Let me know if you have any questions or anything I can help you with. Hopefully my post makes sense!

Take care, goodluck!

Your area sounds exactly like mine! When I first started, I was offered positions on my current floor, a renal/onc floor, and the cardiac floor. I am STILL so glad I chose this one! Many people say med/surg is a good "starting" point, if that's the case I'm still "starting" after over 7 years! I love the mix of patients I deal with. M/S is def a specialty all it's own!

Hi!

I work on a surgical service line floor at my hospital and have been there about two years. I really enjoy how diverse the patients are and the multitude of issues they come in with. .............

You sound like a really good nurse. Everything you described sounds HARD! All the admits and discharges alone sound like a ton and a half of work!! But I'm trusting that with some time, I will get the hang of it and it won't be so hard. Thank you for the excellent rundown of what you do!

Hi,

Will I learn the job with only 2 12-hour shifts per week? And if you don't mind, give me a rundown of your typical day (or night).

THANK YOU!

I think you can learn with 2-12 hour shifts per week.

Thanks - I think so too. It may not come as quickly as 3 12's but I do think I can still learn it.

Surgical floors are VERY fast-paced, in addition to the diverse patient mix you are dealing with a lot of different surgeons all of whom have a different way of doing the same things. I would be concerned about a new grad starting out there with the oportunity to work only 2.5 days a week. If your orientation could be full time before you go to part time, that would be more ideal.

Surgical floors are VERY fast-paced, in addition to the diverse patient mix you are dealing with a lot of different surgeons all of whom have a different way of doing the same things. I would be concerned about a new grad starting out there with the oportunity to work only 2.5 days a week. If your orientation could be full time before you go to part time, that would be more ideal.

I can see your point, too, actually...

I'm wondering if a "VERY fast-paced" floor is the right thing for me, also... I am 44 years old, not the younger, perkier type of new grad. It may not be ideal to start on a really frenetically-paced floor. I can see myself learning a ton, but also burning out really fast....