Transition from fundamentals to med/surg clinicals: any advice, tips, or warnings?

Summer Days · May 19, 2015

There will be a lot of disease processes covered. You will find that keeping up with the reading schedule is a bit like a marathon. Thus, you will need to be a marathoner at some point. But if you employ time management skills, you will find it manageable. Study your meds along with the disease processes they apply to, I found it easier to retain info when I did it that way. Take chances at answering questions in class, you will come away with more than when you went in. In clinical, help your primary nurse with her other patients, too (you will likely be assigned to one pt only). This will expose you to the beginning stages of prioritization, which, by the way, will be tested all through the remainder of your schooling to NCLEX. All the best. Study smart, not hard!!

NurseGirl525, ASN, RN · May 19, 2015

The clinical is much more fast paced and you will be doing lots if med passes. All kinds of meds. You will need to organize your day. We were assigned one patient each week. We did everything for them. Med passes, vitals, assessments, general care. That was our patient. So I made a plan for that day as soon as I got report and got my info on my patient for the day. It's all about managing your time.

Iris_kt · May 19, 2015

As the other replies said- there are a lot of disease processes. It was a lot of work but honestly I liked the clinicals more in med surg than fundamentals. I feel like I learned a lot. It was like the first semester classes all came together for the big picture.

The class is a little intense so you have to be on top of the reading and your time management. We also had a separate med surg class (it was 8 weeks). If you have an NCLEX review book do the questions related to the disease processes in each unit. Review your anatomy/phys during your break before the class starts. Everyone is different but that helped me a lot.

You can do it- just take it one step/one week at a time if it gets overwhelming.

johsonmichelle · May 19, 2015

Hello everyone. I just finished up my first semester in an ADN program which was fundamentals. Our clinicals were at a nursing home and I found them to be fairly easy. We learned basic skills (foley caths, IM & SubQ injections, tube feedings, etc.) in the lab portion of our theory class but didn't apply them in clinical. Our focus was mainly building a solid head-to-toe assessment approach and building good care plans. I administered a heparin injection during a med pass one day, but that was about as in-depth as it got.
So, for next semester this fall, I will be on a busy med/surg floor at one of our local hospitals and am working myself up with anxiety about it. The third and fourth semester students all say that second semester is the 'hell' semester and is like first semester on steroids. Of course I expect the content to get more challenging and in-depth; I'm trying not to feed into the gossip that surrounds each upcoming course. I heard awful things about first semester too but I passed the class with a good grade and didn't find any of the content or tests unreasonably difficult. But what can I expect with med/surg clinicals? I feel like the transition from nursing home to hospital will be huge. The instructors have told us to really focus on knowing our meds like the back of our hands next semester, but other than that I don't know what to focus on to get prepared.
Any advice, stories to share, etc. from your med/surg time in school?
Is there anything you wish you'd known then now that you look back?
Oh, and just to clarify, there is no OB, peds, ortho, anything like that in this clinical. I know some programs do a half OB, half med/surg or something to that extent for a semester, but we have OB/peds and psych in third and fourth semesters.
Thank you to anyone who has anything to share! :)

Is med surgical nursing class the only class your taking for the whole semester? If the answer is yes, then you have it a little easier because your concentration would just be on the one class. I finished the class in march and it was not really that bad, mine was fast pace though. We only had 8 weeks to pass the class and move onto OB. My advice would be continue to study hard and stay on top of things. I like med surg much better than the fundamentals.

Iris_kt · May 19, 2015

Another thing I did was write down everything that was due on a calendar (and keep it somewhere you can see easily). Cross off days as you go or keep a countdown until the end of the class. Sometimes it helps to see your progress if you get overwhelmed or frustrated like halfway through.

Med surg wasn't that bad just really busy and it did go by fast. Be prepared and all but try not to get too stressed out yet because it might be easier for you than what you're hearing.:)

PaulBaxter · May 19, 2015

I would imagine the folks who already took the same class at your school would probably be more helpful than I could possibly be. I just finished my second semester of my ADN program. Our clinical group happened to land at the same ortho floor I was on during my first semester, which made my clinicals much less stressful. We had the added stress, though, of having to take pharmacology at the same time. Ugh.

Anyhow, just from the sounds of your post, I think you are probably about as prepared as you can be for this. A LOT will depend on the expectations and requirements of your clinical instructor. You first job will be to fund that out. You'll probably be expected to do a lot more with meds, so be prepared to write up medication note cards. You'll gradually get familiar with the sorts of meds that are most common in the hospital: sliding scale insulin, pain meds, anti-nausea meds, BP meds, etc. Just focus on what your instructor wants from you. If they want a super tidy care plan, make that a priority. If they want medication cars, jump on that as soon as you see your patient's chart, etc. Be prepared for your instructor to ask you what condition each medication is for.

One of the things I liked last semester was that we had fairly limited patient responsibilities, so I was able to use our med-surg book to look up my patient's disease.

Use common sense. Ask your nurse what you can do to help. Don't get in the way of nurses who seem frazzled or super busy. Absorb the atmosphere. Learn right away where the supplies are kept, since that will be a good thing for you to help out with. Learn how to silence bed and IV alarms. Do your best to make everyone involved glad that you were there that day. Keep practicing your assessment skills. Make mistakes, admit to them, and learn from them. Learn from your classmates in post-conference.

Good luck!